High risk pregnancy .... - Mothering Forums
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#1 of 13 Old 06-24-2014, 08:58 PM - Thread Starter
 
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High risk pregnancy ....

Hi everyone. So, I'm looking for support I guess. I planned an unassisted birth for the first 25 weeks of my pregnancy, and then my hopes became shattered when I found out that I have a placental abruption at 25 weeks, after an episode of heavy bleeding that lasted about 3 hours. My placenta is not fully attached to the uterine wall anymore, and even though it's healed and remains stable, the risk of hemorrhage, internal bleeding, and even the death of my son due to lack of oxygen in labour are now very real threats. My pregnancy is now considered high risk, and I am on bed rest during the times when I'm not at work. I tried to get a midwife last minute but none are available in my town (since their services are now covered by the government). This is very heartbreaking for me. I fear the hospital birth for so many reasons. I fear having a forced c section, I fear my son being snatched away from me and given a pacifier... The list could go on. I already know he will have trouble latching on because of my inverted nipples and now I face the threat of improper bonding, and multiple interferences during what was supposed to be our sacred journey. Sigh. I don't know what to do. I've considered trying to stay at home until the very last possible moment. Does anyone here have a similar experience to share?
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#2 of 13 Old 06-25-2014, 11:23 AM
 
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My first UC was for this reason. I had a placental abrupt ion that caused very heavy bleeding that last for ten weeks midway through my pregnancy. I was hospitalized at one point for dehydration due to excessive bleeding. I was put on bed rest except to use the bathroom. No midwife or home birth dr would see me as I was high risk. By the time I reached my third trimester the bleeding had stopped and I felt confident that I had healed. Perhaps I was merely naive. I went on to have my first UC.
So it can still happen, but there are risks for sure. Perhaps I was just lucky.

I am dealing with a similar situation as you currently. I am 33 weeks along and have been planning a UC since I got pregnant. I have five children already, the last four were UC, so UC is the norm for me. I can not imagine a hospital birth. However, I am currently facing some obstacles which are really making me question my decision this time. I am now almost 43, I am anemic (first time), my baby is malpositioned (currently transverse or possibly breech), I suddenly think there is a strong possibility I have a DVT in my right leg (blood clot) and well, yeah, that's a lot. I am so stressed out over what I should do. I saw an OB at the beginning of my pregnancy because this pregnancy followed three back to back losses and I was paranoid and terrified of losing another. Long story short she has now decided to terminate our relationship and sent a certified letter stating she will no longer see me. There goes my back up plan. She did not say why, nor give warning, although I suspect it is due to having not scheduled an appointment last month. (She cancelled last minute the prior month).

Sorry if I wasn't much help. I hope you are able to search in your heart and find the answer you need. I think my decision, based on what you've said, would depend on the size of the SCH, and when the bleeding stops, in addition to any other risk factors you may have independently of the abruption.

him-- ds 3/91, me -- ds 5/93
us - dd 2/00, ds 8/02, ds 5/07, dd 2/11 & cautiously expecting baby girl 8/14
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#3 of 13 Old 06-25-2014, 02:04 PM
 
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I have not been in this situation. But I did want to just say ...not that I am FOR hospital birth...but my first was hospital birth and even though I hated most of the experience. I will say that you can lay some ground rules.....such as no paci, and that the baby is to be with you at all times unless medically needed otherwise. I didn't know all of this when I had my oldest (hospital birth), so they took her away to clean her up relatively shortly after birth. It seemed like FOREVER before they returned her. I kept pacing the halls and checking in at the nurses station. Finally, I got her back and she never left my side after that. Had I know that I could have said that I wanted to be present for the things like bath and the testing, then I would have said that...but I didn't (and I am sure it depends on hospital policy). But I say all of that to say that even though she was away from me for about two hours after birth, we still had a super great bond. So don't be concerned about not bonding, trust me, you will bond! I don't see any difference in the bonding between her and my other births that I was never away from my child.

I don't know much about the complication, but I do know that I personally would be less likely to uc if I knew I had complications.....but I also know that the medical field has a HUGE tendency to blow things out of proportion. Obliviously the above poster was in the same situation and it turned out fine. If I was you, I would do as much research on the subject as possible .....including statistics.

Hope it all turns out good!
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#4 of 13 Old 06-26-2014, 04:24 PM
 
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By the time I reached my third trimester the bleeding had stopped and I felt confident that I had healed. Perhaps I was merely naive. I went on to have my first UC.
So it can still happen, but there are risks for sure. Perhaps I was just lucky.
Wow...I don't want to judge, but I have to say that the idea of going through with a UC with a placental abruption scares the bejeesus out of me.

Everything I've read about placental abruption suggests that it's a very, very serious complication that poses a lot of risk for a number of problems. From what the OP said, it looks like hers is thankfully not in the most severe category, but her pregnancy is definitely still high risk.

OP: It sounds to me like you already realize that this is one of those situations where you're going to have to go to the hospital. That can't be an easy decision to make, and I understand how upset you must be. I think that one thing you should try your best to come to terms with is that there is a real possibility (though certainly not an inevitability) that you will need a C-section and that your baby will require some interventions when it's born.

