One baby, extra caesarean, hold the VBAC

When I was 26 weeks pregnant with Kara, my uterus measured a perfect 26 centimeters. So when people questioned the appropriateness of my size, I just repeated what my doctor told me: the baby was healthy and doing just fine. I kept the meaner, gutter-language retorts to myself.

Here's photographic evidence of Kara and me at the 26-week mark:

 

...And here I am yesterday morning, 26 weeks in with Baby Brother, just a couple of hours before my monthly prenatal appointment, where he measured a whopping THREE weeks ahead of schedule:

I know. Kara can't believe it, either. See her look of disbelief? She's all, "Who does this kid think he is, showing me up before he's even outside? I'M the miracle-size baby. Just let him TRY to top my birth weight!"

(Um, sweetheart, let's not encourage him.)

What to say to the haters now? There's no denying it: I look huge and I feel huge. The doctor wasn't concerned, but when I told her I wanted remove this boy from my uterus via a planned c-section, she didn't bat an eye, just asked for my date of choice and verified with the doctor scheduled to be on call that day (the doctor who performed Kara's surgery, no less). I've spent more time ordering beef low mein than it took to schedule the birth of my son. And the noodles weren't even that good.

For those not in the know, I've written a couple of times about forgoing a VBAC on my Parents blog, but to document it here on my personal site, I'll share my thought process again. At last month's appointment, I asked the doctor for her opinion regarding whether or not attempting a vaginal birth was a good idea for me. There are five ob/gyns in my practice, and each time I see one, I throw that question out there just to see if everyone's on the same page. And when it comes to supporting a woman's right to VBAC, they are; nobody ever said I couldn't try for one. However, this doctor was the second one to recommend another c-section (my primary ob was the first). She listed Kara's size as one factor, which I knew was still mind-boggling to everyone there; so much so, in fact, that at yesterday's appointment I took my glucose challenge test two weeks early to make sure my body isn't harboring a secret case of gestational diabetes. The other issue was the risk of uterine rupture, a rare but life-threatening condition I'll allow Wikipedia to explain to you. It sounds just lovely.

Anyway, the idea of attempting labor and then deciding Baby Brother was too big to deliver vaginally was never a big deal to me; I wasn't worried about pain because I knew I'd get the epidural again, and the possibility of avoiding surgery was worth risking an unsuccessful trial of labor. It's the uterine rupture thing that's always been a hard pill to swallow. Once I learned from my doctor that the risk of rupture increases when births are fewer than two years apart, there was no question in my mind that for me, a c-section is the way to go. My kids will barely be ONE year apart as it is; hell no am I counting on the strength of an abdominal scar that only had a few months to heal before it was subjected to another pregnancy.

I applaud women who have the confidence to attempt a VBAC. I think it's wonderful that the old adage "Once a c-section, always a c-section" no longer applies. I'm proud of myself for even considering it. But in the end, it's just not for me. So Baby Brother's birth day is officially on the books: Thursday, February 5, 2009, 8 a.m. My plan is to wrap up work the Friday before and spend the first half of that week freaking out about having my second baby, a baby I STILL can't believe exists in the first place. Mark your calendars and hold onto your hats.

As if this post weren't already chock full of meaty content, I also talked to my doctor about birth control after Baby Brother's extraction--something I obviously didn't pay much attention to after Kara. I'm not interested in methods that turn my uterus into a poo-poo environment on the off chance ovulation were to occur; once the life process is in motion, I don't want to mess with that. But I am interesed in sidestepping it for a bit while Luke and I figure out if we want to have more children. Just for kicks, I asked my doctor about having my tubes tied during my caesarean, but since I'm delivering at a Catholic hospital, it's not even an option. Which is fine--I'm not sure how I feel about permanently ending my childbearing years before I'm 30--but I'm not sure I'd ever be up for another pregnancy, either. My doctor recommended Mirena, which sounds great except it doesn't meet my uterus-friendly criteria, and she also mentioned Essure, a procedure that's just as permanent as a tubal but without all the surgery. Also great, if we decide that we're Done.

