Due soon, may do UC, what do I need to know? - Mothering Forums

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Old 12-09-2005, 06:04 PM - Thread Starter
 
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Brief history- My first birth was a c/s after failure to progress. Once the baby was born they diagnosed me GD. At 38 weeks babe was 10lb 12oz. Spent a week in the NICU. Horrible recovery for both of us. My worst nightmare actually as we started as a homebirth.

This pregnancy- diagnosed with GD at 28 weeks, 3hour glucose was failed on every draw. I monitor my sugars 4 times a day, no problems keeping things in range with diet, except for my fasting reading (first thing in the morning) it is always a bit higher than normal, but not way off the charts or anything. I have changed practitioners 3 times. Each time told I was no problem, could have my vbac, and then each time it became clear that would not be the case. Present OB just pulled the "schedule a repeat c/s" speech out at my appointment on Tuesday. Have spent the day researching homebirth midwives in the area and talking to a few. Have been told that because I recently started taking insulin (one week ago) I am now considered insulin dependant and therefore out of their limits here in Colorado. They could lose their liscense if they took me on. So, what to do??

I am not afraid to have this babe on my own, I have actually been thinking about it for weeks and have dropped hints to dh. He was against doing a homebirth this time because of the awful experience we had last time, until Tuesday when he realized that this doctor was also planning to c/s and trying to get us onboard with her plan. Since an assisted homebirth is not really looking possible, the only thing is to do it ourselves. Our only concern, and it is very slight, is that the babe will need care if his sugars were to plumet because of the GD. However, from what I have read the best thing for that is kangaroo care and immediate breastfeeding, two things he is guaranteed to have at home, not so much in the hospital.

Any ideas, suggestions, and words of wisdom greatly appreciated. I am running out of options, but maybe this is the one I should have planned from the start!!
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Old 12-09-2005, 06:43 PM
 
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thrilled to see you over here! You can do it! Personally I think that in the current climate, the only way for a safe VBAC is at home. Don't have a lot of advice, but wanted to give you a big and send you tons of support.

best of luck

-Angela
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Old 12-10-2005, 12:49 AM
 
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I have no advice about how to prepare for UC, but I just wanted to offer encouragement. When I read another post of yours about laboring at home 'as long as possible' the first thing I thought was hm, sounds like as long as possible should be for the whole thing!
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Old 12-10-2005, 01:26 AM
 
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I would plan on a homebirth, just as if a mw would be there.(I would keep my UC plans quiet, however. Most people think it is thier business to stick thier noses into yours, and that would NOT be good.) Read/ have a copy of :Spiritual Midwifery, by Ina May Gaskin, Ina May's Guide to childbirth, also by her; Heart and Hands by Elizabeth Davis; Unassisted homebirth, an act of Love, by Lynn Greisemer, and if you choose other UC books, they are great as well. The more knowledge you possess, the more you can draw on during your birth. you will have to learn to listen to your gut instincts, since we know the med community probably will undermine it. Get supplies from a homebirth list(check the stikies here) and there are other lists you can google ; and favorite music, whatever you feel will make you loose and let go...You will be charting unfamiliar physical feelings in labor(amy realize that labor is not near as painful without pit or other tinkerings),and emotional ones as well...preparation is the best prevention. Allowing your body and baby to do thier work will go a long way to alleviate pain and if you do a waterbirth, that really helps most women, especially VBACs, since there is a tendency to compare the VBAC labor(while in the midst of it) with previous labors that led to the section/s. These are things to be aware of. Of my friends and board members who have VBACed, they are so grateful and empowered after the VBAC, and have restored faith in themselves and thier bodies abilities to give birth unaided. They also had to let go of the reasons for the previous surgery/ies. They have all said it was well worth the preparation and sacrifice, to have a healthy baby on thier own, with no one telling them what to do....
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Old 12-10-2005, 03:17 PM
 
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Also, you might post about your issues with GD on the Homebirth or Birth and Beyond board, or do a seach for it here on MDC -- there have been so many discussions about it, and maybe some of the wisdom and experience of the mamas here can help reassure you. I don't know much about GD myself, but your situation sounds a little odd to me. Maybe I'm missing some info or misunderstanding, but from what you've posted it doesn't sound like you even have GD.
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Old 12-12-2005, 01:17 AM
 
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I have lurked for a few years on here and this post has finally given me reason to register and post.

