First, some background...
My last pregnancy was a twin pregnancy. While I was delighted to be pregnant and both surprised and excited by the concept of twins (fraternal b/g twins, conceived naturally), my pregnancy was "high risk" and monitored to death. I had a regular OB and a perinatologist (a high risk OB). I had sonogram after sonogram. I had so many internals I can't count. At just 27 weeks I went into preterm labor and landed on full bedrest with a terbutaline infusion pump, home monitoring, the whole 9 yards. I bounced in and out of the hospital several times thinking I was about to deliver 28 weekers... 29 weekers... 29.5 weekers. It was a nightmare. Finally at 31 weeks, I was contracting way over my threshold, and was admitted to the hospital where I was put on magnesium sulfate and given steroids to speed the twins' lung development. I gave birth 2 days later... exactly 2 months before my due date. Dd was born naturally - no drugs or interventions - but ds turned transverse and was threatening to become a footling breech, so he came out via cesarean section. Yes, I had both a vaginal and a c-sec delivery on the same day. Well during that c-section, there were major complications. It lasted 3 hours and involved the continuous support of a General Surgeon, because I had severe adhesions from a prior abdominal surgery. My OB knicked my lower intestine upon entering, and said he was within a hair of transecting it completely, because it had adhered to the old incision (also a bikini incision). My twins were in the NICU a month. It was a nightmare as anyone can imagine. But they were healthy and breathed on their own, and basically just needed to get big enough and able to hold their temperatures to come home. They came home from the hospital equivalent to 35 weeks gestation. Breastfeeding was impossible at first - I worked daily with an LC who specialized with preemies, but even then I had to feed them EBM bottles until they were around 3 months old. We never got to cosleep because they had apnea and bradycardia from severe reflux, and were discharged on apnea monitors. Dh and I would roll over onto the leads and the things would scream and scare all four of us awake (and probably our neighbors too). So they slept like llittle papooses next to each other in a crib right across the hall. We never did CIO but we didn't get to cosleep either.
Fast forward to this pregnancy...
When I first found out I was pregnant I was ecstatic. It was a bit of a surprise to be honest - we had planned to start trying mid/late-summer but May '04 was destined to be the month I guess, so we quickly adjusted to the news and were so excited we forgot we hadn't actually intended to conceive until a couple of months later. I held my breath during a quickie 7-week sono to rule-out twins, since the chance of conceiving twins again was high. Dh and I both breathed a huge sigh of relief when it was "just one". By detailed charting, I knew the due date was Valentine's Day 2005.
This pregnancy was a dream, especially compared to my last experience, and so very healing. Just a normal, healthy pregnancy. I felt great and had no problems at all.
At first, I continued at my OB's office. But I started doing a lot of research, and decided I wanted a VBAC. When I started to get serious about questioning my OB and others in that practice about their c-sec/VBAC rates and their "policies", it seemed their practice was not very supportive of VBAC after all.
So let's see... I joined my local chapter of ICAN (cesarean awareness network), fired my OB, switched to the Maternity Center midwives, and hired a labor doula who had VBAC'd herself and was the president of the ICAN group. I pretty much spent every evening Googling and especially doing PubMed searches and knew a heck of a lot more about the risks and benefits of VBAC vs. repeat elective cesarean than most OBs do, honestly.
Everything was going swimmingly until around 30 weeks. I had started measuring "ahead" by around 26ish weeks. No biggie, it was within range. But at 30 weeks, I had a sono to check my cervix (due to preterm delivery last pg) and they checked my amniotic fluid. It was on the high side. That was the first indication the baby might be bigger than just "a little big". By 33 weeks, I was measuring 2-3cm ahead. I was told to do another 1-hr GTT to test for GD. I passed with flying colors. Then at 36.5 weeks I had a sono to check for growth. They estimated between 8.5 and 9 pounds. I went home and quickly became an expert in macrosomia, amniotic fluid indices, shoulder dystocia, you name it. I read every article I could get my hands on. At my next midwife appt. I was armed and dangerous LOL. I knew VBAC wasn't contraindicated by a large baby. I knew there were ways to labor and deliver to prevent shoulder dystocia. My midwife was still concerned. See, the problem in my case is that I had so many problems in my past c-sec. So an unplanned c-sec for me could have been disastrous for my health, risking ruptured bladder, bowel, spleen, etc. So anything that made it seem this wouldn't be a classic, straightforward vaginal birth (lol) and everyone was freaking out on me. I went back to get another growth check "just in case" at 37.5 weeks. 9.4 lbs. Head measured 41 weeks! And worst of all, the baby was malpositioned. In spite of religiously following OFP rules from about 30 weeks on, going to a chiro, getting a birth ball, lying upside down on an ironing board, you name it, the baby was malpositioned (diagonal/transverse). They did a fasting glucose and 2 hour post-prandial test to AGAIN rule out GD. Again, I passed... definitely no GD. So, at 38 weeks, measuring 42 weeks now (4 cm ahead) without a head to be found and so much amniotic fluid no one could tell me for sure what position the baby was in (ETA - w/o a sono) (AFI was 20ish still at 38 weeks - high normal), I went back to my OB to discuss the possibility of scheduling a c-sec.