In the end, Luke and I will probably just use condoms until my cycle regulates itself and I can trust the calendar to tell me when I'm ripe for the picking (thank you, Taking Charge of Your Fertility). It obviously worked before Kara, seeing as we were able to conceive her the minute we stopped avoiding relations on my "high-trigger" days. Baby Brother's conception had nothing to do with botched birth control and everything to do with "Ha! There's no way that could happen to me." A hard lesson to learn, for we all know how well THAT turned out:

Not that I would have it any other way, of course.

Comments

[debi]

Frema you do not look huge. You look slimmer than with Kara. Your belly looks just the right size. I think you look wonderful. My daughter has 3 kids and had 3 c-sections. With babies 2 and 3 she was told she could try for a VBAC since the babies were doing well and because more than 2 years had passed since the births of each baby. I would do just as you are doing. What an exciting time in your lives.

[Kathie]

I'll second that, I think you look wonderful! And woah, look at Kara standing up as if she were some sort of big kid or something! Insane. And, whilst I really want to go for a VBAC when we decide to go for a sibling for Toby (my c-section was done for very different reasons to yours), I say hooray for making a considered choice and doing what feels right for you!

[Bunny]

You sound like you've got a good head on your shoulders about the C-section. You are making the right decision for you. (you already know that, I know, but encouragement always helps, right?) I want to hear all about the birth control options after baby boy. I have decided I don't want to (ever) go back on the pill because it makes me crazy. But I have no idea what we will do once we have another (hopefully-we're trying. i totally hear you about the hesitation at anything permanent before you're 30. I guess since you didn't mention it, it's not something you all are considering, but what about the big V? I;m hoping that's what we're going to do once we are Done. Then he can take a hit for the team, so to speak after I am done bearing his babies.
Hmm, sorry, this comment sort of turned into me rambling about myself. Thanks for the sounding board :)

[Grandma Molly]

I have marked February 5th on my calendar. We are looking forward to the date and to the wonderful times before then.

As usual, both you and Kara look beautiful. :)

[Frema]

Bunny: The Big V is most definitely on the table, as Luke is well aware and totally fine with, though he did point out the Essure procedure would be less involved for me than a snip-snip would be for him. Seeing as my body will have been cut open twice to deliver our children, my sympathy level is low. :)

[Jen L.]

Oh, Kara, do not challenge Baby Brother to be bigger than you! Not nice to do to Momma...
Her face is SO FUNNY in that picture! (That picture taken in your NEW HOUSE! Love it.)
Feb. 5 is a great day. Aquarians are delightful. (I speak from experience;) )
Sounds like you're making a good decision with the scheduled "C."

[Mrs. Squirrel]

Dearest...you do not look huge to me. With my second pregnancy, I got big MUCH quicker. You look fabulous and perfect and your daughter's facial expressions crack me up!

Good for you for investigating your options for baby brother and birth control. GOOD LUCK!

[Rachel]

You look great! Pregnancy agrees with you and Kara, as always, is just so damn cute!!

I had Alyssa via emergency c-section so, of course, my incision wasn't very clean. It's a bit jagged. But my doctor told me while I was still in the hospital that he would be willing to let me do a VBAC. I would prefer that because, my epidural hurt like hell to get and then didn't work so I was under general anesthesia for the birth. But, I don't know that I will be having any more kids and of course I don't know what my decision would be if I did.

I cannot wait to see Baby Brother!

[Christina]

I think that you look great!
I looked into the IUD and didnt do it, we have been using condoms and I used TCOYF and charted for 7 months when trying for Nate so I am damn familiar with what is going on in my body- Im on my 4th post-p period and have managed to dodge the "bullet" (hah!) am comfortable with it for a few more months until Nate is weaned and I can go back on the pill. After #2 it am going to go with the IUD.
The house looks fantastic! I hope you are feeling at home and loving it.

[AJU5's Mom]

I like Kara's floppy toes in the first picture - too cute! The only tings I don't like about Ensure is that it is totally permanent (unlike tube tying and the big V) and if it is like the tube tying, you can still get pregnant - but it will just be ectopic... Glad to hear your husband will at least listen to having a V though...

