So far things are going well. I was very nervous for my first midwife appointment and I think it was mostly because its so different from my last 2 pregnancies and seeing an OB. The midwife was very sweet and extremely informative. She went over every detail of the state required testing and exactly what was being tested for. I remember asking the lab at the beginning of my last pregnancy what was being tested for and the lab tech drawing my blood either couldn't or wouldn't tell me. Its so nice to be openly given information about what is going on and given options to make the decisions for yourself. The MW had a little trouble finding the heartbeat, which made me nervous, but she got a different doppler and found it pretty quickly.
The second appointment was with the other midwife that I hadn't met yet. I'd been warned that she seems harsh and not to be put off by that. I can't say that I found her difficult at all, but she definitely seems more strict. She is absolutely very much naturally minded and did not approve of me getting antibiotics for strep throat. She gave me the impression that she thought it was an uneducated decision on my part and I just blindly accepted whatever the doctor suggested. It wasn't. I did my research on strep and the use of antibiotics for strep during pregnancy. Otherwise everything at the appointment went perfectly.
The only thing that I wish they did that they don't is ultrasounds. As a VBA2C patient I will be required to have one at 36 weeks to check the placenta position, but if I didn't have a scarred uterus they would require no ultrasound at all. There is an option to get an ultrasound after 19 weeks through the local college sonography program. I tried that, but after a month of calling and leaving messages I had not been able to get in touch with anyone. I local friend told me the name of a place just opening up and I looked into it. Its a 3D/4D ultrasound place and made an appointment with them.
My main issue is working on overcoming my own fears and doubts. I'm so terrified that something will go wrong, or some complication will arise and risk me out of the birth center and then I'll be stuck with an unsupportive OB. I've joined the ICAN Facebook group and a VBAC support group as well, but there are so many negative posts and stories about failed VBAC attempts or those who just change their minds. I wonder why some are even there because the seem to do nothing but push interventions and RCS. At this point I'm not there for extra research as I've done tons of that. I'm aware of the potential risks of all my options. I'm looking for positive birth stories with great outcomes to prepare my mind and keep myself thinking positively. I need to conquer my fears and replace the negative thoughts with positive thinking. I don't have a lot of support from the people around me and need to find a way to build myself up. That is where I am now. My next midwife appointment is in January and the 3D ultrasound is a few days after that.
Sunday, December 22, 2013
Monday, November 4, 2013
3 hours till my first midwife appointment
At this moment I am 3 hours away from my first midwife appointment. I am 12 weeks 1 day. There are a million things running through my mind and I'm excited and nervous. Maybe I'm being silly being so about my very first appointment with my third child, but this is different. This time its a midwife. This time I've had 2 prior cesareans and am considered higher risk and I have to think about and prepare for things that non cesarean and non VBAC women don't necessarily have to think about. This time we are paying a very large amount of money out of pocket and we still aren't sure where all of it will come from and how we will work it into the budget. This time is different, and I'm nervous.
My husband and I have talked about this and the risks and his fears and concerns. We will surely talk about it more in the coming months. We will have to 'explain' to our families (once we tell them) and my husbands sister is a surgical nurse and will NOT understand to approve of our decision. Not the we need her approval, but I don't like having to defend myself and the decisions I have the right to make just because she wouldn't make the same decisions. There is just so much to think about and consider and be nervous about. This is uncharted territory for me and I will confess to fear and even lack of confidence. All the what ifs are right there. All the people who won't be supportive or there to believe in me are taunting me in my mind. I know. I know that I HAVE TO get past that and move that mountain out of my way. I know that and I intend to work on it, but right now it is still looming in front of me. I want this VBA2C. I need it. It will take a lot off our plate if I can have a vaginal delivery with a quick recovery with this baby. Being laid up after surgery and not being able to pick up my two older kids will be impossible for me. There is no possible way my husband can take off enough time to help me out if I have a cesarean. We have nobody else who could help me either. I need this VBA2C. I am officially on the path. I hope and pray that I remain low risk in every other way with no complications. I hope there are no potholes or boulders on this path that could derail my plans. I hope and pray that I am strong enough.
