I had an OB appointment yesterday. It was mixed news. But the babies seem to be doing well. She easily found both heartbeats on the Doppler, and heard movement as well. I wish I could feel them moving--sometimes I think "Oh! Maybe that was a baby..." but I wasn't feeling anything at all when she heard Bitsy (presumably, since it was much higher) moving around. And my uterus is clear up above my belly button, which I already suspected because of my home-Doppler time and because yes, ok, I palpate around. I'm measuring at 20 weeks. So we have every reason to believe they're doing well.
I, however, lost 6 more pounds. (I think it's closer to 4 in actuality--I think I wasn't properly rehydrated from Thursday's very badness.) And now she's concerned. Yanked the Reglan, kept the Zofran, adding Phenegran, kept the Unisom (which I don't think does anything, but whatever), discussed adding Prilosec. I really don't know about the last one. It's for heartburn. I only have "heartburn" after vomiting. She left the decision up to me--it's OTC anyway. I asked my doctorsister about it, and she said she personally wouldn't treat someone with it, but she doesn't think it would be harmful.
I have to say, though, after following the link Bridget left in my comments, I'm much luckier than I thought. Her friend who had HG had a PICC line during her 2nd pregnancy! I've only had to get fluids twice, and don't need my meds infused. I'm extremely vigilant about drinking, but I know that only gets you so far, so I'm counting my blessings. One thing I found interesting on her links was that vomiting bile is a "bad sign", an indicator that it's HG and not just morning sickness. Is that really true? Because I know many women dry heave, and you can't get to that point until you've truly emptied your stomach, which yes, means puking bile. And if most women are puking in the morning...isn't it bile? Because that's what I get, even if I force a few crackers down first (they just come back up, and then the bile).
Anyway, I'm pretty well-managed, no central lines and I can live my regular life 8 or 9 days out of 10, with frequent meds and pit stops. So that's a good thing.
But the other news that really upset me came after my cervical check (long and firm, woohoo!) and Pap (I was overdo, but she didn't want to do it till the spotting had stopped). She felt around in there, palpating on my abdomen, good times, you know the drill. She then informed me that my pelvic inlet is very narrow, and if my babies are more than 35 weeks, she doesn't think I can try vaginal.
Have I mentioned that I'm not some dainty little thing? I'm 5'6", and have hips. I know it's the inside not the outside, but...no way. I come from a long, long line (on both sides!) of childbearing Mormons. We're talking mainly 6+ kids, no maternal childbirth deaths. And I know my genealogy, my mom did it all way back when (and we're talking Mayflower and Joseph Smith's brother on my mom's side, by the way, making us both American and Utah royalty). Where on earth would I have gotten some non-functional pelvis from?
I was very upset by this. Hormonal, I'm sure, but it felt like yet another sign in the "you shouldn't be having children" road. Infertility? Check. Pregnancy that maybe would have killed me pre-anti-nausea drugs and IV fluids? Check. Pelvis that can't bear kids? Check.
My birth plan, as I've mentioned, is simple: babies out, all alive. But I don't want a C-section. I will, of course, get one if needed. No hesitating. But hearing my prognosis like that--of course I want my babies to gestate for more than 35 weeks! So fine. Section it will be. But to think that, even if I were having (or am lucky enough to try again and get pregnant with) a singleton, I'd still need one? It's...it's just unfair. I want to give birth vaginally. And my doctor is saying no, never, not unless it's PTL.
I called my sister, to talk about this. Because I don't know much about childbirth, but I know that relaxin is supposed to do something--loosen my pelvic joints, soften everything up. And I know position matters. And frankly, I sort of thought the "too narrow" thing was a myth. My sister says yes and no. She says even when they do fancy ultrasounds and measure the babies' head(s) and the pelvic inlet...they're still wrong more often than not. That she personally would never tell a woman she couldn't deliver vaginally. But that if labor wasn't progressing, she would start recommending a section much sooner, before the mom gets worn out and/or the baby starts showing signs of distress. She said, if I were having a singleton, she'd recommend I find someone else who was more willing to work with me.
