Only five weeks to go!

I've had lots to think about since seeing the obstetrician a few weeks ago.
And thank goodness for Mummy forums and trainee midwife cousins for placating me in the time between that appointment and seeing my Midwife.  Because that appointment really freaked me out.

On seeing my Midwife I have been reassured that the obstetrician was being super conservative (and offering weird advice) and I am entitled to a lot more flexibility in labour than I thought.  Also, the obstetrician's notes for the Midwife were mostly unreadable (she had even passed it around the practice and NO-ONE could read a huge chunk of it), so I had to go over the entire appointment on seeing my midwife as the obstetrician has not yet re-sent readible notes.  This was actually good as meant we could clear some stuff up - and have some stuff explained as I didn't fully realise some things that were important either.

So while I'm happy to get the size scan (next week)* I'm gonna go my own way on a few of the other things.  Cos for me, if I can't have a vaginal delivery in a situation I find at least marginally comfortable, then I may as well have a C Section.  Cos fuck another 17 hours of labour but entirely in hospital under monitoring.  Yes it means a longer recovery, yes breastfeeding may be tricky and yes, this labour may not be as long as the last.  But if it is, 17 plus hours of hospital labour? Sorry, just not worth it to me.

So the plan now is that unless anything is obviously wrong, I will stay home until I feel like I need to go into hospital, or my contractions are at the usual point where you would go into hospital.  I do not feel this significantly endangers me or bubs because we live about a ten minute drive from the hospital (we have made this journey a few times now).  I know ten minutes can make a difference between living and dying, but I'm pretty sure from what I've read there will be other indications I need to get to hospital before things become that dire.  Last time I laboured at home for about 11 hours before going in.  I cannot imagine having to spend that much time labouring in hospital.  And do they have TV and Michael Keaton's Batman in hospital to labour to?  Unlikely.

So apparently the complete opposite is true of an epidural from other practitioners standpoints ie: they prolong labour and increase some other risks so I feel very happy with my decision to be epidural free unless I have to have another Caesar (as is my Midwife - nice to be on the same page).  I don't like giant spine needles.  And I would rather have a quick labour than a drawn-out-can't-move-stuck-in-a-bed-waiting-for-baby-time.  And epidurals increase the chance of requiring fontuse or forceps aided delivery, which I'd really like to avoid (just cos baby heads are squishy - I'm scared to touch them - I'm even more scared of sucky or pointy things touching them).**

And the water birth thing - apparently still possible and my Midwife is totally supportive.  So if I make it past 37 weeks and there is a pool available I'm gonna be all up in it.  Because whilst I've been told I will require constant fetal monitoring, again, this is optional.  Obviously if, at the time, either myself or any professional person thinks this is a bad idea we won't do this.  But at this stage I hope to negotiate monitoring every few hours so I can enjoy bath time once more.  Because I found labouring in water so much easier than not.  Water calms me.  Water enabled me to dilate from 4cm to 9cm in under an hour.  Water is the shiz.

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As for the non-technical day-to-day of things I'm feeling generally pretty bollocks.  Whilst I had an AMAZING weekend and lovely Monday, days have gotten less shiny over the last few days.  Things are generally more painful than they were last time, but I think that's mostly due to this baby being ridiculously active.  I have had to take pain relief to cope with the internal boxing this little one is doing in there just so I don't cry every night (super awake from 6pm - 9pm) and manage to get some rest.

While my hips have been better than last time, it's just at that point where I am very heavy, and that is naturally taking it's toll.  I woke up with numbness down one leg this morning - sounds bad, but it's just something that sometimes happens with hip displaysia so more annoying than anything.  I have physio tomorrow so hopefully that will sort things out a bit.

I do think we're coming into the home stretch.  After how bad things were yesterday Murray predicted we'll have a baby by Sunday.  I think that's pushing things a little.  But I do think it'll be some time in the next few weeks.  There are a few things happening now that feel very similar to during the week before Etta was born: excessive carbo loading, overactive bowel (probably just cos of the carbs), pubic bone pain so bad I sometimes can't walk, sore lower back and period like pains. And (different to last time as didn't get these), Braxton Hicks with any physical exertion ie: getting up.  And my freezer is tidy and has enough meals in it to survive at least a week.  These things are definitely sending me into an early state of Hermitage and making me envisage a baby on the not-so-distant horizon.

