Wednesday, May 22, 2013

Charlotte Janae-Part 1

So after my last post I finally go to go to an OB checkup.  I got all my paperwork filled out and turned in and saw a Nurse Practitioner at the hospital.  I told her about how uncomfortable I had been and all the contractions that I had been having. So she checked me and I was still no where near going into labor.  No surprise really...I've never progressed on my own.  I was still hoping though! I had never been in so much discomfort and pain at the end of any of my pregnancies.  The baby and I looked good, and the NP put in a referral for me to have an ultrasound done at around 38 weeks to check the fluid, since Savannah's fluid was low at the end.  The clinic at our base didn't have any openings for an ultrasound, so I ended up having to schedule one at the Naval hospital 45 min away.  Boo.
 I finally got to see a midwife at my next appointment, at 38 weeks. Two weeks before my due date and that's the first time I got to see anyone that might actually deliver my baby.  For your appointments you see whichever midwife can see you, and when it comes time to deliver it's kinda the same thing. you don't have a set Dr unless you are a special case. I liked this midwife a lot.  She was super nice. She wasn't planning to do an exam to check and see if I'd progressed any, but I asked her to anyway.  Again, I had been having a ton of pressure and contractions and so much discomfort!  She measured me and then checked the baby's position.  While feeling for Charlotte, she said that her head must be way down "there", because she couldn't feel it, or... she thought she felt her head up by my ribs.  A few minutes and a quick peek with an ultrasound later and we discovered that we had a breech baby in there!  Suddenly everything about my birth plan changed.  The midwife brought in a doctor to explain my options to me.  There were a few.  They could do a procedure where they physically try and turn the baby. (Called an External cephalic version, or version. ECV) Then if the baby turned, they would go ahead and induce me so that she could be delivered while she was in the right position so we didn't risk her turning back breach. If the baby wouldn't turn, I'd have a c-section. Or I could just have a c-section.  I felt like a deer caught in the headlights...I went in expecting an uneventful checkup where I would find out that I was still forever away from going into labor.  Tony wasn't with me, as he had to stay with the girls. I suddenly had to decide what the plan was.  The wanted to schedule it for the following week, if they waited too long I could go into labor on my own. If I went into labor on my own and she was breech, It would require an emergency c section.  The Doctor that was going to be working on the day that they wanted to deliver was in the clinic that day and I got to meet and talk to her.  She actually had the most experience delivering breech babies! She felt that she could do a vaginal delivery with her being breech, but she didn't have enough people with that experience to be on her team.  And legally she couldn't knowingly do a breech delivery unless it was in more of an emergency situation. I immediately rejected the idea of just going in for a c-section.  So we made a plan to try the procedure first. I had a friend in Hawaii that almost had to have the procedure done so I knew that it was risky.  I asked the Drs about the risks, what little I knew to ask anyway. (If something went wrong with the procedure, I would end up with an emergency c-section)  They said that the risk was small and that they hadn't seen it happen often.  The Doctor scheduled me to come in the next week (at 39 weeks) and I left.
For the next few days I did as much research as I could on getting a breech baby to turn on it's own, and the ECV procedure. I was also feeling pretty silly for not knowing that she was breech!  It all made so much sense now.  There were lots of times that I told Tony I could feel her kicking my cervix...only to correct myself and say that I guess she was punching it instead? LOL.  All the pain and discomfort and the fact that she felt so much different that the others...I just blamed it on the stress and the move, and the fact that she was #4.  I had also told Tony that it felt like she hadn't gotten the memo that she was supposed to be curled up in there.  It felt like she was all stretched out.  Well, she WAS!  ha ha.  It gust never occurred to me that she was head up. 
In my research on the ECV I came across a couple of friends that had had the procedure done...and it ended horribly with traumatic emergency c-sections! (baby's heart rate suddenly dropping ) The Doctors said it was rare...but how had it happened to two people that I knew??!  I also learned that the procedure was best done no later than 37 weeks, so the baby wouldn't be so big. It was more dangerous if you had an anterior placenta, and if the baby was foot long breech. (Feet by the cervix vs. bottom next to it.)
 I had my ultrasound to check the fluid a few days after the check up.  The fluid was fine.  Baby was measuring over 8 lbs already  and a week ahead.  She had a foot lodged in my cervix and her placenta was on the top.  Her head was tucked behind my ribs so much so that the technician doing the ultrasound couldn't see any of her face, and couldn't get her to move at all.  The technician kept saying that she was squished in there.  This was on Monday, before I was scheduled for the ECV the following Friday.  After the ultrasound I was more nervous about the procedure than ever. I had a final check up on Thursday. I  saw a midwife first who told me that the ultrasound results that had been sent to them from the other hospital said that Charlotte was in the correct, head down position. What?!!  I told her that she definitely was not, and she could also tell by feeling that she was still breech.  So she brought in the little in office machine and check real quick.  Yep, still breech.  The hospital that did the ultrasound just failed to get that little piece of information correct. (government healthcare at it's finest)
I had to wait quite awhile to be able to see the Dr that was going to be seeing me for the procedure and delivery.  I finally saw her asked her about the risk, now that we knew all these things about Charlotte. Tony was able to be with me for this appointment so we both asked all that we could think of.  At this point I was leaning toward not having the procedure done.  The Dr still said that we could "try anyway"
I appreciated the fact that she seemed confident, but she had only met me once before.  She had never given me an exam or seen a sonogram of the baby.  She knew nothing about me, and seemed to dismiss all of the risk factors a little too easily, I thought. I really didn't know what to do.  The only things I knew for sure...I did NOT want an emergency c-section, and I didn't want to risk anything going wrong on Charlotte's end.  At all. We had no idea the position of the cord, or why she wasn't turning in the first place. Even if they could get her out within moments if something went wrong, even moments without oxygen could affect her for the rest of her life.  I wasn't afraid of the procedure on my end so much, even though I'd heard how very painful and awful it could be. The only risk to me was the placement of the placenta.  With it being anterior, it increased the risk of placental abruption which was dangerous for both of us.  Even after much prayer, I just didn't feel at peace with the procedure.  I didn't care at all about a scar from a c-section, but I was concerned about the recovery time.  I had 4 children to care for, and we were in a new town where we knew practically no one.  A long recovery time just wasn't an option. I couldn't get past the fact that I didn't have peace about it though, and my instincts were telling me not to do it. ( My intuition is almost always right)  So...two words that I never thought would apply to me, were suddenly my plan. C-Section. 
I suddenly had to be at peace with that.