I now see my OB every week (on Thursdays), and a high risk doctor for a high level ultrasound on Tuesdays. Seeing the OB weekly at this point in the pregnancy is standard; the ultrasounds are a precaution to keep an eye on the little one and make sure she doesn't have any more heart decels or cord issues. This week on Tuesday was my second high risk ultrasound and our daughter checked out beautifully, and quickly! She practiced her breathing, had a perfect heart rate, responded well to nudges through the belly by moving around, had great bloodflow through her umbilical cord, and the cord was still in the same unthreatening position as it was the week before. As a bonus, the technician was the same woman who did my ultrasound last week and could tell me (because she remembered me) that the baby had changed position a little bit - shifted from the right side of my belly to the left - and had dropped a little lower in the head down position. I was happy to hear that she thought the baby was starting to drop, because her movements are starting to take my breath away and be very uncomfortable and even painful at times. But I'll take it in the name of progress.
My regular OB appointment yesterday was... lively. And I have to write it out so that I remember the details, because - 4th baby.
I headed into the appointment with a week's worth of thoughts and questions about how we should approach the delivery of this baby. Backstory: Robbie was a natural birth, Ellie was a C-section (she was breech), and Maddie was a VBAC that went very well but had to be helped along with breaking my water and doses of pitocin. I switched OB practices after Maddie's birth once we knew we wanted to try for a 4th baby, because my favorite doctor of the 8 or so that practiced with the last group left to practice elsewhere. The new OB I chose for this current pregnancy, Dr. G., is so so wonderful. Many of my friends see him and I've watched him handle routine births as well as tough situations, medical emergencies, and loss in ways that are highly impressive. He's also a one-man practice so you always see him at appointments, and his office is located within the hospital so he rarely misses a birth. All good.
Dr. G. isn't a fan of using pitocin with VBACs though, and that's all I have known with all of my natural deliveries. With the other little hiccups we've had with the pregnancy, I was beginning to question whether we shouldn't just schedule a C-section for the delivery of this baby in a few weeks, even though it's not my preference. I was anxious to talk it all through with him and see what his medical advice would be.
While I was waiting to be called back, I had a strong pain develop at the base of my stomach on the right side. I tried to relieve it by changing positions, rubbing it, drinking water, relaxing, breathing... but nothing was working. It wasn't a contraction but the kind of steady sharp pain (round ligament, I assumed) that makes your eyes water, and after sitting there with it for 5-10 minutes the nurse called my name and took one look at my face and asked "Are you alright!?". I assured her yes, just typical pregnancy pain, and she helped me slowly get up and shuffle back to the exam room. She looked at my chart and mentioned that she didn't think Dr. G. would need to 'check' me today (internal exam to evaluate any progress towards labor), and I explained to her that I actually hoped that he would check me, in order to have as much information as possible as we discuss how I might anticipate delivering the baby in a few weeks. So she laid out the paper cover, left while I got undressed and situated, and then came back and hooked me up to the monitor to observe the baby's heart rate (standard for my appointments now). The pain I'd been feeling had subsided to a manageable level by now, and I sat on the monitor for a while.
Dr. G came in a little later, said hello, looked at the monitor readout and was satisfied, and said he didn't think he felt the need to do an internal exam today. I explained that I wanted to discuss delivery methods and the pro's and con's of scheduling a repeat C-section, and that an internal exam at this point might be helpful to add to the information I'm working with. He agreed, and we discussed at length my options. In summary, he is strongly in favor of me trying to attempt another VBAC. He thinks it will be uncomplicated (as best as he can foresee, of course), that I have a good history of natural births, and that if my labor did stall, he's not completely opposed to using a little pitocin if necessary. What a relief! The answer seemed clear - I no longer felt that a C-section was the best option for us at this point, and put those thoughts to rest.
