Wednesday, August 16, 2006

This is one stubborn kid!

No luck with the flipping today.

We started with another u/s to do a biophysical profile, as well as confirm Phred's position. I was thinking after the last u/s that calling Phred "complete breech" wasn't quite right, because all the pics you can find by googling show that as the head towards the top of the uterus, the spine basically lined up with your spine, then the baby in a cross-legged position. Phred is in a much more transverse like position, with the head over on my right, spine along the top of my uterus, then feet down near my cervix. Although all the websites seem to say that a transverse baby has their back / shoulder against the cervix. So Phred is upside down transverse. M was joking that it's because I was born in the Southern hemisphere, so all we would need to do is go back there to get our phlip.

I was really hopeful - the u/s tech said that there's plenty of fluid, and Phred is nowhere near engaged, so I figured it would be a snap to get a nice big phlip. Well, not so much. There were two docs there, one pushing up and out of the cervix on Phred's bum, and the other pushing down on the head/back. After the first attempt, although they were pushing down, somehow Phred ended up more like a complete breech. Then back to transverse, complete breech, and back to transverse again. Which was when they decided enough was enough, and it wasn't going to work.

They told me I was a real trooper, and took it much better than most. I figured if I couldn't stand this for 10 minutes, there was no way I could manage labor! As others have said, it wasn't exactly painful, but it was also next to impossible to relax. I did find that concentrating on my breathing helped a lot. But yes, it was mighty uncomfortable. I am definitely glad that we at least gave it a shot!

So anyway, now they want to schedule a c-section for 39.5 weeks (8/30 or 31). In a way, at least, I'm glad that Phred is transverse, because even the anti c-section books say that one cannot deliver a transverse baby vaginally, so I don't have to wonder if I should go out and try and find a practitioner who would let me deliver a breech baby.

I'm really torn as to what to do. Go ahead and schedule? Or tell them that I'm not going to, and wait until I go into labor on my own? I know that I had said in my earlier post that I would wait... but honestly I really thought that something would work, at least the version, and I wouldn't be faced with that choice. (Kinda like how I said before IF that if it didn't happen naturally that was the way it was supposed to be. HAHAHA)

Here are the pros and cons of a scheduled c-section as I see them:
Pro #1: Doctor feels it's safer than going into labor, as (especially given I've been contracting for so long) I may not recognize the labor until I'm well into it. Pro #2: Phred is born in August, which means we get a choice of which year to send him/her to school. Pro #3: Easier c-section when I'm not in labor? (must research this one a bit). Pro #4: Labor with a transverse baby can cause cord prolapse if the waters break, and uterine rupture if the labor lasts for a while. Con #1: I don't get to experience any true labor, which you may call me crazy for, but I was actually looking forward to. But then again they probably wouldn't want me to get far enough into it that I'd feel much anyway. Con #2: Phred may want to cook for longer - who am I to say that he/she is ready now? Especially as I was two weeks late myself, and refused to be induced 10 days before that. However, with basically zero pressure on my cervix, chances are that I'd go late just because of that and nothing really to do with how ready Phred is. Con #3: Less time for Phred to flip naturally, as slim as that chance may be, it's zero once I've had the section. Just found an abstract from 1990 that stated that 24/29 patients with a transverse lie at 37 weeks spontaneously converted by the time they went into labor, with 15 of those vertex. That's actually better odds than I was expecting. But the same paper says to perform version at 39 weeks and if not successful, c-section based on "major morbidity associated with expectant management of these patients".

Is there anything I'm not thinking of, either pro or con? What would you do? Yes, I am soliciting advice, opinions, and anything in between. I really can't make up my mind one way or the other at the moment. It probably doesn't help that I feel somewhat gypped by all this. As I said, I really was looking forward to labor and delivery, and I'm sad that I'm most likely not going to experience much if any of it. I know that once Phred is born I probably won't care one bit, but right now I'm a bit down in the dumps.