[Isabel]

Oh Frema, I think you look great (so does Kara, but that goes without saying)!

I love hearing about your decision making process. I always appreciate the thought you put into choosing what is right for you guys. And I love how you always back up your choices.

The topic of VBACs and scheduled c-sections freaks me out. And so I just don't think about them. Which works, for now, but won't work when I'm pregnant. And um, I just choose to not think about BC either.

Clearly I suck. But I'm smart enough to be friends with a smart lady like yourself!

[Molly]

Three weeks ahead, huh? Interesting, Baby Brother, verrrry interesting. Also, woot woot for February 5th! And for your doctor giving you a date in advance! Marin and BB will be exactly five months apart. :o)

You really do look great. As I've said before, you do pregnancy very well. In fact, I think you should be the next Duggar mama. Just keep going! Dunscombe isn't THAT far off. (Ducking)

[eva]

You look great, and somehow more fit than you did with Kara, so whatever you're doing, good on ya:) And VBAC...as a fellow c-section-er, I appreciate reading about your decision making process. Happy gestating!

[r+k+mama]

You 3 are so cute! I agree with pp that you in no way look bigger than a very cute pregnant lady should look at 26 weeks.
I heart my IUD but totally understand your reservations. It's always bothered me that they don't exactly know how/why it works, but at the end of the day I am very lazy and love that I don't have to think about it and it's not permanent (we are also it the maybe/ maybe not camp for a third.)

[elizabeth]

Kara looks so old there, standing and making sarcastic faces! I'm waiting for my little guy to start walking, but just watching him stand up makes me think "No! He's still a baby" when in fact he's 13 months.
We used NFP (just like that taking charge method you use, but catholic-based) for a while, but we're not anymore because my cycles are screwy. Once they get back on track here we can ditch those silly condoms.
I love reading about all sorts of things that you guys do and can't wait to see the new baby!

[Jenny]

Just seeing you the other day in person, I do not think you look huge at all. You look terrific!

Still looking forward to house pics!

[ann]

You look great! You do have very large babies, but you're petite and there's no where for the baby to go but out.

I had a doctor who pushed IUDs and I resisted also. When I got pregnant with my third while still nursing the second, the appointment was made for hubby's big V!

[Fraulein N]

First let me say that the look on Kara's face is hilarious.

I think your decision makes perfect sense. I also think it's great that we're coming into a time where each woman can do what's best for HER.

[eva]

Oh and I know two people who got pregnant with an IUD in...they can "travel" and if you're not checking constantly to see if they're in place, you could end up preggers. Not "you", but your readers...just some random assvice:)

[Emma]

I really, really ought to not stop reading blogs! You're pregnant! Yeah, apparently it's been a while.

And Kara? Is one of the most beautiful blogger babies I have ever seen!

[Katie]

I have the same concerns about birth control. The last time I had a gyn appointment I asked about diaphragms/caps (I'd heard that there were new and modern options similar to the cervical cap), and she said that 'people don't use those any more'. OK then. Also, from what I studied, the effectiveness of diaphragms/caps didn't seem to be much more effective than spermicide alone. So what's the point then? My husband and I both hate condoms. My cycle has not returned yet (14 months post partum), so charting is sketchy. So I guess we're heading for quiverfull! (I jest, but only slightly; I'm really not comfortable with any other option!)

[Katie]

Oh, I forgot to say --
Luke says the Essure process is less involved? Those little pluggy things don't just wander up in to the fallopian tubes by themselves, hee hee. The website says they're "delivered through the vagina and uterus". That sounds quite uncomfortable to me. Of course if you're talking about having it done during the c-section surgery, then yeah, it would be no problem.

[bzmomma]

Hey There! Found your site via Carissa's (andsosheblogs)..I saw the title to your last post on the comment thread and thought it was just brilliant so I had to come and read and I'm glad I did.

Goodluck on your pregnancy and though I just started reading you today, from the picture comparisons, you look smaller now than you did in your previous pregnancy. Do what's best for you :)