Tuesday, May 31, 2011

Our Story (5) : Specialists and Arguments

The week following my first trip to the hospital, I had an appointment with a Maternal Fetal Specialist that my doctor had recommended. She had been suggesting I see him for some time, but I had put it off because, as much as I liked her, I didn't trust that another doctor would be as supportive of my choices. I had finally decided to see him because of her recommendation thinking that perhaps one more person in my corner might help especially since I was now "high risk." I thought maybe he might have some additional ideas about ways to keep my blood pressure down. Thankfully, the medication I had just started taking was working at this point and my blood pressure was ok that day. But, that meant that we didn't spend much time discussing what was important to me, keeping me healthy, and instead focused on my request for a vbac. He came at me guns blazing telling me all the reasons why I shouldn't try for a vbac. I was so shocked. I had come in to discuss hypertension not vbac. I had read A LOT on vaginal birth after multiple c-sections. This was something that was extremely important to me...something I had discussed at length with my own doctor. I knew that most doctors and some states won't allow a woman to try for a vbac if they've never had a vaginal birth and more than one c-section. But, the research just doesn't support that kind of restrictions. In fact, the problem with vbamc (vaginal birth after multiple c-sections) is that there isn't much research on it at all. Here was my standard answer to anyone questioning my decision,
I've read up on the stats as much as I can. I feel strongly that my risk is with any kind of birth after having three c-sections. Whether I choose vbac or repeat c-section, I'm at a higher risk. Because of that, I'd rather go the natural route especially since I know that I have healed well from my other c-sections based on the assessment done by my doctor during my last Cesarean. I will have the highest chance of success with the least amount of interventions. If I need interventions, I'll have to weigh the pros and cons of continuing with a vbac. 
There actually was one recent study that showed that the risks of a vbac after three or more c-sections was the same as someone with only one c-section or with the risks of having a repeat c-section. (I emailed this to the doctor after my visit.) Anyway, this doctor visit was incredibly frustrating especially since it ended up being about something I wasn't expecting. He even left me in the exam room to go get the head of the department to try to convince me I shouldn't vbac. (This was in a state with very low c-section rates.) I think his intentions were good, but his method was everything I hated about the western medicine model of care. Thankfully, the head of the department was a pretty mellow guy and saw that I wasn't budging on this issue. Through the whole pregnancy, I said that if I needed interventions, I would reconsider vbac. But, I wasn't signing up for a repeat c-section unless it became obvious that I needed one. I was actually nervous about going back to my doctor, but again she was wonderful. She was not happy about how I described the appointment and reassured me that it was my right at anytime to refuse a c-section. The ironic thing about the visit with the specialist was that it shouldn't have been about vbac or hypertension. It should have been about pre-eclampsia. The lab had messed up my 24 hour urine test so we didn't have the results at the time of the appointment.  Had we had the results (which I found out a couple of weeks later), it would have shown that my protein levels were increasing. Pre-eclampsia was probably going to rule out the possibility of vbac for me. Maybe it was a good thing that I didn't know yet. Maybe just talking it over with me gave some doctors a different perspective? Doubtful, but I still hope so.

1 comment:

Unknown said...

I'm so sorry there was so much against you having a VBAC, Cari. I was on your cheer squad hoping it would happen. (((hugs)))