Saturday, December 22, 2012

Just Give Me the Drugs

I like controlled environments (and I cannot lie).  

I'm not afraid to say it.  I enjoy a good scheduled c-section.  Not that I've ever had one that was exactly scheduled. 

You know those moms that are all, "I want to push this baby out myself with no drugs to numb the pain?"  Yeah, that's not me at all.  I really admire those women, but I admire them in the way I admire adrenaline junkies.  I think it's awesome that you like to go hangliding from the tops of snowy mountains.  But me?  I'm a bit afraid of heights and I think I'll just stay here on the ground, thank you very much.  During my nursing school rotations through L & D I became even more admiring of these women.  They rock. 

It's just that I feel like I always have to defend myself when I say I've had c-sections.  I'm really not a wimp.  I feel an obligation to tell inquiring people that I was fully dilated and pushing with no drugs on board with Matthew, but when they started squawking about bleeding and placental abruption?   Hell yeah I let them give me general anesthesia.  I wanted my kid out.  Alive.  And they pulled that off.  Mission fricking accomplished.  

When I found myself pregnant with Roo, I didn't even really consider a VBAC.  I was pregnant 6 months after Matthew's death, and I wasn't in the mood to test the strength of my uterine incision.  AT ALL.  Dr M (the exalted first perinatologist who died the year after my daughter was born and is thus unavailable to me during this pregnancy) did suggest one, but he seemed ok when I declined.  Until one hot July day when I wandered casually into L & D and asked to be checked for dilation as I was feeling a bit "off."  The nurses and Dr M were shocked to find I was at a 7.5 and could feel absolutely nothing.  Dr M couldn't help himself and told me I had a great shot at a VBAC.  Perhaps if Matthew had survived past his NICU stay I could've considered it.  Under the circumstances, I went with the original plan.  I didn't want to labor and wonder if it felt like last time and if that was a bad sign.  Or if my daughter was still okay in there.  Or if my uterine incision was going to hold up.  It was a decision made out of fear but I don't regret it.

During my postpartum visits, Dr M and I specifically discussed the possibility of a future VBAC.  He felt very strongly that I should not have one after 2 c-sections.  Because the issue was a moot point at that time, I didn't press him on the matter.  

Imagine my surprise when 6 years later the new perinatologist tells me he'd be "willing to try a VBAC" for this pregnancy if I so desired.  I was actually kind of annoyed.  I've seen the current research.  I know the chance of uterine rupture does not increase drastically between the second and third c-section.  I believe it's something like a 3% rate of uterine rupture for VBACs (correct me if you know different).  I quickly informed him that while he might be willing to take that risk, I was not so willing. 

It angered me because 3% might seem like nothing to him.  But percentages and statistics?  They don't comfort me at all.  Anyone know what the chance of a 22 year old pregnant non-drug abusing female having a placental abruption during the course of a normal pregnancy is?  Around 1 in 200.  Significantly less than 3%.  How about this one.  What are the odds of survival to hospital discharge for an infant born at 27 weeks gestation? Somewhere around 90% of these infants will survive to hospital discharge.  At 28 weeks those numbers increase to 95%.  You would think my son and I would fall on the favorable side of one or both of those statistics, right?  Yet we did not. 

The first thing I said to him was, "Dr. M felt very strongly that I was not a good candidate for a VBAC after he performed a c-section for my daughter.  I can't ask him why he felt that way.  Why do you think I would be a candidate?"  He quickly backtracked and said he wouldn't consider me a prime candidate, but that he'd be willing to let me try if I desired.  Right.

He also then mentioned that I would have to come camp out in his city from 36 weeks on.  And obviously pitocin is a contraindicated wonder in my case.  Pitocin increases the strength of uterine contractions, which is not a desired effect in VBAC patients due to the extra strain on the incision scar.  This means that if by some chance I did not go into labor on my own by 41 weeks, I could not be induced and would have to have the c-section anyway.  No thanks.  

It is my true heart's desire that doctors seriously quit asking me if I'm interested in a VBAC.  Ever again.  I am not. I have no desire to risk my life, my child's life, and my uterus.  I like the idea of holding my baby son in my arms an hour or two after checking into the hospital. The goals here are:  baby out alive, mama out alive, with as few shenanigans as possible. 

My second wish is for other women to not hassle me for my obstetric history and desire to continue with the form of birthing that works best for me.  I'm seriously happy and respectful of your desire to "feel everything" during labor.  Me?  I'm hoping to feel nothing but joy.  Hopefully I'll be seeing you natural birth ladies on the other side.  With both our healthy babies in our arms.


  1. I have three children, all born via C-section. My second was born after 1 yr and ten months and I chose c-section. Third was born seven years after my second. I would have attempted VBAC, but I chose to finally deliver by C-section.

    Marie here from ICLW :)

  2. Hello from ICLW! I've never had a baby but think if the time arrives I will definitely be taking advantage of some serious medications. It's like the natural birth is some kind of bragging honour for women. My bragging rights will be that I actually got a baby after all of my IF-BS.

    Wishing you peace in your decision (and for other people to get off your back about it already!!)

  3. Thanks for stopping by my blog! I think you should do whatever is best for YOU and YOUR baby. I admire my friends who go "all natural" during child labor, but I'm the variety that likes to take advantage of the pain-reducing meds. Good luck!

  4. It's amazing to me that anyone would even THINK to hassle you after everything you've been through. The thought of a c-section terrifies me (I don't have kids yet), but the thought of not taking home my baby at the end of everything terrifies me more. You have to decide what is best for you and your little one. I wish you the best of luck.