Photo chosen not for topical relevance but because a 2-year-old shoveling snow is funny.
I was thinking that I always feel like I have to wait until I am in a great mood in order to write a blog post. Or you know, maybe after some sort of trial has just ended, just in time for me to feel philosophical about it (because you know I always do) and tie it up in a nice bow--a cutesy one with double loops and wired edge ribbon. Plus if I am cranky, or tired, or going through something difficult, then maybe I won't love the end result of the post 24 hours later when I snap out of it. This is not exactly my diary, even though it feels like it is, and once I put something out there I can't take it back.
But oh well. I have been pretty moody lately. Let me rewind. In October I noticed that occasionally my heart would race. Not for long, really only for a few seconds at a time. Matt and I were surprised because I have always had amazingly low blood pressure, thanks to my "big old cow heart" in Matt's words. (Really my heart is normal sized but the low BP is genetic.) So for these "tachycardic episodes" I blamed the iron supplements I was taking for my anemia and stopped them. It got a little better, then worse, so I blamed the anemia and started taking the iron again.
In early December right as morning sickness was subsiding, I contracted a particularly awful brand of food poisoning, on the exact same day that our heater broke on the first day of a cold snap, and so over the course of 2 weeks I thought I might lose my mind, and at very brief moments that my heart might jump through my chest. It reached a grand climax a couple of weeks before Christmas that involved me sobbing to Matt on my basement futon late one night after a nurse told me over the phone that I needed to go to the emergency room. I sobbed so hard that I started laughing in cathartic relief once I heard myself.
Skeptical of the nurse, I talked with my doctor at length about it a few minutes later. I received a diagnosis that finally made perfect sense: anxiety. Pending thyroid tests but anxiety is likely. The antidote for which being: chill out. Of course, said anxiety being fueled in part by hormones turns chilling out into a major challenge.
Now it is early January and the tachycardia is almost completely gone. I seem to have succeeded in chilling out at some level. I feel like after 3 months I can finally say as an absolute fact--YES. I Am Feeling Much Better.
So on to one of many causes of my early pregnancy anxiety. People always seem surprised that VBAC is still an issue once you have had one. I guess maybe for some people it isn't, but for me it is. First of all as much as I love my doctor he is now in a group practice with 3 other doctors and is insanely busy besides. Secondly, my last pregnancy I really wanted a VBAC but also thought I just might not be physically able to do it in which case I would accept my fate. Now that I have proven to myself that I can, the thought of being on an operating table grips me with a cold fear that could send even my big old cow heart into a dither. Could and apparently does.
Every time I think about the unforeseen effects of C-section on subsequent pregnancies for so many women I know, I get upset. Then eventually the Rolling Stones come into my head. Because well, you know...you can't always get what you want. Also I'll never be your beast of burden but that is less relevant.
Sure I've been moody and teary and weak at times as different issues have cropped up. Maybe I am being a little bit cavalier about it at the moment in an attempt to save a few shreds of dignity...but through the various spoken and unspoken trials of the past few months there have been specific times when I have really felt lifted and carried through them. Sometimes by specific people and sometimes not. An amazing feeling I had not felt before. I don't think I would have felt that kind of love without the preceding despair. My life is so good and so full of love. So I can't complain. At all.
Also, as one final note, if you ever need cheering up please let me know and I will have Ida sing to you: "Harp the herald angels sing, glory to babboo-born King."
13 comments:
I have a racing heart too - started when I was pregnant with you and they said it was normal for pregnancy.
I think everyone says something different just to drive us crazy.
But I believe anxiety is the true culprit.
Good for you for working on it - I'm trying to too!
We can compare notes!!
P.S. We still miss you guys!! (but I'm not anxious about it!)
Sorry you are having anxiety. Vbacs can do that to you. The worry! I had 5 vbacs after my c-section, but it was not a real big issue until the last two, then all of a sudden vbacs were bad! It was crazy. (But maybe that will give you a little bit of hope, it it possible to continue with the vbacs safely)
I was so sorry I missed you at the airport. I saw your back, but you had already gone through security and I had come through the other way and couldn't go back. I was a little sad.
You know what's funny Karen, is I am never ever worried about a VBAC not being safe. What I'm worried about is not being supported in the hospital. Not to say I could have 100% avoided a C-section but so many things went wrong in my first experience that could have gone differently if someone had just told me what was going on. Of course now I know better but I just wish I had someone I could completely trust. (now because of the group practice I only have a 1 in 4 chance that I will get my own OB if I go into labor after hours.)
Unfortunately, in many cases because of unsafe VBAC inductions in the 1990s that resulted in uterine ruptures, as you said VBACs now have a stigma they didn't have 15 years ago. (even though I am not going to be induced and am therefore out of that risk category.)
I read that the VBACs with all the ruptures came from them giving women a drug they thought would prevent rupturing which actually increased the risk--did you hear about that?
And I start tensing up when I think about being on the operating table again. Yikes. I just assume they're going to look at my uterus, tell me how close it was or how torn up it is, and tell me never to have kids again. I have a lot of fears about it but when I pray about it I feel like everything will be all right--I think. I have the hardest time with anxiety after the baby comes with the lack of sleep.
And you always sound super cool and calm in all your posts--I wouldn't worry about what you post because it's always good!
Susie: induction in general invites ruptures, and exponentially more so with a scarred uterus. The worst culprit particularly for VBACs was a drug no longer used: misoprostol (prostaglandin E1), also known as Cytotec.