I am all for VBAC and even homebirths. I tried a VBAC of my own - and failed. I ruptured. A severe rupture - over 7.5 inches. But I was lucky - my son lived. Since my rupture, I joined a rupture support board and truly realized just how lucky I was. Had I been at home, assisted or unassited, neither my son nor I would have lived. And that is pure fact.

I, personally, think you are incredibly foolish for even contemplating an unassisted home birth. Other than my prior c/s, I was not at risk for rupture. DS was in the right position. I'd had no other trauma. I had no other health issues besides having Lupus which would have nothing to do with a rupture. GD, on the other hand, has been shown in some studies to increase the risk of rupture. Experts are unclear, as of yet, as to why this is, but they do believe part of the reason is that baby's size tends to be larger, especially in the mother whose GD goes undiagnosed for too long.

Think long and hard about this. Are you really willing to risk not only your unborn child's life, but your own life as well, just to avoid a hospital? Think of your other child. Your DH. I understand that you're uncomfortable with hospitals - I am, too. But I had to set aside my discomfort and my fears for the sake of my family as a whole.

Yes, the risks of rupture are rather minute - but that doesn't mean they don't happen. And you need to know that, when they ruptures DO happen, they are often catastrophic. By catastrophic I don't just mean for you - but for baby. Many of the women I know that ruptured had to have hysterectomies - after learning their babies died. They will never have the chance to carry another child. And quite a few of these women could have had both their uteri and their children saved if they'd had adequate response time by health care providers.

Alice, I don't say this to scare you into a hospital environment. I say this only to make you stop and think about the whole picture. I am also in Colorado. I don't know where about you are in Colorado, but if you're in the Denver metro area, I can recommend three hospitals that have excellent VBAC success rates that also have excellent staff and response times should the unforeseen happen. I did my homework when I attempted my VBAC with DS. My doctor's practice had both midwives and doctors and were affiliated (in the same building) with perinatologists. I saw all of them - including the midwife (who I adored) and felt comfortable with each of them. This is a HUGE deal for me because I do NOT trust doctors in general - for reasons I will not go into here.

Anyway, now that this post is the size of War and Peace, I'm going to sign out. I just felt really compelled to respond. Good luck with whatever you decide.

Blessings,
Niassa
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Old 12-12-2005, 05:42 AM
 
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Quote:
Originally Posted by Niassa
I have lurked for a few years on here and this post has finally given me reason to register and post.

I am all for VBAC and even homebirths. I tried a VBAC of my own - and failed. I ruptured. A severe rupture - over 7.5 inches. But I was lucky - my son lived. Since my rupture, I joined a rupture support board and truly realized just how lucky I was. Had I been at home, assisted or unassited, neither my son nor I would have lived. And that is pure fact.

I, personally, think you are incredibly foolish for even contemplating an unassisted home birth. Other than my prior c/s, I was not at risk for rupture. DS was in the right position. I'd had no other trauma. I had no other health issues besides having Lupus which would have nothing to do with a rupture. GD, on the other hand, has been shown in some studies to increase the risk of rupture. Experts are unclear, as of yet, as to why this is, but they do believe part of the reason is that baby's size tends to be larger, especially in the mother whose GD goes undiagnosed for too long.

Think long and hard about this. Are you really willing to risk not only your unborn child's life, but your own life as well, just to avoid a hospital? Think of your other child. Your DH. I understand that you're uncomfortable with hospitals - I am, too. But I had to set aside my discomfort and my fears for the sake of my family as a whole.

Yes, the risks of rupture are rather minute - but that doesn't mean they don't happen. And you need to know that, when they ruptures DO happen, they are often catastrophic. By catastrophic I don't just mean for you - but for baby. Many of the women I know that ruptured had to have hysterectomies - after learning their babies died. They will never have the chance to carry another child. And quite a few of these women could have had both their uteri and their children saved if they'd had adequate response time by health care providers.