Anonymous said...

Drats, I'm sorry the fliperoo didn't work. I personally think that I'd schedule the c-section for the peace of mind that comes with making a decision, but hold out hope that it won't be necessary b/c Phred would phlip before that. It's funny, even though I'm trying so hard to get Pg, I haven't given any thought to the actual labor part. I'm much more focused on the end result. I'll keep sending flipping vibes. --Tomcat

VanillaDreams said...

Well, since you asked for opinions....

My opinion would be to go ahead and schedule the c-section.

I have many reasons for suggesting that, but one major reason came to mind when I heard the idea of "letting baby cook a little longer"....I know of several women, and one personally, whose babies were not delivered by their due dates....and unfortunately, their pregnancies ended in stillbirths and the only reason which could be found was that the baby was in utero for too long....even a few days makes a difference, as towards the end of pregnancy the umbilical cord and placenta have already begun breaking down and are not providing as much nourishment as in the earlier stages of pregnancy....

I know it sounds so scary to bring something like this up, but I have just read often and been told by the woman who experienced the above situation that it is safer to deliver slightly earlier than to risk going even a little overdue. Of course, I KNOW that millions of people have been born "late" and been just fine, too!

But personally, I would choose a scheduled c-section either right on or just before the due date, for my own personal piece of mind.

I know you will choose whatever works best for you -- and you sound like you research every option very thoroughly, which reminds me of myself!! ;)

I wish you the best with whatever you end up deciding!

You were very brave and tough to go through all that today! Not sure I would have been able to do that!

All the best,

Jenn said...

My vote is to schedule the c-section. I ended up with an emergency one for baby b and i think more controlled is better.

Katie (WannaBeMom) said...

Oh-- I'm caught up now! I know what you mean about wanting to wait and let Phred do his thing. I wish there was some yoga or something else you could do, but it seems like you've done it all. I don't even know if I can give you advice on this because I feel like I know nothing about this. What is your gut saying to you? That's the most important, I think, to follow your instinct about the whole thing.

fitgrl said...

I am so sorry that the flipping didn't work because I know how badly you wanted it to..

I have to go with the majority on this one and agree that I would schedule the c-section. It will be the safest for Phred and ultimately that is what you want most.

There is still time for the dramatic flip and then you will know that the labor was meant to be..

I know that you really wanted to experience labor but you will with the's a quick story about my friend that might help you feel better...

My girlfriend Sam was in labor for 24 hrs before they ended up having to give her a c-sec.. She wanted a natural birth and ended up using all drugs available & epidural and her little guy just wouldn't come out. She says in retrospect that she would have loved to have just had the c-sec to begin with..

I to am still sending flipping vibes!!

Emma B. said...

I'm with everyone else about scheduling the C-section. I'm sorry it feels like a loss, though. Doesn't seem fair that some of us have such a difficult time, from getting pregnant to delivery, does it?

Maybe it's just because I'm coming at it from the premature-twin perspective, but given that you're sure of your dates (within a range of a few days), I don't think I'd worry too much about Phred being "done cooking". (And you've also had steroid shots during the preterm labor scares, right?)

I know I've heard that non-emergent C-sections are easier on the mother and safer for the baby, and that intuitively makes sense. That's one of my major reasons for choosing that myself -- I don't want Baby B to get in trouble, like Jenn's experience.

Perhaps you could ask to do a quick positioning check the day before your scheduled C-section, and then cancel if Phred has done his/her thing?

Also, how amazing that you've gotten this far, especially after all the early scares!

One Mother's Journey said...

For what its worth, I'm 100% with vanilladreams on this one. I know how much you want a natural birth and I did too. I always thought that c-sections were the "easy" way out... that is so not the case in this situation. Your not opting for a c-section just because you don't to deal with labor or becauce your doctor is going on vacation - it's for YOUR health as well as your babies. There is always the chance, though small, that Phred will phlip and you can re-evaluate the situation at that time if it happens. I wouldn't take any chances - I would just schedule.