But I'm not. And we're worried, with Itsy being so low, about placental previa (we'll get a better idea on Oct 3rd, when I have my Level II ultrasound). And, well, with two babies in there, there's not much wiggle room. If Itsy decides breech is best, decision's made for Bitsy too. Or any of the other things that can go wrong, times two.
Maybe I should just resign myself to a section and call it a day. It's not like my babies got inside my uterus on their own anyway.
7 comments:
Many moons ago, I did 1 and 1... 1st was vaginal (and au naturale btw, and very overrated! PAINFUL!) 2nd was emergency c-section which also sucked.. I think planned section is much better than emergency any day of the week! HUGS!
I agree with you that the important thing is babies out and alive, and you as well.
That being said, the differences in recovery between a c-section and a vaginal birth, as well as the risks of various things, also make me want to avoid the surgery route if it's not medically necessary... and I'd certainly be a bit wary of a doctor trying to push that decision now -- at what is hopefully less than the halfway point. I think it's great to frankly discuss that you have less clearance to work with and that you might have a higher risk of needing a c-section, but positioning of Itsy is a pretty huge factor too, and just delivering the judgment that you can't even TRY vaginal birth seems rather hasty. I agree with your sister-doctor about the measurements, even when done with precision rather than an internal exam, not being very good predictors.
Your hospital seems to have a high c-section rate for twins, so perhaps this OB is rather likelier to encourage you down that road than another practice might? Is there a reason you have to stick with this OB?
Regardless, you could very well still end up with a c-section -- placenta previa would be a very good reason, as would Itsy being breech -- but it's way early in the game to call either of those things. Even twins should have room to shift position (you're measuring at 20 weeks, not at 40!) and I know several women who were diagnosed with placenta previa at 20w and enjoyed pelvic rest and monitoring ultrasounds as a result, but for all of whom it resolved completely as the uterus grew, enabling uncomplicated vaginal births.
If you do have to stick with this OB for whatever logistical reasons, I'd consider hiring a doula to provide some reassurance and support for you and your husband through the pregnancy as well as through labor/delivery.
And as for the c-section vs vaginal decision - I think you can safely punt that down the road a good long while and see how things develop.
PS - I didn't have particularly vile morning sickness at all, but I definitely vomited bile at times (other than the Gastroenteritis from Hell).
Sorry about the HG and the weight loss. I hope it improves soon and that the new meds help.
I've resigned myself to a section....mostly because I don't want to labor and labor with one only to end up with a section for the second one. I would rather get them out at once and hopefully lesstrauma for momma and babies. I two am measuring 20 weeks even though I don't have much of a belly yet.....my uterus is just up by my belly button....I am sooooo ready for the big ol belly!!!!!
Hmm tough stuff. I know it must be hard to think that you might not be able to deliver the way you want to. A week ago when we still had twins, I resigned myself also to a c-section. But to be honest, I'm fine wiht a c-section. I wanted them out quickly and safely, and if it meant I was going to be hobbling around for a few weeks with an incision and that I wasnt going to have the "push! push! BABY!!" delivery, that was ok with me. But understandly, its not okay for others. Even now that it's just one I'm still fine with a c-section. But who knows what will happen. Very happy to hear the babies are doing so well! :)
This pregnancy just sucks for you. I'm so sorry. Just keep focused on the end product, I guess!
First, the bile thing. I definitely did not have HG. I was green, but nothing close to what you've been through. And with me it was very frequently bile. In terms of the "too narrow" thing, what your sister says makes a lot of sense to me. I can't help feeling that things may change/shift/give different measurements as you progress farther. But I know what you mean - after fighting so long to get here, it's very dispiriting to be told, "Oh, nope...something here isn't right." Suspend judgment for now? When those babies are ready to make their way into the world in 20ish weeks, it may be a completely different story.
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