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  1. Adventures in Baby Flipping

    March 21, 2015 by Victoria

    Most babies these days come out head first. Breech deliveries used to be more common, but medical schools have pretty much stopped teaching them, so most practitioners aren’t experienced enough to do them. By the end of pregnancy, only about 1-3% of babies are breech. Aren’t I lucky?

    Baby boy was cooperative and head down at 20 weeks, but by his 28 week growth scan he was breech and stubbornly remained that way. At first everyone said, “Oh don’t worry he has plenty of time to flip,” and at 30 weeks my midwives recommended I do a few exercises from spinningbabies.com, and some passive things like put a cold pack on the top of my abdomen where his head was, play music and/or shine a flashlight down by my cervix. I dutifully did all of these things. At 32 weeks, they suggested going to a pool and doing headstands under water. While that didn’t sound like fun, it sounded easier than getting a C section, so off we went to the pool.

    By 34 weeks, they gave me the name of an acupuncturist and I began doing weekly acupuncture sessions and moxibustion several times a week while laying upside down on an ironing board. True story people. I was committed. I found acupuncture pretty relaxing, and the acupuncture and moxa both seemed to make baby boy a lot more active during the treatments but he never fully flipped. So yesterday at my weekly midwife appointment, they got serious and recommended an external cephalic version (ECV) as soon as possible.

    The ECV had been mentioned as the option of last resort at previous appointments, and I knew from my own research that I was an okay candidate for the procedure, but I was not super excited about it. The success rate is around 50-60%, but can be higher with a doctor very experienced in performing ECV. It’s “very uncomfortable,” which is medical code for “hurts a lot,” but the risks are extremely rare and lower than those of a C section, and I figured even at 50/50, it was worth a shot if it meant I could avoid surgery. I had pretty much made my peace with probably needing a C section byt this point, but I just wanted to know for myself that I tried every possibility to avoid it first. Truthfully what scares me most about the idea of surgery is recovery with a truly rambunctious toddler in the house.

    The day of the procedure I got a little panicky. Brent and I both have really negative feelings and worries about hospitals and “procedures” now, for good reason, and it’s just kind of become second nature for us to focus most on the worst case scenarios. I tried to use the afternoon to keep busy and pack a bag and focus on the fact that it might actually work. So at 5pm yesterday afternoon Brent and I checked into labor & delivery to get ready to try to flip this baby. Some rare problems that might arise would be if my water broke and I went into spontaneous labor during the ECV, or if the baby didn’t tolerate it or something else went wrong and I needed an emergency C section, so we prepared for the very slim possibility we might end up with a baby, which was a little overwhelming to think about even though I’m already 37 weeks along.

    To get started, they gave me a non-stress test to monitor the baby’s heart rate and his reaction to my contractions. I have an “irritable uterus” which means I have (usually) painless contractions literally every 2-6 minutes from around 20 weeks until the end of pregnancy. Super fun. After spending 20 minutes on the monitor and making sure everything looked good, the doctor came in and made sure I understood the procedure, went over the risks, and explained exactly what I could expect. The gist of it is, the doctor uses their hands to grab the baby’s butt and the baby’s head from the surface of the abdomen and manually rotates the baby into a head down position (while monitoring with ultrasound to ensure baby’s handling it well). I signed the consent forms and they gave me a shot of terbutaline (used to stopped preterm labor) in the arm to relax my uterus so it wouldn’t contract for an hour. The terbutaline made me super jittery and nervous (the most common side effects), but it wasn’t a big deal. Brent thought it was hilarious I was acting even more hyper than normal.

    I laid down flat on the bed, surrounded by the doctor, my midwife, the nurse, and Brent standing behind them all looking rather nervous. I closed my eyes, started my relaxation breathing and hoped for the best. I kept reminding myself that if I managed to give birth to Cormac without any drugs, then surely I could handle this relatively short procedure. It. Was. Very. UncomfortableThey were not lying. She literally dug her hands several inches into my pelvis and moved his butt out of my pelvic bones. That was uncomfortable but tolerable, but then as she was moving his butt up, she used her other hand to dig under my ribcage to scoop out his head and move it downward. That was really difficult to breathe through. She got him completely sideways with his butt on my left side and his head on my right, but he was not interested in going any further and swung right back into breech. By this time I started getting shaky and sweaty, and they brought me a cool washcloth and we took a 5 minute break.

    The first attempt had only taken 5 minutes, but she called him stubborn, and said that because of the position of my placenta (in the front) that she was having a lot of difficulty getting a good grip on his head. She said it was completely up to me if I wanted to try again or not. I wanted to avoid a C section, but if it wasn’t going to work, I didn’t want to waste everyone’s time and go through more of that pain. I asked her if she though she could actually get him to turn, and she said, “Well usually if they’re going to turn, it’s easier than that, but he’s tolerating it really well, so I think it’s worth trying one more time if you’re up for it.” I nodded in agreement and tried to really focus on my breathing for the second attempt. She moved his butt way up and out of my pelvis and got ahold of his head from under my ribs and it just felt… easier the second time. I was laying there with my eyes closed really trying to relax every muscle and focus on my breathing and I could hear everyone start saying, “It’s working! Look at that!” And then just like that she said, “Okay, he’s there. it worked.” They verified with ultrasound that his head was in my pelvis and sat me upright to have gravity try to help keep him there. The entire thing, with both attempts, only took like 10 minutes, and while it was definitely not a pleasant 10 minutes, I am so glad I did it!