My husband and I have talked about this and the risks and his fears and concerns. We will surely talk about it more in the coming months. We will have to 'explain' to our families (once we tell them) and my husbands sister is a surgical nurse and will NOT understand to approve of our decision. Not the we need her approval, but I don't like having to defend myself and the decisions I have the right to make just because she wouldn't make the same decisions. There is just so much to think about and consider and be nervous about. This is uncharted territory for me and I will confess to fear and even lack of confidence. All the what ifs are right there. All the people who won't be supportive or there to believe in me are taunting me in my mind. I know. I know that I HAVE TO get past that and move that mountain out of my way. I know that and I intend to work on it, but right now it is still looming in front of me. I want this VBA2C. I need it. It will take a lot off our plate if I can have a vaginal delivery with a quick recovery with this baby. Being laid up after surgery and not being able to pick up my two older kids will be impossible for me. There is no possible way my husband can take off enough time to help me out if I have a cesarean. We have nobody else who could help me either. I need this VBA2C. I am officially on the path. I hope and pray that I remain low risk in every other way with no complications. I hope there are no potholes or boulders on this path that could derail my plans. I hope and pray that I am strong enough.
Tuesday, October 8, 2013
Progress!
The last few weeks have been extremely busy! I have spent much time online searching, asking for advice from local mom groups, and calling OB offices everywhere. The OB calls are usually very quick and go something like; "Hi, I am pregnant and looking for an OB who is willing to work with me on a VBA2C.", the receptionist either immediately tells me, "Oh we don't do those." or some will double check to make sure I just said 2 previous cesareans and then tell me that if it was just one I might have a shot but with 2 there really is no way. Its depressing, discouraging and infuriating. Infuriating because I feel so strongly that it should be MY CHOICE! I understand that most OB's are uncomfortable with their own lack of control in a labor situation with a woman who has had 2 cesareans and they have too much fear to want to be a part of it. At the same time, the overall risks are comparable or better if I birth vaginally, but I guess a surgeon wants to cut and feel they can control the risks better in that situation. I get it. But shouldn't I get a vote!?
Well. I did finally find an OB who is willing to take me on as a VBA2C patient. He will be a great option if I risk out or can't complete the pregnancy with the midwives. The issues with this OB are that he has privileges at the local hospital that is VERY unfriendly towards VBACs and if this exact OB isn't on call when I go into labor, I end up cut open. My last VBAC failed due to pressure from supposedly VBAC friendly hospital staff, so that is an option my entire system rebels against. I also really don't like some of this hospitals policies and standard protocol regarding babies and their care. Specifically that they have a mandatory nursery stay for all babies for observation and monitoring. That's it. No medical indications, but all babies must be monitored in the nursery for 2 hours. So, while its great to have that option, it is not my first choice and feel my chances of success are sincerely diminished if I choose this option.
I called the midwives back to see if I could negotiate the price down with them, but they won't budge on the price simply because I'm a VBA2C. So I talked to the hubby again and finally had a really good, long talk about this with him. We talked about the risks and he asked a ton of questions about c/s vs VBA2C stuff and made some comment that I seemed very determined to do this with the midwives. I've been mulling it over for another week or so and called the midwives today to make my first appointment for early November! I'm terrified and excited and nervous and borderline hysterical even. So much running through my mind, and the foremost issue is how I'm going to come up with a second mortgage payment each month to pay the midwives! But my appointment is made!
Well. I did finally find an OB who is willing to take me on as a VBA2C patient. He will be a great option if I risk out or can't complete the pregnancy with the midwives. The issues with this OB are that he has privileges at the local hospital that is VERY unfriendly towards VBACs and if this exact OB isn't on call when I go into labor, I end up cut open. My last VBAC failed due to pressure from supposedly VBAC friendly hospital staff, so that is an option my entire system rebels against. I also really don't like some of this hospitals policies and standard protocol regarding babies and their care. Specifically that they have a mandatory nursery stay for all babies for observation and monitoring. That's it. No medical indications, but all babies must be monitored in the nursery for 2 hours. So, while its great to have that option, it is not my first choice and feel my chances of success are sincerely diminished if I choose this option.
I called the midwives back to see if I could negotiate the price down with them, but they won't budge on the price simply because I'm a VBA2C. So I talked to the hubby again and finally had a really good, long talk about this with him. We talked about the risks and he asked a ton of questions about c/s vs VBA2C stuff and made some comment that I seemed very determined to do this with the midwives. I've been mulling it over for another week or so and called the midwives today to make my first appointment for early November! I'm terrified and excited and nervous and borderline hysterical even. So much running through my mind, and the foremost issue is how I'm going to come up with a second mortgage payment each month to pay the midwives! But my appointment is made!
