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Tuesday, May 31, 2005

Save me from the doctors...LOL...

My poor coughing, hacking , sneezing self got to go have a consult with a maternal-fetal medicine specialist today. He decided that my OBs course of action was basically correct but that, instead of 150 mg of lovenox once a day, I should be on 40 mg twice a day. That will double the number of shots I have to give myself for the rest of the pregnancy. Now I really will know what a pincushion feels like.

Also, I have a question for all of you. Feel free to weigh in even if you haven't had any kids yet. Both my boys were born via c-section but it was never due to an inability to deliver but because of other medical/pregnancy related issues. A recent study (about 2 yrs ago) showed that risks of uterine rupture are a little higher than previously thought during a VBAC (vaginal birth after c-section). However, the risk is still VERY, VERY LOW...less than 3%. The specialist told me that my clotting issue should not effect any decision about whether to attempt a VBAC. Part of me really wants to try for a vaginal birth but another part of me doesn't even want any extra risk...no matter how miniscule. What would you do?

9 comments:

sweetisu said...

Vaginal delivery is not all that's cracked up to be. I was in labor for 15+ hrs and pushed for 90+ minutes (some moms told me they did only FOUR pushes. yea) and it was no fun at all. Of course I don't have a c-section experience to compare.

BUT, given that you've had 2 c already, if I were you I'd just go with the c again in case of rupturing. It's a small % but I wouldnt' want to take any chances. HTH.

JenP said...

This issue came up recently in the media when Posh Spice was to give birth to her 3rd baby. She's had 2 previous C-sections, the first being because they didn't want her to go overdue, the second as a repeat and she questioned her specialists on whether or not she could try VBAC.

They did argue the risks of uterine rupture, minimal but present, and talked about the risk of a 3rd C-section. Posh said she wants to try again (for a girl presumably) and they told her there would be more of a risk having 3 C-sections causing rupture in a 4th, rather than 2 C-sections and a VBAC.

I'm sure that's forward planning (preserving future delivery safety) but it made me question how safe 3 C-sections would be as opposed to 2 C-sections and a VBAC.

I think you definently need to contact some moms who've been there and get more advice. If this is definently your last child, it might make a difference as compared with wanting to preserve future deliveries.

No opinion from me, as I'm terrified of either option, but I think it's definently a situation where you NEED to speak to a lot of women. Ovusoft has a great forum board (don't know if you belong to a forum board) and they're all really good about answering questions.

Lots of luck and I hope you can get some good advice.

Ana said...

I never had a c-section so I can really compare. But I can tell you that I had a GREAT experience with my vaginal delievery and I will do everything in my power to have another one with this baby.
I was in labor for 3 hours and oushed for 15 minutes and even though I had an episiotomy, I felt good as new the next day. Granted, not everyone has a good experience, particularly with their first, but I just wanted to share mine because you always hear the horror stories and it's not always like that.
Having said that, I think you should discuss every aspect of this choice with your doctor and make sure you know all the pros and cons.

Kristin said...

I have a clotting disorder that caused my loss last summer (after I saw the heartbeat) and probably contributed to the other losses (even though LPD was the primary prob...didn't get far enough for the clotting to be an issue). I will be on Lovenox until 36 weeks and then I switch to heparin until delivery. I will also remain on lovenox for 6 weeks postpartum.

Anonymous said...

I think I'd opt for a C-section myself. I cannot compare between the two, but I think you have to ask yourself what it is that you want as the end result with minimal risk of danger to you or your baby.

There's a 3% risk out there for a reason.

As Sweetisu said, vaginal delivery is not all that glorious. To be honest, any way the baby arrives healthy is fine by me.

I wouldn't risk it.

Anonymous said...

First two pregnancies, long labor but vaginal delivery, with blood transfusions after both.

3rd pregnancy (twins), C-section, horrible hemorraging, more transfusions, turns out I had a blood clot the size of my fist going on in my right Ovarian-something. Months of Coumadin to follow.

Fast-forward 14 years:

2 m/c

This pregnancy, did Lovenox first 2 weeks, no clotting disorder(s) found, ok to d/c the damn injections. My OB has given the go-ahead for VBAC. I'll be closely monitored, if there's any sign of any problems, C-section it is.

I guess it depends on how strongly you feel about it. Both my vaginal deliveries were long and PAINFUL (forceps the first, suction-thingey the second) but the recovery from the C-section was the nightmare. I also happen to have a funky heart condition (viral cardiomyopathy) that makes it all even more fun, but they tell me I'm young (33), I'll live. (Sarcasm, me, my team is actually quite amazing.)

Good luck with your decision-making. I'm enjoying following your pregnancy, we're right in step.

Marivic
12w6d

Jenn said...

OOOOh, I would definitely opt for the C-section, just because it is safer and you have a total excuse for getting one. Just in case. Play it totally safe, ya know?

Hostile in Ohio said...

I'd go for the VBAC. You will be in a hospital, and if something happens they are there to make sure it doesn't get bad. Besides, for a VBAC they HAVE to have a full c section staff on hand in case you need them.

Check out: http://www.vbac.com/
and especially: http://www.ican-online.org/

Good luck, and I hope you figure out what is best for YOU. B/c what I would do or anybody else isn't necessarily what you would do.

chris said...

During my last pregnancy, when it looked like things might actually be progressing, I talked to my ob/gyn about a VBAC. They weren't too keen on it. Basically, they said "how old are you?" and I said "I'll be 40 when the baby is born" and they said "well, we'll let you try a VBAC but after 35 you're going to fail at it." I found that attitude to be pretty prevalent.

I think it's also frustrating because you can't get any good, unbiased information. If you go on the net and find a VBAC site, they make you feel like a stupid cow for even considering not doing a VBAC. If you look at an MD's opinion, it's pretty standard that you'll hear that it's dangerous to the mother and baby.

I met a woman from Chapel Hill the other day who had three kids under age 5. Her first was with a mid-wife. Her second was a c-section because the baby was breech and wouldn't turn. With her third, she tried to find a doctor or mid-wife who would do a VBAC (and this is in liberal, mid-wife friendly, crunchy Chapel Hill) and couldn't find one. In the end, she had a really easy birth at home. Of course, she was also a yoga instructor and pretty young, for what that's worth.

I think for the doctors, there is that desirable scheduling factor to be taken into consideration and that just makes me want to rebel and say that if I have another, I'd go for a VBAC, but the reality is, I'm not taking any chances if I get that far.

Good luck. It's a tough decision.

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