Thursday, June 29

Homebirth After Cesearean....Safety and Choices

A member of my extended family recently had a scare because of the experiences of someone she knows and has started to worry over our decisions concerning the birth of this baby. I don't want to downplay her fears, so I reviewed some of the resources I consulted while making the decision to have my baby at home after having had one cesarean birth.

Here are a sample of the pages/links that I read and thought about as I came to my decision. I have spent years reading about VBAC and birth and weighing my options should I become pregnant again. DH, fortunately, is completely behind me on my decision, which makes things all the easier:

Risks of VBAC vs. Repeat C-Section

Safety of Planned Homebirth with a Certified Professional Midwife

Thoughts on Homebirth After Cesarean

Some other materials I have read included A Good Birth, A Safe Birth by Diana Korte, The VBAC Companion by Diana Korte, and Ina May's Guide to Childbirth by Ina May Gaskin.

My midwife has been attending homebirths for 20 years; she is trained and experienced in knowing what complications are and when a transfer to a hospital would become necessary. I will go to the hospital if I feel that the baby and/or I am at risk from complications that arise.

Some reasons I feel hospital births are more risky:

• To me, a repeat cesearean section is more risky (for me, my baby, and my possible future children) than a vaginal birth (see the first link above for a comparison of the risks of VBAC versus repeat c-section).

• Many hospitals/doctors will not even let you attempt a vaginal delivery if you have had a previous c-section.

• Despite the research that shows inductions increase the risk of uterine rupture, I have repeatedly heard about hospital VBAC attempts being induced.

• Two factors that increase the risk of uterine rupture are having had repeat c-sections and having had a c-section within the previous year or two. I have only had one c-section, and that will have been roughly six years ago when this baby is born.

• I believe that my labor will proceed more naturally and more quickly if I am at home in a comfortable environment without interventions that will hinder it. These include continuous fetal monitoring, possible induction, artificial rupture of membranes, and of course, c-section.

As with anything, there are risks. Who knows what will happen between now and then? In the meanwhile, as I do my best to plan for this birth, and after reading and reviewing data, I feel the risks during a normal birth for me and my baby are greater in the hospital than they would be at home.

Feel free to comment/email if you would like to discuss this issue further.

Saturday, June 24

It's a Girl!

Well, that about says it! I had my ultrasound a little bit early and learned that our little baby is a girl! I already have a DS, so having a girl will be completely new and exciting!

I was walking with DS last night and just saying that she'll be "my daugther" was thrilling :) I haven't got to use that term yet. I'm definitely not a girly, girl, more of a tomboy, but I had to go right out and buy some little onsies with pink on them and one that says "I Love Mommy" just for her. It seemed sort of symbolic.

It will be a whole new set of worries, I'm sure. DH has already threatened to buy a shotgun ;) I worry myself that girls are more common targets of abusive situations, but I've always worried about that even with DS. I guess worrying is part of parenthood. Finding the balance between protectiveness and paranoia is quite a challenge!

I had sort of secretly hoped that there would be twins, but I'm not disappointed, especially since that means that my plans for a homebirth are still a go. She was even head down the whole time during the ultrasound (hope she's that way when it's time to be born!).

One thing I want to mention is that as far as interventions go, I've never thought ultrasound to be top on the list of causing too many problems. However, it did affect me, mostly because the technician and radiologist won't tell you if anything is wrong. They insist on sending it to your "doctor" (how many times do I have to tell you it's my midwife, people?!), so they can tell you. So, you have to wait until they send the report and then your provider gets back to you.

My little one (as yet unnamed...that's another debate) looked great as far as I could tell. Let me first say that I have a lot of scientific knowledge, but I am by no means an ultrasound expert. From my lay perspective, everything looked good: all ten fingers and toes were present, as well as all four chambers in the heart. The spine looked complete, and the placenta was not covering my cervix. But still, I've been having nagging worries that maybe there was something wrong...was the radiologist just brisk or was he trying to hide something? You get my point. The test itself instigated the worries. I'm pretty good at telling myself to calm down and not cause problems where there aren't any, but what if I'd had a whole pregnancy full of tests (actually I had many more with DS)? It might just make the whole thing more stressful and less pleasant, but that's just a theory.

I posted some pictures to lighten the mood. Enjoy!

Baby Girl's Profile Posted by Picasa

A Hand! Posted by Picasa

Her Foot! Posted by Picasa

Sunday, June 18

Ultrasounds and choices

Well, I thought I would update everyone on the ultrasound drama. After many phone calls, faxes, and emails, I have an ultrasound appointment for one week from Monday. It turns out that my midwife could "prescribe" the ultrasound (approved my health insurance company), and so she did so. I guess the laws concerning licensed midwives are so new in this state that people are still getting a handle on them.

I do wholeheartedly agree with her that women's health care (and mens' for that matter) should be in their hands, not someone else's. Fears of litigation seem to mean that even for an ultrasound, you must go through an "approved source" instead of just getting it done yourself, even though it is a pretty standard procedure nowadays for pregnancy (I've known women to have 5 or more during pregnancy; I had at least 4 with my son). For now, I'm happy to take it one step at a time and hope that the worst we have to worry about is whether this baby is a boy or a girl! :)

The baby is really active this morning, so I'm just enjoying sitting here typing and feeling those kicks until it's time to go up and make my husband his much-deserved Father's Day breakfast.

In response to something I read in the paper this morning (I refuse to make it worth more than it is), let me just say that the men in households where women stay at home or work at home do do housework and they often also work twice as hard so that this choice (made by both mom and dad) can be supported because they both believe it is best for their family. Also, if their is no intellect involved in raising children, then I've been going about it all the wrong way. Working is a fine choice (I do it myself and "stay home"), but it's not the only choice. It's also not the only worthy one. Sorry, had to get that off my chest.

Happy Father's Day, all!