Tuesday, September 24, 2013
"Failed VBAC"
I got my medical records yesterday. I requested them a couple of weeks ago from the clinic where I was seen throughout my first two pregnancies. I was surprised at the large stack of stuff I got, but there wasn't any information in there that was new or surprising really. The OB had made various notes during my second pregnancy about 'patient desires vbac' and how he had counselled me on the risks and benefits of a vbac. Mostly the risks and repeatedly on the 'chance of rupture'. Don't get me wrong, the OB is a great one and he was very supportive and mentioned that the risk is only 1% higher for rupture as compared to a first time pregnancy. But is was interesting to look through all the paperwork and look at all the test results of all the blood tests I underwent. I was in a groove and had a good pace going in looking through everything beginning with the infertility before we conceived our daughter and the procedures and tests we went through to figure that out. Then the pregnancy when we finally got pregnant including the sudden bleeding at 17 weeks and how the ER doctor told us we had a 50% chance of losing our baby and diagnosed me with placenta previa. I had to wait 2 weeks to find out from my OB that is a subchorionic hemorrhage and that everything was fine. All of this I knew and read over with relative ease. And then I got to my second pregnancy, specifically the birth.
'Failed VBAC', 'Failed attempted vbac' or some variation of those words appear repeatedly on the pages. It describes my 'failure to progress', and that they couldn't use augmentation methods due to my previous cesarean. I knew this too, of course. I still have a lot of regret over not staying stronger for longer to wait it out. I could have done it. I should have done it. Then I wouldn't be where I am now. I would have a chance now, if only I had persevered last time. Its already hard when you internally feel like a failure and weak because I caved in to the pressure and negativity being thrown at me by the medical staff. But nobody forced me to make that call. Yes, they mentioned it every single time someone walked into the room, but they didn't make me do it, I could have said no. I did many times, but that last time I didn't. I failed. I failed because 'they' failed me. Because they wanted me to fail. They expected me to fail and did absolutely nothing to help me not fail. None of those people working there that day, on Good Friday, were there for me. None of them wanted to be there and none of them wanted to wait for my baby to be born on his terms. So I failed. I am a failed VBAC patient. Now because of the '2' added to VBA2C, I will have to fight twice as hard (if not harder) for what I want for me and my baby. Because I failed last time.
'Failed VBAC', 'Failed attempted vbac' or some variation of those words appear repeatedly on the pages. It describes my 'failure to progress', and that they couldn't use augmentation methods due to my previous cesarean. I knew this too, of course. I still have a lot of regret over not staying stronger for longer to wait it out. I could have done it. I should have done it. Then I wouldn't be where I am now. I would have a chance now, if only I had persevered last time. Its already hard when you internally feel like a failure and weak because I caved in to the pressure and negativity being thrown at me by the medical staff. But nobody forced me to make that call. Yes, they mentioned it every single time someone walked into the room, but they didn't make me do it, I could have said no. I did many times, but that last time I didn't. I failed. I failed because 'they' failed me. Because they wanted me to fail. They expected me to fail and did absolutely nothing to help me not fail. None of those people working there that day, on Good Friday, were there for me. None of them wanted to be there and none of them wanted to wait for my baby to be born on his terms. So I failed. I am a failed VBAC patient. Now because of the '2' added to VBA2C, I will have to fight twice as hard (if not harder) for what I want for me and my baby. Because I failed last time.
Thursday, September 19, 2013
Searching, Searching and Searching
Since it appears its the money is going to be an issue and I may not get to go with the midwives, I've been calling and searching and calling, desperately trying to find an OBGyn who is willing to work with me on a VBA2C. Every single place I call tells me that they 'don't do those here'. I have had some secretary/nurses tell me that that OB sometimes does VBAC, but not a VBA2C. They say its because of the risks and I just want to SCREAM!!! I want to throw a temper tantrum the likes of which could compete my nearly 3 year old daughter. Do you not ever ready anything new that comes out from the ACOG?! You are so misinformed! I asked on a local facebook group for suggestions and advice and I got nothing but negative information about how impossible it is to find a VBAC friendly doctor, much less someone who'd be willing to advocate for me. Its an impossible dream, apparently, to want a VBA2C in the state of Texas, or at least in my area of Texas. Its been suggested that I go to a town 2 hours north of me, where there are supposedly some OB's who would 'allow' me a trial of labor. The issues I have with that are that it is 2 hours away, and if I go into labor in the middle of the night, I have to wake up my two kids and drag them with me because I don't have anyone to watch them here, and I wouldn't be comfortable with that anyway because I don't like being that far from them. Or from home, for that matter. It would also mean that I'd have to drive 4 hours for every single appointment, with my two kids. And I'd have to drive that every week during the last month. That wears me out just thinking about it. I shouldn't have to do that. It shouldn't be this hard! Its my body and I should be able to choose this for myself. I am a grown as woman and I have done my research! I can make my own medical decisions! Why should they get to force a surgery on me when the overall risks of surgery versus vaginal birth after cesarean (even multiple) show that vaginal birth is overall safer? Anyway, that's where I am with that.