    They put me back on the monitors for an hour to make sure baby’s heart rate stayed stable and I didn’t go into labor or have any complications, gave me a menu and told me to order food and we just hung out watching basketball for awhile. Before going in for the ECV I looked up a lot of info online and there were a lot of women saying they had opted out of trying it because “it only works half the time” and “it wasn’t worth the pain.” I know every doctor and every woman is different, but I’m so glad I got it done. I think I’d be glad I at least tried even if it hadn’t worked. (I really do not want surgery.) The likely reason baby was staying breech was my constant contractions keeping him in place, so the shot to relax my uterus was really vital according to the doctor. It wore off within an hour or so and my contractions resumed (which will now hopefully hold him head down!) and now we’re at home and we’ll just wait for labor to begin. I’m still sore from the procedure, and it feels a little like some one repeatedly punched me in the ribs and stomach, but it’s not really too bad. I’m also a little paranoid and keep worrying that he’ll flip back to breech, but the doctor said if that is going to happen it will likely happen in the first day or so, so if I make it through the weekend, things are looking pretty good.


  2. A Pregnancy Update

    February 17, 2015 by Victoria

    Guys, I don’t like to complain, but… Actually that’s probably a bit of a lie. I’m kind of a complainer. But I’d still like to think of myself as a more positive than negative person, but I’m over it. Just. Over. It.

    What’s interesting is that this pregnancy has probably been my easiest, physically. I had the hemorrhage early on, but it resolved. And I’ve had [a normal amount of] nausea/vomiting, but no hospitalizations or IV fluids, but mentally/emotionally every day is kind of getting harder. Because of my history, I get more frequent monitoring, which seems like it would be reassuring, but honestly, for me, it just seems like a million more opportunities for them to find something wrong.

    Around 18 weeks, the office called to tell me that baby boy had a very high risk of neural tube defects. Weeeelllll, apparently that was only because a lab tech input Alfie’s death as a neural tube defect, which it wasn’t. So once that got cleared up, all results appeared normal, which is great, but that was not a fun couple of days. The anatomy scan at 20 weeks looked absolutely perfect, and I had a really blissful couple of weeks where I allowed myself to finally get excited.

    Then I had my 1 hour glucose screening test, which I failed, so I had to take the 3 hour diagnostic test. Except I puked and fainted 17 minutes after drinking the liquid, so I couldn’t complete the test and spent a few days convinced I had gestational diabetes (not the end of the world, but still a risk factor for things like stillbirth, which is absolutely the last thing I can tolerate hearing right now). Well my midwives just had me check my blood sugar 4x a day for a week instead, and it turns out I do not have diabetes. Wonderful.

    At the same time, I had my 28 week growth ultrasound required by the perinatologists and they found out baby boy’s kidneys are enlarged, the left one much more so than the right one. The midwives explained it might just be a fluke, and the scan caught the baby at a weird time, holding his pee in or something. So they scheduled a follow up ultrasound at 32 weeks, which I just had this morning. Well his left kidney is still significantly enlarged, so there is an issue with it, but it will hopefully resolve itself sometime in the first year of life.

    So for now, they’ll likely do one more ultrasound before birth because kidney issues can cause amniotic fluid issues, and then he’ll need frequent monitoring and routine ultrasounds after birth to check to see if its resolving, and worst case, if it doesn’t resolve in the first year, he may need a surgery to fix it. All in all, obviously it could be something a lot worse, but my mind is really in a state where every little thing feels huge and significant and unfair. I’ve only got 7 more weeks left, give or take, and honestly everything scares me right now. Everything. It’s hard to explain to people who haven’t been through it, but I really lost trust in my body. Like, in my mind, he doesn’t feel safe in there, even though rationally I understand he’s growing as he should be. I just really need to see him and touch him with my own hands to know that he’s really okay, I think.

    Oh, and because he’s stubborn like every other member of his family, baby has been persistently breech since 26/27 weeks, despite my efforts via spinningbabies.com. Next step is acupuncture & moxibustion to try to get him to flip, but I’m already preparing for nothing to work out on that end either.

    Alas, here are some more light-hearted updates and another bathroom selfie for you all to enjoy.

    unnamed-5

     

    Weeks along: 32 weeks, 4 days

    Weight gain: 17lbs

    Cravings: All the sweet things. Please send me all your chocolate, thank you.

    Symptoms: Heartburn (Apparently you should cut out chocolate to help relieve that. Not happening). Also I now move with the grace of a super old elephant combined with a penguin. And reaching my feet to put on socks and shoes is becoming a bit more difficult.

    Working out: Now means waddling myself around Green Lake. It’s a very slow 3.5 miles from my front door, around the lake, and back, but I figure it’s better than nothing.

    Baby’s name: Has been agreed upon!

    What Cormac thinks: He thinks baby brother is either a body part that refers generally to your torso, or that “baby brother” is mom’s “other name.” So yeah, he’s in for a bit of a surprise.

    What’s left to do: Find a pediatrician (Cormac uses a family doc, but since we’re looking at future ultrasounds and follow ups, we’d rather find a dedicated pediatrician this time), buy a car seat, hang some curtains and art in the nursery.

    We’re in the home stretch! (At least that’s what I keep repeating to myself)