Thursday, March 18, 2010

Holding Pattern

I am 40 weeks and 4 days today and although each night for the past week or so I would swear labor is imminent if not already getting started, the next morning I am back to neutral. I think I am just more warn out by the end ot the day so it just seems like things are moving along.  I went into labor spontaneously at 41 weeks and a day with LB so I ought to be more patient.

The good and the bad about waiting is that Mach 20th would be the best birth day for LBII. It is the Spring Equinox and since LB was born on the Summer Solstice it would be a great pair. The downside is my buddy who was there for both Ernest's and LB's birth will be leaving town on the 19th for a week. I really want her to be there.  She is wonderful support, but I will survive either way.

Speaking of surviving, I feel the need to document - just in case things go terribly wrong - that I am not unaware of the added risk inherent in a planned VBAC homebirth.  If my uterus does rupture things are pretty grim for LBII, but wouldn't be much better in a hospital - death is not uncommon. One may argue that the chances of a rupture are higher in a hospital due to the increased chance of intervention. But then, I am sure death is more likely if the rupture happens at home.

In the intervention subject, I did a bit more research after posting on my blog that the chance of a rupture after cesarean was 4 out of 1000.  Some readers commented that those did not include augmented and/or induced labor but I found the studies I read (which had around the same odds) did indeed include augmented and/or induced labor.  My own OB will induce / augment with a VBAC although he said it needs to be done more gently.  I have also found, to my surprise, that there is a chance of rupture with no prior cesareans so we are not even comparing 4 / 1000 to 0 / 1000.

A couple of articles for anyone interested in more. The first is a study about planned homebirths and the second is an article about the NIH recommending a new look about guidelines around a VBAC.  Then I read this article which basically says not to believe anything you read because scientists don't understand statistics.

What can you do?  For me, I am still hoping for that homebirth VBAC and I am still seeing Dr. Wonderful (my OB) just in case.

15 comments:

Sunny said...

Wow! You are really going the distance with LBII! Hanging in there... it can't be too much longer. My brother was born on March 20, and I wonder if that's the day my twins will chose to enter the world as well.

I heard that they never induce/augment with a VBAC? Either way, hoping that you get the birth experience of your dreams with no complications.

niobe said...

When this post popped up in my reader, I was really, really hoping that you were announcing the safe arrival of LBII.

Guess I (and, more importantly, you) are going to have to wait a bit longer. Fingers crossed that all goes absolutely perfectly.

MrsSpock said...

I would agree that a chance of rupture with an augmented VBAC is much larger than a non-augmented. The type of incision also comes into play. The classic vertical incision (used in many crash c-sections) are more likely to blow. I only knew an OB or two that would be willing to Pit a VBAC, and they only used a whiff of it. For myself, I would refuse. Too risky.

I will say that a child has a much higher chance of surviving a rupture in a hospital with 24/7 anesthesia than at home or in a community hospital. I think there was a history of a rupture or two on my old unit, but each child survived. The decision to incision time was 7 minutes or less there, however. In a community setting, you have to wait for a squad to arrive, transport, and OR setup. In a community hospital, usually you have to wait for anesthesia to arrive from home, which is at least 30 minutes during off shifts.

Hope everything turned out swimmingly for you- not too much longer!

Panamahat said...

My EDD for lucky number seven was today. Perhaps I should be commemorating him/her all week since they never seem to come on the day, and look how yours run over time!

Thinking of you often and wishing you all the best for a perfect home delivery. x

Lavender Luz said...

You and LBII are on my mind, Kami. Wishing you the best and the easiest. And according to your plan.

Lisa DG said...

Take my advice- not that I do. I will believe that this birth will go smoothly and easily- no ruptures...no problems.

Looking forward to hearing your happy birth story from the other side.

xoxox

Summer said...

I haven't been able to catch up on your latest posts until now. Can't believe how fast this time has gone (well, from my end, anyway).

Hoping to hear the story of a smooth VBAC with no complications and the announcement of the arrival of LBII, soon.

Will be thinking of you constantly, Kami!

Me said...

I'm so optimistic for you luv. You've paid your dues - the Universe is only doling out good things to you now! :)

Caro said...

Thinking of you and looking forward to hearing about LBII when it's all over.

Leah and Maya said...

Hoping LBII is still in there, see you this afternoon!

battynurse said...

I was hoping too to hear that LBII was here. I really hope this birth turns out fantastic for you. I know how much you want the home birth and you have researched things and are making an informed decision. A decision only you and Brad can make. Thinking of you and hoping it all goes wonderfully.

Laurie said...

Thinking of you Kami and can't wait to hear when LBII arrives!

Sky said...

My best friend's first child was a c-section. 15 months later she gave birth to child number two in the hospital, vaginally.

There were no complications whatsoever.

musicmakermomma said...

I really hope you have an uneventful home birth! And there is no good reason you won't so think positive. Sending good vibes. Would love to drop something by for LB2 but I realize I don't know where you live! Anyway, it can wait til you are a bit recovered. Unless you are bored and want company - let me know.

Also, I HATE all the OBs in this town, please at some point give me the scoop on Dr Wonderful, I am happy to drive an hour if I don't have to see an a$$. Good luck - thinking of you!

Sara said...

I was just thinking about you, so I thought I'd comment just to say that tons of positive "good delivery" thoughts are coming at you from the Southeast.