Great Expectations: Pamela @ 32 weeks

What a change these past two weeks have been from the previous two.  After an upsetting prenatal appointment at 29 weeks I had a lot of homework to do which did a LOT of good both emotionally and physically.  I went to see a certified dietician and she gave me a breakdown of how much I should be eating per day. It was an excellent reminder of ways I could make my diet friendly again.  I was so anxious about what I could eat that food became stressful and my dietician helped put food in perspective.  I have been staying as active as possible, walking and seeing my trainer, as well as chasing the boys around umpteen pumpkin patches.  I also started taking a Vitamin D supplement, and between that and everything else I've been doing, my blood sugar numbers have been outstanding.  I hope that my endocrinologist will agree at my follow-up appointment tomorrow.

Physically, I was really sore after an ambitious workout with my trainer as I am dealing with a recurring issue with my hip flexors and psoas.  After an amazing massage with my therapist, nightly stretching, and a very kind husband giving me massages, I am feeling MUCH better.  I also am enjoying the cooler weather so I can get out more often for walks without melting.

Since I feel as though I have a much better handle on my blood sugar issues, I've been spending more time thinking about optimum fetal positioning.  With about eight weeks to go, I still have time to help encourage this kid to be in good position for birth.  I started going back to ICAN (International Cesarean Awareness Network) meetings as I did after Julian's birth so to remind me from where I came and how I can avoid a repeat cesarean.  Despite having had a successful home birth after cesarean (HBAC), I will always be considered a VBAC mother with subsequent births and the fear and anxiety over having a repeat cesarean will always be there for me.  With Julian, our birth was induced due to preeclampsia one day before my due date.  They started' labor for me by breaking my bag of waters and looking back, I would have asked for any other way to induce labor other than this way because I believe it was one of the major reasons why I ended up with a cesarean section.  Once your water is broken the baby is much less likely to get into a better position and in our case, Julian was posterior as well as asynclitic.  With the amniotic fluid leaking out, he couldn't get into a better position.  If you are unfamiliar with the website Spinning Babies, I highly recommend it.  It is an amazing reference for all things regarding baby positioning, which is one of the major causes for cesarean sections.

Julian's labor was one of the toughest things I've ever had to do.  I've climbed fourteen-thousand foot mountains and completed half-iron distance triathlons and those physical feats were nothing compared to what labor demanded from me.  Anyone who has experienced back labor due to a posterior baby will tell you just how excruciating it is.  When they broke my meconium-stained water nothing happened (common for a posterior baby) and my labor was eventually augmented through Pitocin.  Let me tell you, Pitocin-induced contractions without an epidural is the worst pain I've ever experienced.   After hours of erratic contractions (almost 15 hours total) I relented and got the epidural that I never wanted to get in the first place.

For the record, I do not have anything against epidurals and cesarean sections because they do have a place in childbirth.  I do believe, however, that they are often used unnecessarily in what could be seemingly normal labors and births.

By the time we got to full dilation (almost 28 hours after my water was broken) the anterior lip of my cervix would not retract.  The nurse was trying to hold it out of the way while I pushed but he still would not come down.  Looking back, we know that his head was holding my cervix in place because of his position.  When we went to the cesarean (33 hours after my water was broken) and they discovered not only his poor positioning but also that his cord was wrapped twice around his neck, I had mixed emotions. Cord wrapping is actually very common in babies but in our case could have been part of why he would not descend.  Incidentally, Dash's cord was wrapped around his neck when he came out but my midwife was able to unwrap it as he slid out and it was not an issue.

If I could go back in time, what would I change about my birth experience with Julian?  I would start by not letting them break my water.  I also would have tried harder before his birth to help encourage him into a better position.  Would those changes have helped me avoid a c-section?  I don't know, but at least I could have done more to encourage him.   Having learned many lessons from Julian's birth, as my pregnancy with Dash progressed I was obsessed with encouraging optimal fetal positioning.  I saw my chiropractor more often, I almost never reclined or sat back, and I used my exercise ball daily, among many other things.  I wholeheartedly believe that if Julian had been in a better position, I would have been able to birth him vaginally.  I do not feel as though his size (8 lbs 13 oz) was the reason he could not get into a better position, although having a smaller baby with Dash certainly helped (6 lbs 11 oz).  This time around, with my blood sugar under more control and my growth slowing down in general, I feel confident that this baby is going to be a good size for me to push out.  It's all about his positioning now.

If there is anything that I've learned since Julian's birth it's that we have the power to influence our births, especially if we take the time to learn about potential issues beforehand.  Do I know for sure the work that I am doing to encourage this kid to get into a good head-down position is going to work?  I don't but at least I know that I am doing everything possible to help.  As of right now, he is head-down and anterior&let's hope he stays that way!!

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