Then at 38.5 weeks, I just started having this feeling that something was not right. I thought I had felt the baby move a lot the night before, but the kick patterns were scary... I thought the baby was going to rupture my membranes... hardly the soft "flutters" of hands. No, to me, they felt more like feet. BIG feet! I also began having nightmares about cord prolapse. Lots of amniotic fluid and a floating baby are not a good mix.
So after months of preparing to have a VBAC, I made the decision to schedule the c-section after all - I had a limited choice for days because they needed to schedule it with my OB and the General Surgeon they wanted, and set it for Feb 9th (39.5 weeks). For the first time in weeks, I slept that night.
I lost my plug the day before the surgey. On the day of the surgery, they were doing the 20 minute strip and I was conracting every 3 minutes. I considered calling my OB and saying, let's have this baby here and now, but really felt scheduled c-sec was the way to go given the risks of a failed trial of labor to me and just my sense that it was the right choice.
At 2:46pm, he was born. 10 pounds 9 ounces, 22 1/4", 15 5/8" head. DOUBLE FOOTLING BREECH.
When I heard that, I felt all was right in the world. Suddenly the gnawing feeling of doom I'd been experiencing for the past few weeks was lifted. Dh and I rejoiced in the choice I made. I realized that the best outcome is not always the natural perfect delivery, but the one where the woman makes a completely informed choice and both mama and baby are healthiest in the end. I owned this birth more than my natural delivery of dd. This was my birth, my way.
He was healthy as can be... Apgars of 9/10. They pricked him to get blood sugar (due to his size) and his sugars were beautiful. He nursed in the recovery room for almost an hour and was allowed to room in with me the whole time!! We came home less than 2 days after he was born - a very early discharge for a c-sec. My milk came in and he nursed great. We are cosleeping, which is more wonderful than I could have imagined.
He regained his birthweight (plus 4 oz.!) by 2 weeks, and now weighs 12 1/2 pounds at 4 weeks. He is exclusively breastfed and we are both doing so well. He is the sweetest little bundle you ever did see.
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When you said the Maternity Center- was that the one in Bethesda? I had my last there.
But I have to say that just for the benefit of anyone reading this thread, it's good to be reminded of two things:
1) Babies turn, IN LABOUR, all the time. So footling breech at X days gestation does NOT by any means mean that baby would have come out footling breech, or would have been when labour started naturally.
2) Women have and do choose to birth their footling breech babies. I have several friends who have safely birthed footling breeches, some unassisted. A footling breech baby is not an automatic reason for a c-section if you have a skilled provider with breech experience. (Which I would guess does not apply in this case, since hospital staff rarely get experience delivering breech anymore -- if my only option was birthing in a hospital I might rethink a breech birth as well, truly) That may not have been the best choice for YOU, but it might be for someone else.
I just would hate for people to be reading this thread and thinking "OMG footling breech is sooooo scary and dangerous" because it doesn't have to be. I would hate for another woman to schedule a cesarean just based on reading this thread, instead of perhaps consider other options as well, kwim?
Again, I fully support you Periwinkle in your difficult decision. But I do want to remind anyone reading that footling breech is not always an automatic reason for a cesarean.
Hoping not to offend,
Originally Posted by Periwinkle
I realized that the best outcome is not always the natural perfect delivery, but the one where the woman makes a completely informed choice and both mama and baby are healthiest in the end. I owned this birth more than my natural delivery of dd. This was my birth, my way.
However, a DOUBLE footling breech, 10 lb. 9 oz. baby, 15 5/8" head, a previous c-section, high amniotic fluid, AND nasty adhesions requiring attendance of a general surgeon (i.e., a failed trial of labor or emergency c-sec for me was NOT an option)... and yeah... it's pretty much thank GOD there are c-sec available to women like me!
Anyone reading this and taking any part of it to relate to their experience is doing themselves a disservice, whether they would repeat what I did or not. The triumph of this event for me, was that it was -- hand's down -- the best decision for ME, and an incredibly well-informed one at that.
My baby was footling breech untill about 33-34 weeks. At a 32 week u/s the dr said if he didn't turn by 37 weeks we'd have to talk about c section. That made me do my research- because I KNEW there were ways to try to turn the baby, and like someone mentioned- babies can turn during delivery...I know for you it could have been more risky...and I enjoyed reading your story, because you made the best choice, based on not only your research but your Mama's intution
By the way I am seeing midwives but the Dr does u/s- it made me angry that he automatically talked about c sections because for some people- they might automatically assume they have no other choice!
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