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I spent most of last week and this past weekend reading and preparing myself for my doctor's appointment today. We are at the point where it is time to talk about the birth. Ryan's birth started pretty normally, with my water breaking in the doctors office at a routine appointment about 6 days past due. We had just finished talking about scheduling and induction for the next morning since I was almost a week past due, Ryan seemed a fair size already and I am a little more on the "petite" side. My labour progressed relatively quickly (from 2 cm to 10 cm in just a couple of hours) but without what I was expecting as contractions. Without the contractions to help me know when to push, I was unable to push effectively. Even when the nurse told me when to push by watching my contractions on the electronic fetal monitoring, it was not much help. Ryan ended up being born via a c-section(Cesarean), his pointy head telling me that he and I tried our best.
At my 6 week post-partum visit my doctor told me the next baby would be a repeat c-section. I did not pay much attention to what he said because I had just had a baby and was not thinking of having another just yet at that point. When I did get pregnant again, my doctor did say his personal recommendation would be a repeat c-section (which he went ahead and scheduled for 10 days before my due date) but he has acknowledged my lack of interest in an elective repeat c-section. Thus began our dialogue of a possible VBAC (vaginal birth after Cesarean) for this birth with both Brad and the doctor thinking that a repeat c-section is the best choice here. I just wasn't sure it was the best choice for me, or my baby.
I began by reading The VBAC Companion. It had some really great information. It included addressing fears that many woman have of VBACs, the risks and the rewards. There were lists of questions to ask your doctor/midwife, your hospital/birth centre and doulas. It did recommend some sort of labour support, the most common being a doula and how important it is to have another woman, especially one who has also given birth, there with you, one on one, focusing only on you. There was a section on labour and how to make the most of your labour to make your VBAC successful. Many of the suggestions for a successful vbac labour were things that I did not have in my labour with Ryan. The book also talked about having a repeat c-section, when it is necessary, pros and the cons. I especially appreciated the first hand accounts from different women with different birth stories.
Next, I moved on to Having A Baby, Naturally. This book was recommended to me by most of the other mothers in my breastfeeding support and play group. I read the whole book but focused on the chapters dealing with labour and birth. There was information about each type of birth, different types of medical assistance during labour and different pain management techniques both drug related and non drug related. I easily understood why it was so popular with the women who had recommended it to me.
In this technology based age, I moved onto Internet searches about vbacs. I found quite a few sites that helped me in my research and decision making process.
Finally, I talked to a couple of people I know who have had both successful VBACs and attempted VBACs. While I still had a couple of questions for my doctor about my own situation and my previous birth history (somethings I don't quite remember about Ryan's birth), I felt certain that I wanted at least a TOL (trial of labour) with this baby with the hopes of a successful VBAC. Armed with my list of questions for my doctor and my own knowledge on the subject, I walked into my appointment.
"If you want to make God laugh, all you gotta do is tell him your plans..." goes a line from When You Say You Love Me by Clay Aiken. Very fitting for this afternoon. This was my first appointment since my 20 week ultrasound (which due to unforeseeable circumstances actually ended up being a 23 week scan). My doctor was able to confirm that the baby is a boy! He also said that things looked very good, EXCEPT... and before he even said it, I knew it was something that would make a difference in my VBAC attempt. At this point I have placenta previa. I think he said partial, but he said that if the placenta did not move, a c-section would be mandatory. So for now, we are looking at having another ultrasound at 32 weeks to see if the placenta has moved or not. I told him of the research I had been doing on VBAC and how that would be my choice if the placenta moved. He said we would talk about it again after the 32 week scan but that he still felt a c-section was the best bet. He also suggested I search for VBAC in small women since my frame is so petite. He said if I was a normal to tall woman he would wholeheartedly support my VBAC efforts.
So, for now, I am looking to keep an eye on the placenta previa situation. I hope it will change and so I will search for information on VBACs in small women. I will also research the different types of placenta previa and if infact it means a mandatory c-section or if a vbac is possible. This diagnosis has made me a little more cautious. While I may want a VBAC, and while it may be a good choice for my baby, that was before I knew of this possible placenta previa complication. If the placenta does not move, it very well be in the best interest of my health and the health of my unborn baby boy to go ahead with a planned c-section.