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Pick a door

October 15, 2009

One of the strangest things that happened while I was hospitalized after Teddy’s death was a visit from the obstetrician who performed my c-section.  On the one hand, it was nice (I would say compassionate, but I didn’t pick up on a lot of compassion from him, which may be unfair. Not everyone has a good bedside manner and my state of mind wasn’t precisely sunny) of him to visit.  On the other hand, upon finding out that we’d made the decision to let Teddy go rather than to put him on ECMO, he said this:  “If we’d have know that, we probably wouldn’t have done the c-section.”

You know that tiger that lives inside you?  The snarling, growling, hungry beast who wants to rend anyone limb from limb when they imply that your child’s life wasn’t worthy, wasn’t important?  If I hadn’t been exhausted, on painkillers, and recovering from abdominal surgery, that tiger (barely awake) may have done serious harm to this doctor.  Here he sat, at my bedside, implying that since my son died anyway, the c-section that was performed because he was showing signs of distress from labor was to be regretted.  I had no response for him, then, but I couldn’t wait until he got the hell out of my hospital room.

What I wished, later, that I could have told him was this: It was important to me, so desperately important, that I did everything I could to give my son a good chance.  No one knows how a baby with CDH will do once she or he is born until she or he is born.  That c-section is one of the things that lets me sleep at night, that lets me say we tried everything and (mostly) believe it.  It was the right thing to do.

I tell myself this, too, because I am now at the point where I can actually think about giving birth to Dot.  I don’t count on it.  I’m too afraid and she’s still so tiny and vulnerable that attempting to plan for her birth seems overly eager, to say the least.  But I do think about it, partly because my doctor has already started talking about options.

Sally, of Tuesday’s Hope, wrote a good and thought-provoking post on birth options, The Means to an End.  Reading her post and thinking of our different situations started my brain churning in interesting ways.  On the one hand, the main and most important goal of any birth is a living, healthy baby and a living, healthy mother.  But there’s more to it than that, even when the more isn’t nearly as important as the main goal.

Because of my c-section with Teddy I have two options, a door on the left and one on the right.  On the left,  a repeat c-section, on the right, a VBAC (sounds like an American football position, doesn’t it? Quarterback, halfback, fullback, VBAC?).  They are perfectly good options, and one seems as likely as the other to get me to my goal of a safe and healthy Dot.  But I find myself wishing for the option that no longer exists, for a plain old vaginal birth without the added (super fun!) risk of uterine rupture.  The words “uterine rupture” make me want to curl up, put my fingers in my ears, and sing “la la la la la la la” until reality goes away, even though the risks are small.  And I think I finally know what that blasted OB meant, over a year ago in that hospital room.  I think what he really meant was that he was sorry I’d be facing decisions like this some day, that my options would be limited.  I still would have preferred a very simple, “I’m so sorry about your son,” but I can almost forgive him, now.  Now, that I’m looking at my choices and worrying about them and sighing over the one that isn’t there any more.

My doctor is leaning towards a c-section, thoughtfully, and at least partly because she’s concerned for my state of mind.  After my first long, anxiety-ridden labor that ended as it did, well, I’m concerned for my state of mind, too.  And recovering from a c-section is absolute cake compared to all of the other recovering I had to do in the months after Teddy died.  It’s not that bad, or that scary.  I could do it.  But I have the option of a VBAC, too (amazing considering the size of my local hospital) and I wonder if it might be healing, somehow, to go through labor and delivery, one where there’s no induction or induction meds, where I might not spike a fever, where there might not be meconium in the amniotic fluid, where my baby wouldn’t be already compromised by a condition I have no control over.  I know there are no guarantees, but I have to be honest about the fact that part of me really wants a second chance to do this.  To do this right.

That’s the problem, of course.  There’s no wrong way for me to give birth to this baby so long as it results in both of us coming through in good health.  I know this.  I’m not even certain as to why I think a VBAC might be healing – am I out for catharsis? redemption? a second chance?  Am I looking for these things in the wrong places?

I don’t know what I will do.  If I can, I’ll pick a door and be glad for the luxury of choice.  In the meantime, I’m thinking away like mad and hoping the information I need finds me.  I’m grateful to Sally, who wrote the post that caused these thoughts to surface, and to Kate, who just recently wrote out many truths I needed to hear, and to others who keep discussions about this going.

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5 comments

  1. Ugh, that doctor. My inner tiger is snarling for you.

    I wish I had something more useful to say about birth choices than this: you are a smart, thoughful, informed woman. You will make the best choice for you and your baby in any given moment. I’m sure of it.

    xx


  2. It is the control thing, and realising we have none that is so hard. We can all wish for things, but in the end, it is going to work out how it is going to work out. Either because medicine, our bodies or our babies say so.
    I hope we can both get healing “experiences” (I do shudder to say that word) this time around, but more importantly, living, healthy children. In the end, that is all that matters. It is just so huge to think that these babies have to be born, one way or another, and in the very near future decisions have to be made. Really, can someone just wake me up when we’re done? Wanna come nap with me?
    And you’re so right, recovery from either type of birth is cake compared to trying to recover from their deaths. That’s a life long process. Makes me tired thinking about just how long there might be to go in that process.


  3. i’m with sally on the control thing. we can make decisions but as we all know it doesn’t always work out the way we planned. i believe that the healing and the second chance will happen once we (i have to say ‘god-willing’ or something, even though i have lot so issues with ‘god’ these days…) have live healthy babies to take home with us.

    xox


  4. I’ve been thinking about this topic a lot lately, as I get later into this pregnancy. I recently visited a friend and her newborn lately, and heard her terrifying birth story…as her (now healthy and alive) son’s heart was rapidly decelerating, she was offered a c-sec, but having labored for nearly 5 days her rationale was ‘i didn’t come this far to have a c-section’. All I could think was ‘you certainly didn’t come this far to have your baby die.’ I don’t think there’s any right answer…other than whatever is safest for you and baby.


  5. you can have a loose plan, but maybe dot will be the ‘decider’

    and that doc should learn when to keep his mouth shut.



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