That means that there's a chance that you won't get to bond with your baby right away. We all know that this is not an ideal situation, but I think it's important to remember that a period of separation doesn't mean that you'll never bond with your baby. Thinking that a separation will ruin your possibility to bond is probably much more likely to cause problems than the separation itself.

Good luck! Please keep us updated.
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#5 of 13 Old 06-26-2014, 07:16 PM
 
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I want to offer you some encouragement and support. I agree with everything that nedurak says.

As a teacher and a parent, one thing I often say to my kids and students when they're upset and looking at all the possible outcomes is, ask yourself, what is the worst thing that can happen, and what can you do to avoid that? Having a c-section, while obviously not as natural as an uncomplicated vaginal delivery, is NOT the worst thing that can happen, and you are NOT a failure if you need one. A placental abruption is a pretty ironclad reason for needing one. You can absolutely still bond with your baby even after an emergency c-section-- I had one, and my kids and I are crazy-bonded! You can still be a crunchy earth mama after a c-section in the hospital, too. We co-slept, used cloth diapers, nursed into toddlerhood, delayed solids, and made our own baby food; and we continue to grow a lot of our own food and use natural cleaning and grooming products. I practice a very Alfie Kohn style of discipline with my kids.

My advice is, come to terms with all the different possibilities, and communicate, communicate, communicate. Also, I had the most horribly inverted nipples ever with my first. PLEASE feel free to PM me if you need help/advice/support nursing. My nursing journey included over six weeks of pumping exclusively while my daughter's mouth grew large enough to nurse with a shield, then a few months using a shield, and then just regular unhindered nursing until she was three and a half, including nursing through my next pregnancy and a year of tandem nursing.
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#6 of 13 Old 06-26-2014, 07:39 PM
 
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I think there is a not a reason to tell anyone that they are absolutely going to have to go to the hospital. As I said, I had an abruption, bled heavily for ten weeks, and went on to have a lovely UC and later three more.
I think it depends more on the size of the abruption, and when it stops bleeding, as I mentioned before. Mine was from about 10 weeks to 20 weeks. By the time I had my daughter I had not bled for 21 weeks.
Every UC birther must make these decisions for herself, based on reliable fact based information.
I am sorry, but I definitely feel judged by your above comments. I am a responsible mother with four UCs so far. As I also pointed out before, I also realize there are times when a UC is not possible. I am personally struggling with this as I type. Clearly the OP may be in such a position, but for a any support person (as I thought this list was created for) to make a blanket statement that UC was no longer an option is irresponsible.
Subchorionic hematomas, and placental abruptions can heal. My daughter is proof of that.

him-- ds 3/91, me -- ds 5/93
us - dd 2/00, ds 8/02, ds 5/07, dd 2/11 & cautiously expecting baby girl 8/14
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#7 of 13 Old 06-26-2014, 07:44 PM
 
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I am astounded by the advice being given here. Ironclad? Seriously? If that were true my daughter would not be here.
I agree we all need support in any decision, just thought this was a UC forum. Does anyone here actually have UC experience? Perhaps I am in the wrong place?
Sorry, I joined here to be supportive and to receive support.
I wish you all the best in your births. I hope you find what you need.
Peace.

him-- ds 3/91, me -- ds 5/93
us - dd 2/00, ds 8/02, ds 5/07, dd 2/11 & cautiously expecting baby girl 8/14
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#8 of 13 Old 06-26-2014, 07:53 PM
 
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I am astounded by the advice being given here. Ironclad? Seriously? If that were true my daughter would not be here.
I agree we all need support in any decision, just thought this was a UC forum. Does anyone here actually have UC experience? Perhaps I am in the wrong place?
Sorry, I joined here to be supportive and to receive support.
I wish you all the best in your births. I hope you find what you need.
Peace.
No one is saying that there is an ironclad rule that all babies and/or mothers who choose a UC are going to die or suffer horrible effects if they don't go to the hospital. In fact, we know very well that the majority would be just fine if they stayed at home.

What people are saying is that this is a very serious complication and that the massively elevated risks mean that a UC is probably not ideal in this circumstance.

I think people actually ARE being very supportive. We're supporting this mother's decision to do the responsible thing by acknowledging that she has a high-risk pregnancy that requires medical attention.
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#9 of 13 Old 06-26-2014, 08:06 PM
 
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No one is saying that there is an ironclad rule that all babies and/or mothers who choose a UC are going to die or suffer horrible effects if they don't go to the hospital. In fact, we know very well that the majority would be just fine if they stayed at home.

What people are saying is that this is a very serious complication and that the massively elevated risks mean that a UC is probably not ideal in this circumstance.

I think people actually ARE being very supportive. We're supporting this mother's decision to do the responsible thing by acknowledging that she has a high-risk pregnancy that requires medical attention.
But there should be room left that if she does get the medical attention she requires and she then heals, she could still go on to have a successful UC. I speak from experience. This does not mean a c-section is her only hope.
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#10 of 13 Old 06-26-2014, 08:42 PM
 
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But there should be room left that if she does get the medical attention she requires and she then heals, she could still go on to have a successful UC. I speak from experience. This does not mean a c-section is her only hope.
I never said that a c-section is her only hope. I said that my understanding is that the odds of one being necessary are far higher for her.

