WARNING: This is like the longest post ever. I have a lot of thoughts on what I'm going through, and its all spilling out here.
So, at the appointment this morning, we found out that we ended up with
Option #3. As you can imagine, I'm a bit disappointed that my baby and my body are not cooperating with me on this. The Cesarean birth is planned for Monday, December 22nd, at 9am. The bad news is that its not what I wanted. The good news is that my pregnancy is over in just a few days and I finally get to meet my son!!!
The reasons for the Cesarean Birth are the same as I explained in the post I linked to above. However, I do want to clarify a few things, since I don't think my last post on it was very clear. Several of the comments and emails I received made it seem as though this issue is *just* about the size of the baby. Its really not. I would not be afraid of pushing out a 14 lb baby if I were given the opportunity. The problem is that I'm not getting that opportunity. And I know that the ultrasound is not known for its accuracy in predicting size, but its just as likely to be a pound under the real weight as it is to be a pound over.
The real issue is that his head is still "bollattable". Basically this means that his head is not down in my pelvic bones like it should be. Because of this I'm not dilated and my body is no where near labor - and won't be unless this were to change. Now, this situation is complicated because of the gestational diabetes, and again, not just because of the size. The fact is that babies with gestational diabetes not only gain more weight than other babies, but the WAY they gain weight is different - with a concentration of fat in the head, neck, and shoulders. This, of course, complicates delivery - with extra risk to his neck and shoulders. Well, extra risk to my body too, but I'm not so concerned about that. If it weren't for the gestational diabetes, I could wait until I was 42 weeks to see if things work themselves out. But I can't afford to do that, or I elevate the risk that we have to break his shoulders to get him out... or I'll labor for a long time and end up with a Cesarean Birth anyway.
Either way, it doesn't seem like that's going to happen anyway. We had a great talk with my OB-GYN today. Who, by the way, I love. If I may just take a minute: I could not be happier with ending up with
Dr. Rosenberg. She has been so gracious and understanding of the fact that my vision of birth has undergone some serious demolition in the last few months. And, she has never been pushy about any one course of action. At every step of the way she has made sure that we are informed of what was going on and what all of our options were. She is not the one that made the decision to move forward with the Cesarean birth. And she has also made it very clear that if I change my mind between now and Monday, one phone call to her will have it canceled, and we'll just move forward with my next scheduled appointment, which she didn't cancel just in case. She also let us know that she is on call in triage all day on Sunday, and I can go in again and have her check to see if anything changes over the next couple of days. Today at our appointment I had to really work to get her to tell me what she would do in my place--she didn't want to unduly influence my decision at all. I'm just really grateful that I ended up with such a fantastic OB-GYN, since I didn't want one at all in the beginning. I couldn't be more blessed in this regard (and its nice to have *something* with this pregnancy).
ANYWAYS, one thing I did get from the conversation with the doctor this morning is that if his head is not in place by this point, its not even really likely that its going to be. And beyond what she says is the norm - I'm listening to my body. I don't intuitively feel like labor is coming. I haven't any contractions. And I just haven't *felt* it. Its nice that the medical science backs me up this, but it doesn't matter anyway because I feel like I know whats going on with my body.
I'm doing okay with all of this, though. I've been reading
Birthing From Within in preparation for labor. I'd actually put it down for a while when all of this started, because I was feeling upset that I wasn't going to need all of its special little tips for a natural birth. But, on a whim, I picked it up again this week, and I'm SO GLAD because I came across
Chapter 25: How to Give Birth if You Need a Cesarean. The chapter starts off by encouraging us to use a better term than c-section. We're calling the birth of my son a Cesarean Birth. Its not a sectioning or a separation. He is being born.
She also gives some incredible tips in this chapter on ways to create a special environment so that we can have the kind of birthing experience we want, even though it is not the method we would have preferred. A lot of the burden for this falls on William's shoulders - describing to me everything he can see that I can't see, being my advocate to make sure I get to hold the baby as soon as possible, going with the baby everywhere he goes that we are never separated from him entirely, etc - and I'm so grateful for a husband who is willing and happy to step up to the plate to make this a great experience for our family.
So, we're going in with a game plan, and I'm feeling good about it. I've come a long way from the natural birth and the birth center that I had originally intended, but I've come to terms with that. Birthing From Within is a great book for many reasons, but I'm particularly in love with the very balanced approach that Pam England took towards the need for medical interventions in some cases. The fact of the matter is that if this were happening to me more than 500 years ago (Cesarean births were first successfully performed, with both the baby and mother surviving, in the 1500s) me and my baby would probably both end up dead.
There are a few studies out there that suggests extra risks to babies born via Cesarean Birth, namely allergies and asthma. These studies are sadly lacking, however. I can't find one that included more than a few hundred babies, and I've taken enough statistics classes to know that's a desperately sad sample for this kind of study. Especially given that the studies have all mostly included babies that were born EARLY (before 37 weeks) via Cesarean Birth, and so would have had underdeveloped lungs and immune systems anyway. My baby will be 39 weeks and 1 day, so that's not really an issue. AND, most of these studies make a point of saying that babies are especially at risk if their parents have asthma or allergy issues (wouldn't they anyway? - genetics, right?) and neither William nor I do--in fact, William has a Superman immune system. Again, not an issue. This just isn't something I'm especially worried about.
The baby will also be at higher risk for blood clotting issues, which means that I'm going to allow the vitamin K shot that I was otherwise going to decline. There are, again, studies linking the vitamin K shot with leukemia, but none of these studies are conclusive, and most of their findings don't even make sense. These studies are worse than the ones linking Cesarean Births and asthma. I was going to decline the vitamin K shot not because I thought it was dangerous, but just because I thought it was unnecessary. A baby having a normal birth, and then being breastfed usually has normal amounts of vitamin K within a week and doesn't need a boost. Even most formulas are fortified with vitamin K these days. BUT, I'm not having a 'normal' birth, so that changed my mind on that one.
Okay, I think those are all of my thoughts for now. If you made it through this post I applaud you. Longest post ever.