Luckily for me I have a lot of family support and have finished work.  I have someone helping look after Etta (or taking Etta away for a bit) every day besides Wednesday's and Thursday's - and there is always someone on call to help out those days if needed.  I want this baby to cook a little bit longer.  35 weeks is a fab achievement, but as I said above, I'd love to make 37 and get another crack at this natural water birth thing. 

So fingers crossed for a fairly average sized baby at next weeks scan!

*cos it's not that intrusive or difficult to get to (I go to a place literally 2km from my house), and if I am carrying a giant baby and it is going to increase risks in labour I do want to know.  Mostly because it's quite likely the baby will be posterior again (I found out this is also far more common if you are a short arse like me, and Etta was, and this one currently is) and that plus big = particularly hard times.  In saying that, I've just read multiple accounts of sizing scans being notoriously unreliable (like, out by up to 2 pounds unreliable).  So they're going to have to present me with some elephantastic type size before I go yeah yeah nah on the VBAC thing and yeah yeah yeah on the celebrity style C Section.

**Please know I do not judge women who choose these things - they just freak me out, so I don't want them.  And I have had an epidural as had to prior to the C Section and it was a total lifesaver in that instance.  But if I can avoid having one in future then I totally will!

On Pondering a VBAC*

So I had my obstetrician appointment on Tuesday and was overwhelmed by information.

Mostly because I'd been in this Hannah-daze where I just figured having a baby naturally was no big deal.  I hadn't researched it at all, cos I naively figured there was nothing to it.  I figured the hoohaa about VBAC was to do with ladies being traumatised by their emergency C Sections (fool!)  So although I am allowed a VBAC (yay?) I came away a little shell shocked by stats and rules and numbers.

The main scary stat being that 1 in 200 VBAC's end up in uterine rupture.  And that's just the stats if everything is straight forward.  That's not including the increased risks if:

1) You have to be induced
2) The baby is large
3) You fit into a high risk category (I tick at least two of the high risk boxes)

I don't want my uterus to rupture.  I had never considered this ever being something that could happen to me.  I've had enough experience with almost exploding organs to not be so keen on having that happen to anything else.  And sure, that's a 0.5% chance, but given how many times I've been the random 0.0054 something percent thing that goes wrong on so many occasions - I don't trust me to not be that 1/200 person.  There are many reasons why it's good to have a uterus, even if you don't need to use it any more.  Even as just a place marker, it's really important - trust me.  I'd really like to keep mine if possible please.

And then she told me all the 'rules' around VBAC:

1) You must go to hospital as soon as your waters break, or your contractions are a few minutes apart.
2) You must have a line in once you get there.
3) If I go over, I go Caesar (cos higher risk again)

They sound like small things, and they are very practical things but they also make me have to completely rethink how I plan to labour.  Cos line in generally means no water birth.  And, having previously experienced both, labouring in water is way easier than labouring outside of water.  And it's recommended you have an epidural to increase your chances of not ending up in an emergency C Section.  Fuck that.  I'm good with needles but I don't like them near my spine.  It's just one of my things.  That was the worst part of the C Section last time.  But it ups your chances of success (70%) by something like 10% because you are less stressed and comfortable.  And there's still a 30% chance of failure - so if you're that guy you have to get an emergency C Section after all that suck not-in-the-water style labour.  Suck.  Stupid damn stats!

I don't think I'm gonna go over though.  So I'm not too fussed about that.

Also - and this was actually interesting to learn - babies positioning is not always just random luck or not doing the right yoga all the time.  It can be affected by the shape of your uterus or other genetic factors.  Etta was posterior and face first which is why she got stuck.  I was also born face first (naturally).  My Mum was also born face first (naturally).  None of these labours were simple.  Grandma 'saw the white light' whilst having Mum, and Mum had massive problems in labour and post birth with me.  I was the lucky one having the C Section.  So it's totally possible this baby will try to come out face first too (but equally, it may not).

