Getting A Second Opinion

I feel a lot better about the delivery issue that came up with my doctor yesterday. Last night I decided to watch the documentary The Business Of Being Born which was a DVD I had wanted to see for the past two years so I finally bought it a couple of months ago. It was very good (although I'm still not comfortable with homebirths) -- it reinforced that I should not be forced into a c-section for no reason. If there is a reason, then by all means bring it on.

But women are having VBACs all of the time now despite doctors trying to convince them that their uterus might rupture. They are being allowed to (successfully) because every pregnancy and delivery are different! The theory for VBACs is that whatever situation caused the mother to have a c-section the first time is not going to happen again. So what makes my reverse situation any different? In fact, out of EVERYTHING regarding a woman's pregnancy, labor/delivery is what is MOST likely to change the next time.

For example, I recently read that for most women having low progesterone and morning sickness can be expected in subsequent pregnancies. With Logan I had to be on progesterone and had terrible sickness -- not only that but I was uncomfortable throughout my entire pregnancy. This time my progesterone was already high without supplementing, and I have not had any nausea and feel better than NOT pregnant.

It's the same as, chances are my kids are going to look different and have different personalities. So why should I assume that my delivery is going to be identical to last time? Even if it is, I feel I'd handle it better this time. I told Joe that I'm not even sure I pushed right for the first two hours!!! And, aside from being more active during this pregnancy (which is going to happen this time no matter what just because I have a toddler), I would get my butt off the hospital bed and squat, among other tips that I wrote about on my other blog under the category How To Avoid A Small Pelvis And/Or A Posterior Baby.

If what I do doesn't make a difference, I feel there is a way to avoid the "point of no return" that my doctor fears. Using my last experience as an example: Logan didn't move at all the first two hours. If that was to happen again then I would have no problem saying "okay let's do a c-section" because that would signal a possible shoulder dystocia again. Considering that most women I know only pushed for 30 min to an hour I think it should be very clear within one hour whether I'm going to have a long pushing phase again and so I'm even willing to stop at one hour. But I want the chance to try. I do not feel that the decision should be made for me in advance any more than anyone else. After all, even flawless first deliveries can end up with major complications in the second. Nobody knows until they're in that moment what the birth experience is going to be!

So I am going to write everything out and present it to my doctor at my next appt (1/11/11 at 1 -- is that cool or what?!). If she still insists that I'm getting a c-section this time (if my baby is bigger) then I am considering changing doctors or hiring a midwife.

My friend Chris who moved away from Omaha this past March dropped her doctor in her last month of her pregnancy! Her doctor was not willing to let her have a natural childbirth and so she hired a midwife and had the birth that she wanted. So I emailed her and got the name of the team (they're at The Nebraska Medical Center here in Omaha) to talk with them if I no longer feel comfortable with my doctor. I also have other friends around Omaha who have different doctors and might even check one of them out just to get a second opinion to see whether it's all doctors who feel this way or just mine. I kind of think that it's only because my doctor went through my last experience with me. I loved her during Logan's birth because she was PERFECT through the whole thing but apparently inside she must have been freaking out and doesn't want to go through that again. I remember one of the nurses glaring at me and saying that no other doctor would have let me push for 4 hrs without a c-section. But I was GLAD she let me (I had learned all about c-sections during my pregnancy from my friend Kendra who had a blog at the time and so I had requested not to have one) but maybe she risked losing respect from her fellow staff or something.

So much is done for legal reasons (I'm sure she's afraid of being sued if she let me have a vaginal birth and then a tragedy happened) so from her perspective of course it's way less stressful to just schedule a c-section for me and feel that she is in control. But I have been researching this and there is nothing that states that if shoulder dystocia happens once then it will happen again. Generally, second deliveries are easier and quicker than firsts. If a vaginal delivery does go well then it is better for both the baby and me than a c-section.

I AM glad that she brought this up now rather than waiting until my third trimester because this does give me the chance to get comfortable imagining myself having a c-section and being okay with it so that if it happens I won't feel disappointed. One pro is that right now Joe & I have no idea what to do with Logan, but if I know in advance when I'm having baby #2 then we can arrange for our parents to come or something.

This also reminds me that there could be a completely different issue that arises. If the baby is even earlier than Logan then he/she could be breech which would mean a c-section. If for some reason I don't go into labor on my own and have to be induced then I'm more likely to end up with a c-section. If I go to full term next time and my baby is ten pounds, then I will run to the c-section room :p

But what if everything is the way it's supposed to be? What if I have another seven pound baby that's in the right position and my blood pressure and the baby's heart rate and everything else is well? I don't want the decision on whether I get a c-section to just be the baby's size because whether I only gain 25 lbs or not, it is very possible that is out of my control. There are a lot of big babies in my family and Joe's family. I need something more from my doctor that is going to convince me that she is open to letting me try rather than just if my baby is less than 7 lbs 13 oz. If not, then I will be sad to say goodbye to her especially since I've spent these past three years saying that I didn't want to move before Baby #2 because I didn't want a different doctor! (I have adored her and her nurse the past six-and-a-half years, recommended her to other people, given her good reviews on the internet, and spoken very highly of her wherever I go.) My feelings haven't and won't change for her, as I have learned enough about the medical profession in regards to childbirth to know that she is just doing her job. But, she does have a very dominant personality so I won't feel comfortable continuing to see her if I feel she is going to force me into a c-section without a current reason.

I wish I could see the future because if I'm going to end up in c-section even with a midwife or new doctor then I'd rather my current doctor be the one to perform it. But I also don't want to stay with her and have a c-section and then look back and wonder if I wouldn't have had one had I gone to someone else. If this baby is another boy and the pregnancy continues as easily as this one (and they're not a horribly difficult child) then it is possible we might even have a third child, who knows. So I'd rather have another vaginal childbirth this time than end up with two c-sections since I probably wouldn't want to try a VBAC with my third.

My due date is seven months away so I'm going to tuck this issue away and continue on as I have been -- happy and relaxed and worry-free. It is possible that since I had such a fast dilation phase last time that this time it could go even faster and then the baby could start coming out before my doctor can send me in for a c-section! But, since there's no way to know, then I am going to explore my other options.