Showing posts with label VBAC. Show all posts
Showing posts with label VBAC. Show all posts

Saturday, July 9, 2011

High Risk Evaluations

I had my consultation with the high risk doctors this week. Let me spoil the ending by shouting loudly from the rooftops:

"They didn't want me! I'm not high risk!"

With that out of my system, I do have some comments on the appointments themselves. (Of course I do. You know me well enough by now, right?)



Appt #1
Provider #1 reads through my sugar level notebook and downloads my glucose meter's chip to verify that the blood sugar numbers I've recorded are accurate (i.e., I haven't "adjusted" any numbers in my favor).

She seems concerned that I won't be able to manage my blood glucose via diet without nutritional counseling. Except that I have been managing. Which is perhaps why she doesn't provide any nutritional counseling during the appointment. (?)


Appt #2
Provider #2 dismisses the blood sugar numbers printed out by Provider #1 because it's in a graph form and his brain doesn't like looking at graphs. He prefers to read summary reports. Since my file doesn't have one we will skip discussion of my blood sugar numbers and he will defer to Provider #1's assessment that my numbers are fine.

He waxes eloquent about what Type 2 Diabetes is and what Gestational Diabetes is (mainly, he explains, for the benefit of the medical student sitting in on our meeting). The lecture begins with the question "You know that your body is made up of small pieces called cells, right?" and ends with a detailed description of the liver and pancreas and what he believes are ideal postprandial numbers.

Once he hears my first baby was born via c-section because of breech presentation he completely drops all concern over my VBAC attempt. Absolutely fine with him. Go for it.

He recommends additional thyroid testing due to concern over my Grave's Disease and how it may affect the baby's thyroid. He says that if the baby's thyroid is having issues they can treat the baby in the womb. I ask for details. He says he will not discuss the treatment until after the testing. I surmise it must be rather intense/worrisome treatment. He will not confirm nor deny and tells me not to concern myself about it--just leave it to the doctors. [I have since talked about this with my family practitioner and have received confirmation that the testing I plan to have for my baby after the birth includes thyroid testing. No need to do any special tests during pregnancy.]

He suggests getting the ultrasounds previously recommended by my family doc to help estimate the baby's size. He says that the ultrasounds are especially helpful to doctors when women fake their good blood glucose numbers--the ultrasounds can help "catch" those mothers in their lies. How flattering. I voice my concerns about the inaccuracy of sonograms and sizing and my worry about being induced for "big baby" when in reality the baby may not be too big at all. He assures me that never ever should any woman ever be induced for suspected big baby based on an ultrasound. He says that sort of thing puts the academic OBs into fits of despair. But he does understand that this sort of thing unfortunately happens in clinical practices, so he will put into my file a note that I am not to be induced due to suspected big baby. I am pleasantly surprised. "No, no, don't worry worry," he assures me. "If we suspect a big baby based on the ultrasound, you will not be induced. We will just automatically [c-]section you. Never an induction and trial of labor." Well, consider me relieved! :p

Both providers were very pleasant, certainly very smart, and neither had anything helpful to say at all, other than I'm not high risk. Best estimate is that I'll be charged a total of at least $600 for the two visits. I used nearly a full day of ETO time and lost 6 hours during which I could have been earning wages. Overall, a totally awesome way to spend a day. I absolutely recommend that every healthy pregnant woman check out their local high risk perinatology clinic, just for kicks and giggles.

Tuesday, March 8, 2011

Preparing for a Hospital VBAC: My Top 10



Welcome to the March Carnival of Natural Parenting: Natural Parenting Top 10 Lists

This post was written for inclusion in the monthly Carnival of Natural Parenting hosted by Hobo Mama and Code Name: Mama. This month our participants have shared Top 10 lists on a wide variety of aspects of attachment parenting and natural living. Please read to the end to find a list of links to the other carnival participants.

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I'd planned a homebirth for my first baby. As sometimes happens, things didn't go to plan. The baby turned breech late in pregnancy, and I ended-up delivering via cesarean. 

Now I'm pregnant again, and this darn scar on my uterus has meant I'm planning my next delivery at the hospital with an MD in attendance. But I'm trying once again for an unmedicated, instinctual birth.

I cannot say that this is the way to prepare for a hospital VBAC, but it's how I'm preparing for it.


  1. My first choice was to find a midwife to attend my birth, but when I was unable to find a homebirth midwife who was both available around my EDD and who was comfortable attending a primary HBAC (homebirth after cesarean), I turned to MDs. I interviewed several doctors and finally chose a Family Practioner rather than an Obstetrician. I've learned that Family Practice docs (who don't themselves perform surgeries) tend to have fewer patients who "need" cesareans than those who see an OB as their labor attendant. It's not a guarantee,  but after several interviews I did find an MD I'm happy with and who seems truly supportive of VBACs and unmedicated labors.
  2. I've hired a doula to assist me during labor and for any immediate post-birthing breastfeeding guidance I may require. (If you're not familiar with why hiring a doula would be on my list of "Top 10" you can click here to see DONA International's list of how doulas make a positive difference in births, including the reduced use of pain medications, less need for tools like forceps and vacuum extractors, and mothers feeling more positive about their births.
  3. I'm researching the best pushing positions that may help reduce pain, allow my pelvis to open, and help me to avoid tearing.
  4. I'm practicing my squats. 
  5. I'm reviewing my workbook and notes from the Bradley Method natural childbirth class I took during my first pregnancy. (I cannot say enough positive things about that class!) 
  6. I'm reading and re-reading books about natural childbirth. My favorites are Ina May Gaskin's Guide to Childbirth, Birthing from Within by Pam England and Rob Horowitz, and Henci Goer's The Thinking Woman's Guide to a Better Birth. 
  7. I'm preparing a birth plan that will describe my labor wishes to the L&D nurses while keeping in mind the environment in which I'll be birthing. (As my doula told me, "You'll be walking in there with a doula and a Family Practitioner and a birth plan---believe me, they'll know what kind of a woman you are!")  HERE is the finished birth plan. 
  8. I'm trying to focus on eating well to avoid diet-related complications (toxemia/pre-eclampsia) that would affect my and my baby's health and thus the delivery itself (see the Brewer's Diet for a description of a healthy pregnancy diet and click here for checklists with omni, lacto/ovo and vegan variations). 
  9. I'm exercising regularly I'm planning to exercise. This is by far the preparation I've been least successful with, even though I know how important it is to both my baby's health and my stamina during labor. But wintertime in Wisconsin is not an ideal time to go strolling about the neighborhood for a brisk walk, and I was so tired during the 1st trimester I had a difficult time staying up past 7pm much less exercising. However, now in my 2nd trimester I'm starting to get my energy back and have dug out my prenatal yoga tapes and can see a hint of Spring (and the return of evening strolls) around the corner. I will exercise!
  10. Finally, I'm keeping a positive outlook. There's every reason to believe that all will go well. After all, I'm mentally and physically preparing myself and will have emotional support both during and after labor. I will have a VBAC, I just know it!






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Carnival of Natural Parenting -- Hobo Mama and Code Name: MamaVisit Hobo Mama and Code Name: Mama to find out how you can participate in the next Carnival of Natural Parenting!


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