Thursday, June 21, 2007

To C or Not to C, That is the Question

Luckily, just as I was growing bored with the debate between “working” and stay-at-home moms, I was able to find that the caesarean section (c-section) debate is red hot. And I’m center stage.

In six days I will be going under the knife to deliver my second son at 38 weeks gestation.

Or not.

Technically I have the surgery scheduled, but I am mentally still debating it. My first son was born the old fashioned way at 37.5 weeks. Before he was born, I was virtually certain I would die from labor pain and sort of hoped my doctor would insist on a c-section so I wouldn’t have to face it (she didn’t).

Turns out labor was painless (thanks to God’s real miracle, the epidural). The day of his birth was like a low key party where you are in a jovial mood but anxious for the person of honor to arrive. Inheriting my flair for the dramatics, my son got stuck just before his grand entrance; went into distress and things went from calm to crazy in a hurry. Operating rooms were prepped, vacuums and forceps were used, pitocin drips administered, cuts made, I even had someone practically jumping on my abdomen to try to force him out that way. They got him out, barely, and with a huge audience of people gearing up in scrubs for emergency surgery. We both had fevers and dehydration; he had a double cord around his neck and was sent to the NICU and then, days later, readmitted for jaundice from the bruising. It wasn’t *exactly* how I had pictured the moment. Being wheeled into a NICU and seeing your son for the first time, hours after his birth, is surreal, I wasn’t sure which one he was. All this, and he was less than seven pounds.

This isn’t the type of delivery where you jump up the next day and go out jogging, but strangely enough, I don’t really remember the pain or long recovery. I remember it intellectually, but it doesn’t really register. My primary emotional memory of that day and the days following was of complete joy and wonder at the birth of my son. Funny how that works.

So this time around, they said: “Let’s have another small baby, don’t gain a lot of weight”. I promptly put on 40lbs.

In the ultrasounds, this baby is showing to be above the 90th percentile for gestational age, or about 8lbs already. I don’t believe these ultrasounds since they thought my first son was also over 8lbs, but let’s say an official Big Baby diagnosis has made my OB “skittish”. To the point that she “highly recommended” a c-section, advising me that she would allow a trial labor, but that she believes we will end up in surgery either way. She reminded me that my last delivery was extremely precarious and we were lucky he had no long term effects. My high-risk OB also says, all things considered, do the surgery. My husband, who was more conscious than I of the urgent concern in the room during the last delivery, wants the surgery.

I, however, do not want the surgery. But I do want a healthy and safe baby. I scheduled surgery, thinking I could always cancel.

Or, as turns out, I could entertain a plethora of comments from friends and acquaintances about the proliferation of “elective or scheduled c-sections”. I have been advised to challenge my doctors with specific risk percentages of various birth injuries if I elected a natural labor, been told stories of women who couldn’t deliver a 6lb first baby but delivered their second 9lb baby in 23 minutes flat with no tearing, and been told to expect a long and painful recovery in exchange for “not even trying”. I even had a man today explain to me in great detail the pain of abdominal surgery and how you are never the same.

The worst part, of course, is they may be right. Certainly there are stories out there about difficult first labors being followed by quick and easy second deliveries. There are stories out there about horrible c-sections. And the reality is, I have no idea how easy or hard a second labor would be. The problem is, by the time I know whether it’s going to be a problem, I will have a problem.

I would love to have an uncomplicated (heavily medicated) birth and have the baby in my arms minutes later, but chances are just as good that I’d be peering into a NICU isolette hours later. There is no way to know. So I think I have to choose the middle route. The delivery that I don’t prefer but one with a more predictable outcome. It’s what the doctors recommend. So why can’t I just accept it?

I will probably still be in denial in post op.


Elizabeth said...

Hi Amy,

I saw this in TheGoodBlogs and after reading it I just want to say good luck, no matter how the baby comes out!

a happier girl said...

Tough call. I'm the sort to go with the doctor's advice. But I totally get that's it still hard. Hope the baby comes quickly and without complication.