Then he started the internal exam. They're always pretty, um, uncomfortable... but this one went on for longer than usual and it was all I could do not to crawl up the table (and I might have yelled at one point). When he finished, he had this odd look on his face, and said "Well, now we have a different situation! Your baby seems to be breech." I could not believe it - "Are you serious!?" I said to him, "Just two days ago the ultrasound showed her to be head down and starting to drop more...".
Dr. G says to me, "I could not feel her head, and I was reaching pretty far, as you know... but something grabbed my hand. I think she tried to grab on to me." I started laughing and thought he was joking, but he assured me that he wasn't joking at all, that he definitely felt our baby's hand during the exam! He also said that I'm softening and dilated to 1 cm (last week I was 'a little soft and totally closed'). So, progress.
He then spent the next few minutes scaring me with a lecture on what to do if my water spontaneously breaks while she is in this position... that I am to get in my car and drive straight to the hospital, don't wait for anything, don't even bother calling 911 because in this situation they would BE TOO SLOW, etc. He explained why - if my water breaks and the baby's breech, the cord could come through the birth canal and present a dangerous situation for the baby. Then he asked me to follow him across the hall for an ultrasound so that we could determine exactly what position the baby was in and get a better look at things.
He did the ultrasound himself, and within a minute or so was able to tell me that the baby was actually still head down, just not sitting very low. And then he pressed the ultrasound wand right where I had been having such intense pain while I waited in the waiting room for my appointment, and said "Look at that!". Our daughter had her arm stretched out and her hand was above her head, right between her head and the lowest part of my abdomen. What a little stinker. That nearly debilitating pain was her hand reaching out!
A sigh of relief. Dr. G and I laughed at the turn of events, and he said "Ok, forget the complications we just talked about related to her being breech - she's head down and we are back to our original plan of waiting for labor and attempting another VBAC!" I asked him if she could still change position between now and 40 weeks, and he said it's definitely possible (and then told me a story about a baby literally turning from being head down during labor as the mom was dilated to 6cm, to being breech and having to be delivered via emergency C-section, so anything's possible!). So we will continue to check in on the baby twice a week just as we have been, and pray that she stays head down!
I felt like I needed a nap after that appointment - I went from concerned about her birth, to at peace with the idea of a VBAC and totally confident that I could wait for labor to happen naturally and deliver her that way without complications, to concerned that she was breech and that I'd have to make sure at any point in time I could get myself to the hospital should something happen, and then back to relieved that she's in a head down position... and even laughing at our girl for her spunk. When I walked down the hall and past the front desk, the nurses were all laughing with me and cracking jokes about how my baby is trying to climb out of my womb, she's so ready to be born!
This pregnancy has been far from what I 'expected' it to be when we first discovered we were pregnant. I have dealt with more sickness in the last 8 months than I typically do in the span of a few years. When I'm pregnant I'm usually healthier than usual, so this has been a totally different experience (food poisoning, strep, sinus infections, pneumonia, colds, stomach flu...!). I knew I would probably have a harder time for the last 2 months or so of the pregnancy simply because the last month or two of my pregnancy with Maddie was difficult to endure. I contracted a lot, had a lot of pain, and needed extra help with the kids. But aside from the physical discomfort I've had, I've needed bedrest, and to keep a closer eye on this 4th babe with a few extra doctor's appointments. I've needed a lot more help than I ever dreamed I would, more help than I would say I am comfortable with.
After this last experience at the OB, I've resigned to submitting to whatever these last few weeks hold. I'm giving up trying to predict how things will play out, I'm letting go of hoping for a certain outcome or bracing myself for disappointment... I'm reminded that I've always been asked by the Lord to hold this baby, this pregnancy, this process with an open hand. To accept whatever might come along the way and trust Him with it. It's hard to do, moment by moment! I'm human and I have preferences. At times, strong preferences. :) But I hope and pray that He is refining me every day that I carry this baby, that He is using each unique circumstance for His glory and our ultimate good, which is to be made more like Christ.
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