Alice, I don't say this to scare you into a hospital environment. I say this only to make you stop and think about the whole picture. I am also in Colorado. I don't know where about you are in Colorado, but if you're in the Denver metro area, I can recommend three hospitals that have excellent VBAC success rates that also have excellent staff and response times should the unforeseen happen. I did my homework when I attempted my VBAC with DS. My doctor's practice had both midwives and doctors and were affiliated (in the same building) with perinatologists. I saw all of them - including the midwife (who I adored) and felt comfortable with each of them. This is a HUGE deal for me because I do NOT trust doctors in general - for reasons I will not go into here.

Anyway, now that this post is the size of War and Peace, I'm going to sign out. I just felt really compelled to respond. Good luck with whatever you decide.

Blessings,
Niassa
I totally agree with Niassa!!! You took the words right out of my mouth. I think if your midwives won't touch you, you are insulin dependent for GD, and have a history of a birth of a VERY large 38 weeks baby that was in NICU for GD related problems, you really need to do some research and think whether or not you are willing to risk your childs life (and possibly your own) with rupture, and or blood sugar problems
Good Luck and STAY SAFE
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Old 12-12-2005, 12:50 PM
 
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delurking to say that last i checked this was the UC support board not the 'spew paranoid medico BS' board. beyond that, i didn't get the impression you were looking for anyone else's personal opinion on your decision. that said, i've had 2 UCs and i've never tested for GD. in Obstetric Myth vs. Research Reality Henci Goer desccribes GD as a 'diagnosis looking for a disease', meaning that it isn't one (a disease that is). so i don't believe there's anything wrong with you, chances are you don't need the insulin you're taking. as for your babies, it may well be that there wasn't anything wrong with the one that ended up in NICU - but once you're in the hosp the staff need to put on a good show to prove that the horrors they subjected you and your child to were 'necessary' i.e. your baby would have died if we didn't do all this crap. wrt the size of your babies, chances are they're just the right size for them and for you and you'd be able to birth them just fine if left to your own unhindered devices. if there is something wrong with your baby at birth you're more than likely to notice and can transfer at that point.

and yes BE SAFE! and stay away from that nasty hospital!

wishing you a peaceful unhindered birth,

beeba
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Old 12-12-2005, 01:09 PM
 
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Alice, talk to midwives and your doctor about your plans. There are a minority of women who do need to birth in the hospital. People on this board can say "go for it, mama", etc but that is as far as it goes. We don't know your individual situation and that is what it should be based on. Please talk to your doctor about your feelings.
Wishing you the best of luck here.
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Old 12-12-2005, 01:53 PM - Thread Starter
 
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Thank you for all the replies! I understand the passion that is behind each one and I am not offended by any. We are all entitled to our opinions and we all have personal experiences that color our views. That said, we have decided to stick with our origional plan, but we have done some more serious thinking about how to protect ourselves and our son. I talked to some midwives this weekend and I was highly impressed with them. They encouraged me to get off the insulin, and helped me see how that would be possible. They were right, I have changed my diet (yet again!!) and my fasting readings are now "acceptable" for the first time since I started monitoring. I am refusing the further interventions my doctor has recommended (another ultrasound, induction, scheduled c/s) because they are all just ways to guarantee another scary and painful birth and recovery. We are going to stay home as long as possible with our doula, and once we arrive at the hospital my dh and doula will be hyper-vigilant about what I need and want. I do not doubt that I can do this naturally and have the empowering birth I am imagining. However, I do have to consider my dh, my daughter, and my doula. They are all also accepting a great amount of risk should something go wrong. I do not think anything will go wrong, but unfortunately I cannot see the future. (I sure wish I could, then all the stuff that happened the first time could have been avoided and I wouldn't be a VBAC!! )

Again, thanks for all the words of encouragement and please wish me good labor vibes. I have been experiencing some really good pre-labor stuff the last few days, things I honestly never felt with dd. It is good to know my body is working on having this baby. I am happy to feel the pain of my muscles working!! Today is my due date according to my LMP!! So, it's any time now!! Yea!!
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Old 12-12-2005, 02:12 PM
 
