Saw this on Facebook this morning. Given my current predicament, it was timely.
Just like it was when I was pregnant with Mabel, I am 41 weeks (tomorrow), with a healthy fetus, no signs of impending labor, no complications that warrant intervention. I’m grateful. However, I’m also wondering when to draw the line.
I searched high and low for a doctor who would support my trying for a VBAC (Vaginal Birth After Cesarean). I wrote a little about it here. It took me 2 months of researching and in-office visits to see five practices and talk to several others on the phone. Finally at 33 weeks I had my first visit with my OB. A doctor that comes highly recommended by strangers on the internet, acquaintances in my local ICAN chapter, and personal friends- moms who delivered with him, as well as nurses who work with him.
I really like him and I really trust him. He’s very level headed. He didn’t tell me my chances for a successful VBAC were nil. He made a point to meet with me in his office before he examined me in an exam room. He seems like an all around great doctor.
So far, all has gone smoothly in this pregnancy. He’s been totally fine with me going past my due date (his policy is not to consider induction/surgery in advance of 41 weeks without a medical reason). While he answered my questions about it, he didn’t even bring up scheduling me for a C-section (in case this baby is like his big sister and refuses to be born) until I was overdue. Even then, he said let’s talk about it when you hit 41 weeks.
The only hard and fast recommendation he has made is, that he does not feel comfortable with me going past 42 weeks. His reasons for this are valid. According to my doctor, prior to 42 weeks fetal non-stress tests and biophysical profiles are predictive of the health of the fetus- meaning a good result predicts that the fetus will continue to do well for several days. After 42 weeks these tests are no longer predictive, meaning something could be about to go wrong and you would have no forewarning. I trust my doctor, I trust this science. I have no intention of going past my due date.
I see him again tomorrow and Mac and I just cannot decide how to proceed. There are basically two options (note: induction is not an option given my previous C-section):
1. Wait the full 42 weeks (as long as the monitoring continues to show the baby is healthy) to give me every/any chance of having a VBAC. This isn’t cut and dry. The longer I wait, the less likely it is that I will be able to successfully deliver vaginally. Nemo, this baby’s blog pseudonym, is already predicted to be around 9lbs (although the estimate has an error of 1lb in either direction), the longer I wait, the bigger he will get. Also, the older he gets, the more ossified his skull becomes, the less malleable it is, the harder it is to fit through the birth canal. It’s kind of like the law of diminishing returns- the longer I wait, the longer the odds of success. Considering I was induced at 41 weeks and 6 days with Mabel and as of 40 weeks and 5 days with Nemo I show no signs of progress, I feel that the chances of my spontaneously going into labor on my own are slim to none
2. Pick my baby’s birthday. The 42 week mark is out of my hands, it’s a definitive cutoff in terms of medical necessity. However, Mac and I could pick any day (assuming my doc is available to do surgery that day) between now and May 25th for our son to be born. It just feels so wrong, so odd, to pick. Also, it’s not at all trivial to willingly submit to a surgery that may not be necessary. With most any other surgery, people would do their utmost to avoid an unnecessary surgery. With C-sections, people seem very nonchalant, forgetting or ignoring that it is major abdominal surgery, with all the associated risks. Not to mention 6 to 8 weeks of recovery- during which time my toddler will be hard to avoid.
This is where I am today. This is why that Facebook image was so timely. Mac and I need to decide tonight what to tell the OB. Option 1- do nothing and just wait it out. Option 2- do something and pick a date prior to the 42 week mark.
While I’m eager/impatient to meet my little boy, that’s a really stupid way to make a medical decision. I’m sick of coming to work EVERY SINGLE DAY to the same barrage of STUPID questions from my coworkers (i.e. “Wow! You’re still here?). Not to mention how bad it is for one’s productivity to leave EVERY SINGLE DAY ready to not come in the next morning. Again, stupid reasons for making a medical decision.
What to do, what to do?