Good luck Nico.

PS. Thanks for the "pointing down" tip you left in my comments. I did wonder about that and decided that was probably the reason they ended up giving 2 cups instead of 1. LOL

DD said...

Keep in mind that with a scheduled c-section you get to be awake and your husband gets to be with you. You can even request to have a mirror aimed so you can see it happen.

If this goes emergency c-section (goodness forbid), you won't have any of that.

Ideally, yes, a phlip will happen, but why not have the c-section scheduled just in case?

I had a c-section, and quite frankly I couldnt care less if they had pulled him from out of a hat.

(another Pro: no squished up head. He'll be the most beautiful baby in the nursery!)

pixi said...

Ugh, I'm so sorry. I know you were really hoping that Phred would turn over. I guess it's good, though, that they're willing to schedule so close to your due date (you know, should you choose to go ahead and do that). At least that'll give Phred as much time as possible, so that he/she may do his/her thing. It's still possible, right?

I guess my inclination would be to go ahead and schedule. I think (as others have said) that if it has to happen, it's best that it happen in the most controlled circumstances possible. I'm sorry that you have to be contemplating this at all, though. It's really crummy. I'll keep my fingers crossed that somehow, there'll be a "turn of events," and you won't have to go that way after all.

S. said...

I think the more controlled c-section would be ideal.

Emma made a good point about checking his position the day of c-sect and if he's turned, then wait. Otherwise, just go ahead with it.

You know, it took some "work" to conceive Phred and things didn't come together right away like you'd hoped - and that was difficult for you to go through (as it would be for anyone). Try to enjoy the last few weeks w/Phred (the kicks, movements, etc) and don't be disappointed with whichever way you give birth. It's the end result you've worked so hard for! :)

Anonymous said...

I have been lurking for awhile, but wanted to post since you asked for opinions. I have had a long induced labor that ended without a c-section and a scheduled c-section due to placenta previa. I would have to say that after the initial pain of the c-section fades that the c-section was easier to heal from. Although I really wanted to try and have a natural birth that time, but it was not possible. I think that your situation is similar in that there are true medical reasons (avoid a cord prolapse which sounds like the cord is just about the presenting part for your baby) to have the c-section. Nevertheless, I have felt the stigma of saying I had a scheduled c-section because people tend to think that you chose it instead of it being for medical reasons. So my opinion would be to go for the scheduled c-section because recovery is much easier than from an emergency c-section and to avoid the possibility of a prolapsed cord which if your baby is facing downward seems like a significant risk. Whatever you decide, know that in any birth things would not go exactly according to plan so you would likely have some regrets to deal with anyway--I don't know if that helps, but nearly every mother I know and have talked to about this has something that she wished had gone differently. Good luck with your decision, and if you decide to schedule a c-section know that you are doing for true medical necessity. Sarah

soralis said...

Sorry that phred isn't cooperating with the flip-a-roo. I had to have a c-section and wasn't to happy that I was going to 'miss-out' on the whole labour thing. But really all that mattered in the end is healthy baby and mom!

Good luck with your decision. (Maybe if you book it Phred will decide to flip for you?? Maybe that might work! LOL)

Take care

Gandksmom said...

I went through labor (27 hours) with 2 hours of pushing for my oldest and ended up with an emergecy section. I was exhausted and felt as though I was really cheated out of the "experience". When they took her out, my MD told me that my pelvis was too small and that I would likely never deliver naturally (whatever that means). When I got pregnant with the baby whom I lost to ectopic, I was all gung ho on a "natural delivery" to make up for the one I was "cheated out of". Anyway, to make a long story short, when I was pregnant with Katie (my 3 year old) the MD told me I had a 20% chance of delivering vaginally. Too low for me and I went with a scheduled section. It was the best birth experience I have had. I wasn't tired, I was alert and the baby was fine. I vote for scheduled section.