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Hey Alice! Fancy seein' you over here
You know, every woman could possibly have a UC, so there's no reason to not prepare for it. Just because awomen schedules a c/s doesn't mean that the baby won't come flying out on their own at home, unassisted Everyone should plan a UC, no matter how they intend to birth. So I say go for it, at least plan it. Get supplies together. And if you decide to stay with your OB but just stay home for a loooong time, that's okay too. I think that if someone came at me with a "repeat c/s just because" speech I'd walk out of their office. And don't let the naysayers scare you too much. Just like every women could possibly have a UC, every woman with a birthing uterus runs the risk of a natural rupture that has nothing to do with a previous c/s. Rupture is rare but it is also very dangerous, however, I could have one myself and both of my previous births have been vaginal. What I'm saying is, it could happen to anyone, so if rupture is the only fear, I wouldn't let it scare you away toomuch.

You sound confident in your body and your abilities. Listen to your heart, your gut and you do what feels best for you. ONly you and your baby know what you both need to have the best birth possible. Talk to that sweet little one and level with him or her about how they are to be born, then go out and have a fantastic birth. I've said it tyou before and I'll say it again: I think you are going ot have a fantastic birth!! I'm really rooting for you and have been for a long time. I think you're awesome mama!

Namaste, Tara
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Old 12-12-2005, 02:14 PM
 
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Alice, (yes I've been lurking on this thread too) I am sending you many many many wonderful Vbac vibes!!! I am very supportive of UC and would have supported your decision to do so but I am also very supportive of women making the best informed decision they can. I'm glad you have made peace with the decision you have made.
Here's to you having an awesome and empowering birthing experience!!!!!!!!

OUR DAUGHTERS ARE PROTECTED SHOULDN'T OUR SONS BE TOO! :
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Old 12-12-2005, 02:33 PM
 
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Sadly, it's quite simple, VBAC is safer than a section.
Home is safer than a hospital.

Another vote to ignore the nay-sayers (man, do you guys work for an OB or what?)

Unfortunately chances are that if you walk through the door of the hospital, you will have a c-section.

-Angela
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Old 12-12-2005, 06:27 PM
 
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Um, does anyone else think it at all strange that we have three first-time posters in a row in this thread? That is SO unusual that it makes me just a wee bit suspicious...

Well, in any case, good look to you Alice, it sounds like you're feeling much more comfortable with your choices, and I hope it works out for you!
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Old 12-12-2005, 06:50 PM
 
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Quote:
Originally Posted by Niassa
Had I been at home, assisted or unassited, neither my son nor I would have lived. And that is pure fact.
Not fact, at least as far as the information you've given about it here. It is assuming that the rupture was not iatrogenic in nature or environmentally induced.

Quote:
GD, on the other hand, has been shown in some studies to increase the risk of rupture. Experts are unclear, as of yet, as to why this is, but they do believe part of the reason is that baby's size tends to be larger, especially in the mother whose GD goes undiagnosed for too long.
That might be relevant if she was known to in fact have GD, and if her labor was to be managed in such a way as to exacerbate the stress of a large baby on the tissues.

Quote:
Other than my prior c/s, I was not at risk for rupture. DS was in the right position. [...] Many of the women I know that ruptured had to have hysterectomies - after learning their babies died.
Under exactly what conditions did all these ruptures occur? What kind of incisions and repairs were done for their c-secs? How were the births managed? Were they induced or augmented? What positions were these mothers pushing in? Were they directed in pushing or believe they had to push at a certain time? Were they bearing down forcefully or allowing their bodies to do the work? Was there anything in their birthing environments to cause stress or inhibition or anything that would interfere with the body's ability to release the hormones necessary to keep the tissues from being unnecessarily stressed?

Ruptures don't "just happen". There is always a cause. And under certain conditions those causes simply don't exist.

