Monday, October 11, 2010

Gestational Update

I just returned from my third prenatal chiropractic visit, and I think once the stiffness wears off (I'm always a little stiff for a few hours after the visit), I will be pain free. I was significantly better after the first visit, and almost all better after the second. She's like a miracle worker! I'm sure in a few days I'll begin to take for granted that I can sit, stand and walk without pain, but for now it's still an amazing ability! She also showed me a model of the spine and pelvis, and how these adjustments will make a VBAC more likely. The shape of my pelvis had twisted from a circle to an oval, with one hip significantly higher than the other. In addition, my spine was over-extended, and blocking the pelvic opening, so had I gone into labor that way, I would have ended up with back labor when her head bumped into my spine, and a less likely chance of her circular head fitting through my oval pelvic opening for a successful vaginal delivery.

Speaking of the VBAC, I got some bad news at my last appointment. The latest doctor I met with (I'm rotating through the practice, and it seems to be a rather large practice, so I meet someone new each time) told me that the success rate for VBACs ranges from 30%-70%. Because of the circumstances of my last birth, I'm starting off at the low end of that spectrum, with a 30% likelihood of success.  Specifically, because there was no precipitating event leading to the c-section that we can point to and say "well, if this doesn't happen again..."  With my first birth, the baby was head down, not breech.  I got to 10 centimeters, and didn't get stuck along the way.  I pushed for 2 hours, and made no progress.  He was never in distress.  I didn't gain an excessive amount of weight (35 pounds), "causing" him to be big.  My husband was over 10 pounds at birth.  My mother had 6 c-sections because her pelvis is too small.  The doctor kindly told me "you did everything right, and it just...didn't work".

While it's always nice to be told that you did everything right, given the context, it was unwelcome news.  I cried in the car on the highway coming home.  But then I thought it over, and decided: a 9 pound, 15 ounce baby IS a precipitating event!  I can point right to that and say "well, if this doesn't happen again..."  They want to give me extra sonograms near the end to see how big she looks.  If she's over 9 pounds at 38 or 39 weeks, they would prefer I agree to a scheduled c-section on my due date.  This led to a long conversation with my husband, who asked me: why do you want to have a VBAC?

I thought it over, and told him it's the same reason I always imagine that my father goes to church.  It seems like the right thing to do.  Deep in my heart of hearts, am I personally passionate about having a VBAC?  Not particularly.  But it seems like I ought to at least try.  I've never heard my father express any feelings of deep, personal connection to the Roman Catholic church.  That's not to say he doesn't have them;  I can't speak for him in that regard.  But I always imagine he attends church in much the same way one puts the salad fork on the outside of the dinner fork.  It's just the way things are done, and you ought to at least try to do things that way.  I try to exercise, recycle, and buy organic food when I can.  I know these are the right things to do, mostly because I've read about them.  Other than exercise, which has grown meaningful to me over years of practice, none of these things excite my passion.  But I do them nonetheless, because I feel like I should.  And I guess that's how I feel about a VBAC too.

In the meantime, there is nothing much to be done except to continue along the same path: eat well, exercise, go to my chiropractic visits, and keep up my verbal suggestions to my growing daughter:  6 pounds, baby girl, c'mon, 6 pounds, you can do it!  I promise to stop berating her about her weight as soon as she's born, but in the meantime she's off the white carbohydrates.  And there's another example!  Whole grains.  Tough to give a damn about them, but they're just the right thing to do.  And in the end, once she's in my arms, whether she slithers through my loosey goosey pelvis or is pulled through a precise slit in my stomach, so long as we're both in decent shape when she gets here, I will be grateful.  My dad has long told me: sometimes you just do the best you can.  And so I will.  And that will have to be enough.

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