I went to a hospital tour of the local hospital that is literally one minute from my house. How awesome would it be if they were an awesome hospital? Unfortunately, they are not in the least bit VBAC friendly. There were a few things I did like about the place. I liked that in a vaginal delivery they immediately place the baby on mom's chest as routine policy. I like that they encourage breastfeeding and rooming in. I liked the big clean labor rooms, but why are the regular rooms always so cramped and small? That is where you have more visitors. Also, why separate rooms for labor, recovery and then a regular room? Why can't there just be one room that you stay in? But I digress. I didn't like that they take the baby after you leave the recovery room just to bathe and observe the baby for 2 hours in the nursery. I don't understand that. Why are parents in a hospital not allowed to bathe their own baby for the first time? And why can't they 'observe' the baby while he or she is with mom? I didn't ask, but I imagine the separation is even longer with cesarean babies. I am also annoyed by the no pictures of video policy of hospitals during the deliver of the baby, especially cesareans. It makes it seem like they have something to hide. They don't want any record of it if the screw up, giving them deniability. That's how I see it anyway. Maybe they have a genuine and reasonable reason for this policy, but it has never been explained to me. They also had a booklet handout at the tour. I've read through it and am annoyed at the tone of it. The baby will have routine this or that, This WILL happen, that WILL happen. As though there is no other way and no choice whatsoever of the parents/patients. That was that tour. I will hopefully not see the inside of that L&D anytime near May!
This is where I am now. Still not sure what will happen or how or even if I will get my dream. I have had almost all hope dashed at this point, but I am not above going rogue and just doing my own prenatal care and waiting till the baby is literally coming out before going into the hospital if I can't get the midwives.
I went to a hospital tour of the local hospital that is literally one minute from my house. How awesome would it be if they were an awesome hospital? Unfortunately, they are not in the least bit VBAC friendly. There were a few things I did like about the place. I liked that in a vaginal delivery they immediately place the baby on mom's chest as routine policy. I like that they encourage breastfeeding and rooming in. I liked the big clean labor rooms, but why are the regular rooms always so cramped and small? That is where you have more visitors. Also, why separate rooms for labor, recovery and then a regular room? Why can't there just be one room that you stay in? But I digress. I didn't like that they take the baby after you leave the recovery room just to bathe and observe the baby for 2 hours in the nursery. I don't understand that. Why are parents in a hospital not allowed to bathe their own baby for the first time? And why can't they 'observe' the baby while he or she is with mom? I didn't ask, but I imagine the separation is even longer with cesarean babies. I am also annoyed by the no pictures of video policy of hospitals during the deliver of the baby, especially cesareans. It makes it seem like they have something to hide. They don't want any record of it if the screw up, giving them deniability. That's how I see it anyway. Maybe they have a genuine and reasonable reason for this policy, but it has never been explained to me. They also had a booklet handout at the tour. I've read through it and am annoyed at the tone of it. The baby will have routine this or that, This WILL happen, that WILL happen. As though there is no other way and no choice whatsoever of the parents/patients. That was that tour. I will hopefully not see the inside of that L&D anytime near May!
This is where I am now. Still not sure what will happen or how or even if I will get my dream. I have had almost all hope dashed at this point, but I am not above going rogue and just doing my own prenatal care and waiting till the baby is literally coming out before going into the hospital if I can't get the midwives.
The Back Story
On September 6, 2013 I got a positive pregnancy test. The line was very light but definitely there and confirmed the following day with another test and a darker line. My mined immediately went to the birth and what I wanted for the birth. A VBA2C. This is apparently twice as hard to get as a VBAC.