You might want to go over to the VBAC and homebirth forums here, not all those women would be comfortable having an unassisted birth, but they can give you plenty of reasons why planning an HBAC can be as valid (or more so, depending on the situation) than planning a hospital VBAC, from a perspective of safety.
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Old 12-12-2005, 06:50 PM
 
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Like I said, I am very pro-VBAC, despite having ruptured. If I'd had it to do all over again, I honestly probably would still try for the VBAC. I am also generally pro-homebirth - but I do believe that every case should be looked at individually. I am pro-homebirth, unassisted or assisted, in cases where there are no current medical indications that could lead to catastrophic events - just as all those midwives cannot (and will not) take that risk. It's more than just a malpractice risk - it's a real and actual risk of people's lives.

Yes, I know my post came across rather dramatic, but I just think of my friend Chloe whose son died from a massive rupture during an at-home VBAC birth. Chloe very nearly died herself and she has three other children at home. It is a very real and very scary thing to happen and to this day she blames herself for her son's death. I don't want to see anyone else go through the pain and suffering that I see Chloe go through every day - and it's been nearly 2 years since William died.

The thing is, GD may be as one poster called it above "a diagnosis looking for a disease" but the actual evidence-based information regarding GD is that babies of GD mothers tend to be quite large for gestational age. When you add larger-than-considered-normal baby to previous c-section you get a much more increased risk of rupture. And let us not forget that babies of GD-diagnosed mothers often times have a very difficult time regulating their own sugar, even with copious amounts of colostrum (I am a certified lactation educator - I'm not just talking out of my arse on this).

I PMed Alice and further mentioned that I am not normally one to advocate for hospitals or doctors at all. I personally can't stand them. But occasionally they are a necessity. For me, I know that my son would not be alive had I tried to labor at home (or work, since work was closer to the hospital that my house was) and ruptured. My doctor and midwife were very pro-VBAC and worked with me every step of the way to insure that I would have a good VBAC experience. They weren't trying to sabotage me every step of the way, unlike many doctors and nurses that I know. Yes, there are those kind of doctors out there - believe me, I know - and it frustrates me to no end to see so many women that are patients of those kind of doctors that end up with unnecessary c/s probably because the doctor gets his jollies off of cutting women up. I get that, believe me.

In Alice's case, however, I felt that I needed to (at the time) be the sole voice of contention simply because you have to look at all of the pros and all of the cons before making a decision. And yes, this is a support board, and I do support Alice. But that doesn't mean that I can't offer her other information, kwim?

At any rate, I'm glad that you found a decision that you are at peace with, Alice. You know that I'm sending you lots and lots of healthy labor and fabulous VBAC vibes. Again, lots of bright blessings to you and yours. I can't wait to hear how things work out for you!
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Old 12-12-2005, 07:05 PM
 
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Niassa, thanks for clarifying where you're coming from on this.

You wrote: "Chloe very nearly died herself and she has three other children at home. It is a very real and very scary thing to happen and to this day she blames herself for her son's death. I don't want to see anyone else go through the pain and suffering that I see Chloe go through every day - and it's been nearly 2 years since William died."

I'm so sorry for your friend, especially so that she is still holding herself responsible for this. We all try to make the best choices we can with the information we have, but there are never any guarantees. There are plenty enough women out there who have made all kinds of choices everywhere from highly managed hospital birth to completely unassisted birth, with disastrous results. Every choice carries its own special risks. She couldn't have predicted what would happen. The only difference if something bad had happened in the hospital is that no one (probably including herself) would have blamed her for it, because of the assumption that the hospital just is the safer choice. And I'm not saying that's not a significant difference. Just that it's something to acknowledge and come to terms with before you make the choice.
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Old 12-12-2005, 10:45 PM
 
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I agree with what you said, four. Sometimes my fingers type faster than my brain can compute... or maybe it's the other way around. Either way, sometimes my true intent doesn't come through or gets muddled. I hope the clarification made a bit more sense. It's hard to really type and think well while nursing and trying to read a 3yo a story and trying to concentrate on what you're doing for yourself!
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Old 12-12-2005, 11:10 PM
 
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Quote:
Originally Posted by fourlittlebirds
Not fact, at least as far as the information you've given about it here. It is assuming that the rupture was not iatrogenic in nature or environmentally induced.

You might want to go over to the VBAC and homebirth forums here, not all those women would be comfortable having an unassisted birth, but they can give you plenty of reasons why planning an HBAC can be as valid (or more so, depending on the situation) than planning a hospital VBAC, from a perspective of safety.