I'm no expert on placental abruptions. I assume you know more, having experienced one, so I'd be interested in learning from you.

Here's my understanding: placental abruptions pretty much happen two ways:

1) The abruption is severe. If it's early in the pregnancy, the baby dies. If it's later the baby has to be delivered prematurely.

2) The abruption is milder. There's bleeding but after bed rest it stops.

It sounds like what you and the OP experienced is, thankfully, the second kind.

But here's the thing: My understanding is that even the second kind is associated with a whole range of risks for baby and mom (prematurity, low birth weight, bleeding, complete rupture during delivery and others). That is, even a "healed rupture" is still a serious, but by no means always fatal, complication.

Again, I'm no expert- Am I wrong on this?
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#11 of 13 Old 06-26-2014, 09:17 PM
 
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I am astounded by the advice being given here. Ironclad? Seriously? If that were true my daughter would not be here.
I agree we all need support in any decision, just thought this was a UC forum. Does anyone here actually have UC experience? Perhaps I am in the wrong place?
Sorry, I joined here to be supportive and to receive support.
I wish you all the best in your births. I hope you find what you need.
Peace.
*tip toes in and raises hand*
to answer your question...I have had 3 UCs and am planning my 4th

but again, I have no expertise in the area of the issue at hand...

*tip toes out*
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#12 of 13 Old 06-26-2014, 11:11 PM
 
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I have not had a UC. I will comment anyways. I am supportive of UC, and have considered it myself. I understand this is a forum for those supporting UC, but I don't read that you are looking to be convinced to UC anyways, but rather for support of your need to change your UC plans.

I was planning a HB with DD, who was born very quickly and unexpectedly at 27 weeks (infection, possibly leading to abruption). With your significant abruption at 25 weeks, anything could happen- totally normal birth at term, or every intervention needed for a birth tomorrow (of course we all could say that about any pregnancy; mine was 100% low risk until I basically walked thru the door fully dilated). I like to think that attachment parenting means being present with yourself and your child to do what is needed, not what your preconceived ideas were, or what other people say you should do, or whatever- but listening to your child and responding. Being flexible is a part of that. This is a sacred journey regardless of the road you are traveling on. A component of being sacred is deserving respect. For how huge, unexpected, life-altering it is, and we don't get to choose the details. Yes, you will have to advocate for yourself, and you need to start planing that now. Know the "routine procedures" and how you want that handled. Some hospitals are awful- but lots of them aren't. Some are really really good. Don't assume it will be an adversarial relationship- start from the view point as you are all a team working together, you are not forcing them into things they aren't comfortable with and they aren't forcing you into things you aren't comfortable with, and then bring out the fierce protective instincts if needed. Like, what does "forced c-section" mean in your mind? Or to flip that, what would feel like a good justification for a c-section? What would your role be as a member of the team that decides on a c-section? You have only part of a functioning placenta. This is a very real possibility. A placenta that does well during pregnancy may not fare as well once labor starts. What is a time when you feel comfortable going in, in labor? When does your team feel comfortable with it? What would help you bring your expectations closer (i.e., what would make you feel better about going in earlier in labor, or make them feel better about you being at home longer?).

And don't fear the bonding issue. That bond is sacred in a way that is deeper, but also more complex, than the immediate hours after birth. DD was on fentanyl for a week, we couldn't hold her for even longer, couldn't even be cradled while being fed (once she started that months later…) etc. My husband was bonded to her the instant he saw her. It was more complex for me, not in a bad way per say, but in a way that I think again emphasizes the sacredness and respect of this- I was perhaps in awe of her, and respected her, and as I got to know her, became as bonded as any mother, and I think something even deeper.

We shouldn't avoid things we know are needed based on fear (in whatever way we "know" things or "need" things- from reading your post it sounds like you "know" this is the right choice for your situation). Fear of birthing at home, fear of birthing in a hospital- neither is helpful, except that fear tells us it is something to be respected and to pay attention to and prepare for.
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#13 of 13 Old 07-14-2014, 12:29 AM
 
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There will always be conflict between those for whom logic rules and those for whom feelings/intuition take first place. The rationals always come across as judgy to the feelers, even though they don't mean to be. The feelers are not necessarily lacking in critical thinking skills, but they do put a greater weight on personal insight-experience than the thinkers, which doesn't make sense to the thinkers. Hopefully the OP has had enough input on this thread to recognize that many options and outcomes are possible and that she might find support (and possibly, judgement or castigation) for any choice or any outcome- so ultimately, she'll have to make her decision based on her own values. There are some who believe uc is appropriate only for low risk women, while others are attempting UBAC after 3 cesareans. We all get to make our own decisions about risks.

(OP) I'm sorry you have this crisis to sort through at this time, recognizing the fear and weight of all the decisions you are wrestling with, I wish you well, and peace in your decisions.

~Alison Murphy
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