Wednesday, October 6, 2010

34 week OB appointment

And it went great!  Weight gain is up to almost 40 lbs, I'm sure we'll pass that by my next appointment!  Uterus is measuring right on target, blood pressure is at 100/68 and my urine dip was good.  I was sent to do a Urine Analysis immediately after my appointment though because of my experience the last couple months with UTI's we want to be sure the last of it is all gone :)

We had the opportunity to discuss labor.  Contractions have definitely picked up and gotten more painful.  At this point (34w3d) they will not try to stop labor, so I just need to see if there is a pattern, it's close enough and then take our bags and head in to L&D if it's time.  We made a decision regarding the whole VBAC vs. Cesarean dilema.  He agreed that a VBAC is a great option for us and there is no reason, as of right now, why it wouldn't be feasible.  His question: If it turns out that I get to 41-42 weeks, what will *I* want to do.  Will I want to try to wait it out for a VBAC or would I want to cut it her out.  Induction is not an option because of the risk of uterine rupture and I know well enough to expect to fall into the 1% group when making any decision.  I told him, honestly, I don't want to get too far past 38 weeks.  He said that was fine with him, he would be willing to do a cesarean anytime after 37 weeks if that's what I wanted.  So, my chart has been updated to read that if I do not deliver by my 38 week appointment (Nov 3) I will get the next available surgery time and Samantha will be born.  Which means, Samantha will be here no later than November 8!!!!  That is only 32 days away!!  And this is something I feel really comfortable with.  More than anything I just want her here and healthy.  And the positive note is that it will give me at least 12 days to recover before Kaitlyn's birthday party, I don't have to worry about not being there for Kaitlyn on her birthday, their birthdays can still be close without sharing a weekend and I can know that within the next 787 hours she will be in our arms.

If we go before 38 weeks (which is still highly likely), we will have a VBAC.  It will be at Mercy San Juan and as long as we go another week and a half, she will come home with us.  Dr. Z did tell us that because it's a VBAC and because there are still risks associated, that I cannot have the room full of family I wanted for delivery.  Which sucks.  I had really wanted to at least give aunts an opportunity to be there when Samantha was born, but he said there is limited space and if something were to go wrong and I would need an emergency surgery, they want to be sure I'm easy to get to and the room is easy to clear out.  So, we are limited to 4 people.  Obviously Dusty and Kaitlyn will be there and then we will ask our moms if they would like to be.  Which of course means I need to rethink all of the camera angles I was originally thinking about...

So, there it is.  32 days, at most, until we meet our little girl.  And there is a possibility, if we go cesarean, that she could share a birthday with Uncle Scotty, Cousin Lisa or Auntie Jamie.  Lol, like we don't have enough November birthdays as it is :P

*Edit to Add*

I forgot to add the latest update regarding the Factor Leiden V!  Which is another reason we discussed cesarean.  So far, the clotting disorder has been managed just fine with simple baby aspirin.  However, he does want me to stop the baby aspirin 2 weeks before I deliver to reduce the risk of excessive bleeding after delivery.  Obviously, I want to be able to clot then to help my body heal.   He would like me to stop baby aspirin when I get my last p17 shot in 2 weeks.  BUT, if for some reason, I don't go into labor in that time, I worry about the risk of a blood clot in the placenta or umbilical cord or diminishing her blood supply by being off of the baby aspirin for so long.  I would hate to put her in a position where she wasn't thriving just so I can have the birthing experience that *I* want. 

4 comments:

Alyssa said...

I have a question. I had a c/s a year ago (Oct 13, 09) with my daughter. I'm pregnant again and have a scheduled c/s on Dec 30 (which will be 38w2d).

I was told I could do a VBAC, but I didn't want to risk the uterine rupture. But in your post you said you were only risking uterine rupture if you were induced? What's the difference? Doesn't an induction result in a VBAC, the only difference is whether you go into labor on your own vs being induced? Either way, isn't there still the same uterine rupture risk?

Thanks!

Denise said...

With a VBAC there is always a risk of uterine rupture. When you have an induction, the risk of uterine rupture increases because typically the contractions are more intense, last longer and are more stressful on your uterus.

So, there is a risk both ways, however your risk increases with induction :)

Jen said...

not too much longer!! YAY!

Natalie said...

Alyssa, Denise said everything perfectly about their being more risk having a rupture if you are induced. But also, I noticed in your post that the two dates of birth( the two cesareans) will not be 2 years apart, which is also a bigger risk. For me( I had a c/s with my 3rd baby, he was breach, and then I had a successful VBAC with my fourth) but the doctor was real strict about the fact that the two dates have to be at least 2 years apart. Hope this helps :)

Denise, Congrats!!! She will be here before you know it :))