I didn't think it would be THAT hard. We moved about 9 months ago from one Texas town to another one 2 hours away, but this one has a birth center and midwives so I had high hopes. I thought that was all there is to it. I'll go with the midwives and that will dramatically increase my chances of success because they will support me and help me. They will believe in my and the ability of my body to do what its designed to do. There is no reason for me to not be successful. My first cesarean was scheduled because my daughter was breech, my second was an attempt at a VBAC with absolutely no support. My water broke at 2:30am on Good Friday and we went to the hospital at about 5am. My progress was slow and the nurses wouldn't let me eat or drink anything. I was told my birth plan was meaningless and it was completely disregarded and then I was badgered non-stop for the next 13 hours to give up and just go with a c-section. I finally ran out of energy to fight it anymore and gave it. I have regretted that every day since. I promised myself that if I ever had another child I would try harder, be stronger and be successful. Now, here I am. Pregnant again.
After I got that BFP, I called the midwives a few days later and made an appointment for a consult the next week. When I met with them a week later, I adored the one I spoke with and at the end of the meeting she went in and consulted with the other midwife in the practice and they decided that if I wanted to use them, they were willing to take me under their care. That was exciting. Then she asked about insurance and when I told her my carrier, she told me that they don't pay for midwives. Apparently, the midwives have been trying for years to get them to cover their service, but the refuse. This would make me a cash paying customer, and that fee is not too outrageous, but still pretty high when paid out of pocket.
When I got home, I began researching my insurance company. I looked over the policy and couldn't find anything there. I googled but didn't come across anything new or helpful to my situation. So, I called them and confirmed what the midwives told me, but I also got a rough estimate of the cost to us, after insurance, in the event of a repeat cesarean. The amount is almost exactly the same as the no-insurance amount we would pay the midwives. If it were a simple choice of picking one or the other its a simple choice, but in the event that I go through the entire pregnancy with the midwives into the start of my labor and then, for some reason, end up as a hospital transfer we would instantly double the cost of having this baby. And that is a LOT of money to us. When I told my husband about the costs being the same either way, he immediately went to how much it would cost if we had to pay both. And said that its a lot of money to throw at a MAYBE (referring to my VBA2C attempt). Without his full support and backing, I've got nothing. The midwives are my only option for even having a chance at a VBA2C at all. There is no doctor within a 4 hour drive from here that would even allow me to try for a VBA2C. Under the current circumstances I am left with only one option and that is a scheduled RCS.
I didn't think it would be THAT hard. We moved about 9 months ago from one Texas town to another one 2 hours away, but this one has a birth center and midwives so I had high hopes. I thought that was all there is to it. I'll go with the midwives and that will dramatically increase my chances of success because they will support me and help me. They will believe in my and the ability of my body to do what its designed to do. There is no reason for me to not be successful. My first cesarean was scheduled because my daughter was breech, my second was an attempt at a VBAC with absolutely no support. My water broke at 2:30am on Good Friday and we went to the hospital at about 5am. My progress was slow and the nurses wouldn't let me eat or drink anything. I was told my birth plan was meaningless and it was completely disregarded and then I was badgered non-stop for the next 13 hours to give up and just go with a c-section. I finally ran out of energy to fight it anymore and gave it. I have regretted that every day since. I promised myself that if I ever had another child I would try harder, be stronger and be successful. Now, here I am. Pregnant again.
After I got that BFP, I called the midwives a few days later and made an appointment for a consult the next week. When I met with them a week later, I adored the one I spoke with and at the end of the meeting she went in and consulted with the other midwife in the practice and they decided that if I wanted to use them, they were willing to take me under their care. That was exciting. Then she asked about insurance and when I told her my carrier, she told me that they don't pay for midwives. Apparently, the midwives have been trying for years to get them to cover their service, but the refuse. This would make me a cash paying customer, and that fee is not too outrageous, but still pretty high when paid out of pocket.
When I got home, I began researching my insurance company. I looked over the policy and couldn't find anything there. I googled but didn't come across anything new or helpful to my situation. So, I called them and confirmed what the midwives told me, but I also got a rough estimate of the cost to us, after insurance, in the event of a repeat cesarean. The amount is almost exactly the same as the no-insurance amount we would pay the midwives. If it were a simple choice of picking one or the other its a simple choice, but in the event that I go through the entire pregnancy with the midwives into the start of my labor and then, for some reason, end up as a hospital transfer we would instantly double the cost of having this baby. And that is a LOT of money to us. When I told my husband about the costs being the same either way, he immediately went to how much it would cost if we had to pay both. And said that its a lot of money to throw at a MAYBE (referring to my VBA2C attempt). Without his full support and backing, I've got nothing. The midwives are my only option for even having a chance at a VBA2C at all. There is no doctor within a 4 hour drive from here that would even allow me to try for a VBA2C. Under the current circumstances I am left with only one option and that is a scheduled RCS.
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