Cervadil (prostaglandin E2) is still widely used but is not safe for VBACs. For induction, Cytotec and Cervadil were/are both used as a suppository to open a stubborn cervix. It's thought of as less intense than a sudden Pitocin (synthetic oxytocin) drip if you are not dilated yet. Once it is sufficiently dilated then the Pitocin can start.
The problem with jump-starting a uterus that has a scar, is that if it is not ready for the intense, sudden, regular contractions that Pitocin and Cervadil can bring, it's more likely than an unscarred uterus to tear, because it has that weak spot.
However, studies show that it is much much safer--practically as safe as an intact uterus--for the scarred uterus to go through natural labor that is not enhanced by Pitocin. Natural oxytocin which is produced in the human body when the baby is quote-unquote "ready" is much gentler and works on its own timeline.
Some doctors are willing to use Pitocin to "help" labor along that has already started in a VBAC uterus. That is safer than inducing from nothing but I am still dubious, although if faced with Pitocin or an automatic repeat C-section I would think long and hard about it. The very questionable safety of being induced should I want to be (which I don't, but what if I had preeclampsia or some other medical indicator to have my baby early?), is one of the reasons I am not happy about having a scarred uterus.
The fact is that I feel the same way you do Susie--that things will work out the way they are supposed to. However I still get fired up about the topic. :P
Oh and your specific question, I'm not sure--maybe could have something to do with induction being thought to increase the risk of VBAC because an earlier baby is likely smaller? I don't know; I am interested to know more. Where did you read it?
You are loved! I think it is smart that you are tackling this head on, you can do it.
By the way. I can only imagine (and hope I only ever need to imagine) the anxiety of approaching a 4th visit to the OR. I am pulling for you, Susie.
Katie...thank you for being there, my dear dear friend.
Exactly what went wrong with your first delivery that you would do differently? I'm curious...
Susie - I don't think I know you but Eliza's sister did a 4th trip to the OR last summer - I was there holding down the fort with the other 3 - and she came through it fine. I'm betting you will too - any friend of Eliza's is a friend of mine, so I will pray for you!! Try not to be anxious!! (This from the queen of anxiety!!)
I should clarify my comment. I understand what went "wrong" but what do you think you could have done to prevent it? I've got "mom brain" so I guess I need it spelled out in black and white. I was put on petosin with both pregnancies and did just fine. In fact, Simon came out it 2 pushes, but I hope nothing would happen in future pregnancies (yes, I'm thinking about it ;)
I kind of like reading your diary. And, as long as you don't mind, I'll keep it up. Because, who else uses the word "dither" in relation to a "big old cow heart." It's all that stream of consciousness I can't get enough of. It is...well, Awesome.
Also, I wish you would share more of your woes at their present time. I can at least try to ease some of your anxiety. Please.
Sarah, sorry I'm just now getting to this. There are a few big things that come to mind:
1-I would rethink my early labor. For me, I wanted to do natural birth but in retrospect it was a BAD idea to go to the drafty hospital with its VERY uncomfortable bed and VERY uncomfortable fetal monitors when I was only 4 cm dilated with contractions 7 or 8 mins apart. If I could do it again I would have gone home and come back later when contractions were less than 5 mins apart, closer to 3 if possible. So far I don't seem to have very fast labors. (Theo's = 24 hours, Ida's = 12 hrs)
2-I wish I had known about posterior babies, which is one of the things that cause back labor (which I had with both babies). Theo and Ida were both posterior (facing up instead of down) which makes it really hard for them to move down. They can get hung up in the birth canal that way, especially for a first-timer with a big baby. My doctor broke my water early on in labor, which only served to get Theo more wedged because he had nothing to float in. No one said anything to me about how Theo might be malpositioned and how to get him to turn. I pushed for over 2 hours with no progress, at which point I decided to have a C-section. (it was not an emergency... yet.)
In contrast, Ida was also posterior and although not quite as big (she weighed 1 lb less than Theo) her head was just about as big. But I did not have my water broken and I moved around at my doula's suggestion to try to turn her. She turned right before my water broke when I started pushing, and she came out in less than 30 mins. She had water to float around in and room to move, which Theo did not. I think that was a big factor.
And, hospitals are just really uncomfortable and cold. If you have an epidural you can sleep or something, but otherwise you can't get comfortable. Later on in labor my contractions were almost on top of each other and I didn't have time to think about being uncomfortable. I don't recommend trying natural childbirth for the first time in a hospital, that is going through early labor in the hospital. I would rather be in a birthing center or at home where it's more comfortable. Then I'd move to the hospital when things really start moving.
An epidural (without breaking water) could maybe have solved my problem if it had helped me relax. Of course some doctors won't give you an epidural too early on for fear that it will stall labor. I did get an epidural when I was at 4 cm (after 12 hours of contractions I hadn't progressed past 4) but the doc broke my water 5 mins later. (and it took her about 5 mins of poking to get it broken--which makes sense since with Ida my water didn't break until the very very end of labor. Clearly a tough bag to break.)
The problem with an epidural in that scenario is that I couldn't have changed positions if I needed to get the baby to move. The potential problem with Pitocin is if your uterus/cervix aren't ready. Lots of women have Pitocin with no problems at all. But nonetheless it is a big factor in C-sections because it is hard on the uterus and therefore can be hard on the baby.
Everyone is different. You had great births, but my first one was bad enough that I didn't want to risk interventions with the second one. And it went much better for me.
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