I just saw this post... we cross-posted earlier and I didn't scroll up.

For me, it definitely is fact. I wasn't pushing - actually, I was 9.5cm dilated and getting ready to push any minute. I had just rolled over to try to catch a couple of snoozes while I could to maintain strength and energy. Then the pain. OMG the pain was the worst pain I have EVER felt in my entire life! It is a pain I would not wish on even my worst enemy.

We don't know exactly what contributed to my rupture - and that's probably why I feel that had I to do it all over again, I'd try for the VBAC. The rupture didn't occur along my previous c/s scar. It did start, as far as we could tell, from the corner of the scar, but instead of running along with the scar, it traveled up and around the back and then down in to the vagina. I was told that if I hadn't been as dilated as I was, the rupture very likely could have compromised my cervix. All said and done it was a little more than 7.5 inches long.

For some reason, during labor, my uterus goes weird. With my first, I had ctx that literally lasted 5 minutes each and were very intense - but they'd be 10-15 minutes apart, even in active labor. With my first, I was given pitocin, because I stopped dilating at 8cm. The hope was that the pit would even out my ctx and get things moving again. Because I was given the pit, I opted to get an epidural - my biggest mistake. Because of the epi, I was forced to be on my back and they had me so numb I couldn't even feel my legs. I couldn't have moved if I wanted to. To this day I hate that feeling. And I know, deep down, that is the reason I ended up with the c/s. She was in the wrong position and wasn't putting enough pressure on my cervix to help dilate it - had I not been numb and been able to move, I would have been able to help her get into a better position. Eh, hindsight is 20/20.

This time around I had the same kind of ctx. The doctors, midwife and nurses were all astounded, even though I'd already prepared them for the possibility of those kind of ctx since I'd had them the first time around. It was horrible. But I managed quite well until I was about 7cm. I really just couldn't take it anymore. I was in the shower... in the tub... back to the shower... moving around... rocking on hands and knees... lying on my side... on my back... squatting as best I could (I have a bum knee). He was in the right position, I could feel it. But, in the end I was a wimp and opted for a mild epi - the key word being mild. It didn't make me numb, just took the edge off. And actually, I'm grateful for it, because if it hadn't been in place when I ruptured, I would have ended up with general anesthesia, and I would have REALLY freaked (long story).

At any rate, it may have just been the force of my ctx that caused the rupture. We'll never know. It may have been the fact that, for the last 5 months of my pregnancy, DS literally never stopped moving. I swear he moved in his sleep. My belly was always in constant action. For all I know that may have contributed.

The point of this novel is that sometimes ruptures DO occur for no apparent reason. And I don't have a problem with HBACs (assisted, though, by at least someone who has done them previously) when there are no other medical considerations. In the full-term, healthy mother, I think it's a fine option, but again, with at least some kind of assistance from a midwife, but that is just my opinion and I realize that my opinion differs from many on this subject.

None of this really matters in the long run, though, since Alice has already made up her mind.

Thanks for your thoughts on things, four. I like when people try to keep me on my toes.
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Old 12-13-2005, 01:41 AM
 
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Mama to 9 so far:Mother of Joey (20), Dominick (13), Abigail (11), Angelo (8), Mylee (6), Delainey (3), Colton (2) and Baby 8 and Baby 9 coming sometime in July 2013.   If evolution were true, mothers would have three arms!

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Old 12-13-2005, 01:42 AM
 
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Alice...I am glad that you have found peace with your decision

Mama to 9 so far:Mother of Joey (20), Dominick (13), Abigail (11), Angelo (8), Mylee (6), Delainey (3), Colton (2) and Baby 8 and Baby 9 coming sometime in July 2013.   If evolution were true, mothers would have three arms!

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Old 12-13-2005, 01:58 PM - Thread Starter
 
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Wow, I am getting such an education reading all this stuff!!

Niassa I am so glad that you had a good outcome with your rupture, what an amazing story. It definiately could have been tragic, and I am glad you were near an OR. Thank you for sharing so much of what must have been a very scary ordeal.
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