So after learning all this stuff, I can fully see why so many women opt for an elective Caesar following an emergency one.  WAY less complicated than VBAC.  You get given a date.  You can tell your family and friends and husbands boss.  You can find somewhere to store your toddler while you're in hospital.  You don't have any pain (usually) beforehand.  It heals much easier than an emergency C Section and you get handed a baby at the end like magic. Ta da! 

The downsides are you still have to recovery from a major surgery whilst looking after a newborn.   And it's major surgery, so there is always a risk involved.  Also, any future pregnancies must be delivered by C Section (cos uterine rupture stats increase again).  I don't want to have any more kids so not my problem, but still, something to sway other folks.  Also, just more scar tissue in your body, which is not really great.  Cos scar tissue complicates everything (like causing uterine rupture).  Also, more drugs for your baby (this had no impact on us last time, but something to consider).

What was also quite humorous was having this professional obstetrician lady stare at me and say - 'You look big.  I think your baby is big'.  I told her I've been measuring totally normally but she gave me that look like, no, there's no way.  So she measured me.  I'm measuring totally normal.  More normal than with Etta.  It's just an optical illusion.  I am a short arse (quite.  5th percentile).  I am carrying an average sized baby (50th percentile) ergo I look 'big'.  But I'm not big.  So shame on everyone.

In spite of saying in a recent post that I didn't care what size this baby is, apparently I should.  Because I had a C Section last time, and because of all the risk factors blah blah, I have to have a 'sizing' scan at 36 weeks.  Based on that scan if the baby's EBW (estimated birth weight) is 4kg or more (8lb 13oz) then I have to have a Caesar.  To be honest, I'm good with that.  Equally though, I doubt I'll make it to term.  I had a gut feeling last time and I have the same again.  I reckon I'll pop somewhere between 36 and 38 weeks.  I just have to wait and see.  Not long now...
                                                                                                                                                
                                                                                                                                                                      This is not big.  This is totally normal.  Shame.                                                                                        
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So I totally freaked out a bit after that appointment.  Subsequently I've asked other people (via my fab Mummies group) about their experiences with VBAC, and spoken to my awesome trainee midwife cousin about her thoughts on it.  And, of course, talked to Murray about it.  I haven't seen my Midwife yet, but I trust her to provide me with even more information and her thoughts and feelings on it cos she is awesome.

All of these things have been super helpful.  While I did hear some horror stories via my Mummies forum I expected and needed to hear these**.  And for the most part people were quite positive about their experiences.  My cousin is also in favour, but reiterated how important it was to make the right decision for me.  And that there was some flexibility within 'the rules' (very important to me).  I know for some women (via forum and general discussions) it's important to deliver naturally as they felt robbed of this with their initial C Section.  I don't.  I felt totally ok with what happened last time, so I don't feel any strong need to 'rectify' this the second time around.  However, I do like the idea of getting to know my new baby without having just had major surgery.  That would be pretty cool.***

The best thing is that no matter what I decide, I can change my mind at almost any time (probably not once I'm in labour).  So bearing that in mind, it seems most logical to me to choose VBAC (without the epidural thanks).  There's less pressure and stress having to book a Caesar than having to unbook one.  And in the meantime there are many resources to peruse to aid in my decision.  And hey, come 36 weeks they might find a whopper in there and the decision will be out of my hands.  And that'll be ok too.

* Vaginal Birth After C Section

** In a forum of almost 2500 women who (mostly) have been through labour, with stats of 1/200 there are gonna be some women who've had a uterine rupture.  And they will likely also be the people who are most likely to comment on a post about VBAC (cos that's hella traumatic).

*** Equally, secretly the planning part of me would love to have a date.  So convenient!  No labour planning required.  Just get up one day and go 'hey baby, I'm going to see you today' and have a lovely ride into hospital without being in contractions.  And Etta can go get an icecream with my Mum and then hey presto - there's the new baby!  She can come and meet it.  And I can dress nicely and look like celebrities do when they've just had a baby (rather than like someone who's just survived Texas Chainsaw Massacre).