Monday, April 25, 2011

The VBAC Consult

Okay. I promise this is my last post for awhile. Thanks for keeping up with me. Just so much to write about this week!!!

I had my appointment in Winston with Dr. Dorn. It was AWESOME!!! He went over my surgery notes and current prenatals and determined I was a great candidate for a VBAC. He said based on all the information he has received, he really doesn't think I was given a good chance to labor. Knowing the history of my family genes (big babies and long labors), he said the baby probably just wasn't ready to come, i.e., in a high station since I was laying flat pretty soon after my water broke. I mentioned to him about the thought of scar tissue and he said, any person can have constricted dilation if the baby isn't imminent.

He was very encouraged by several things:

1. My mom's ability to deliver 5 babies, two of them over 9 pounds. He said this is a great factor to determine if I'm able to do the same. Thanks mom for good genes!!
2. An ultrasound determined the thickness of the uterine wall at the incision site was optimum. Minimum is 3 cm. Mine was 7 cm. There were no open windows at the incision site.
3. Weight gain is perfect. Vitals are perfect. He felt I was a very healthy candidate at this point.
4. An ultrasound showed the baby to be HEAD DOWN!!! Thank you Lord!!! Thank you thank you thank you! Thank you to all who prayed, and please amend that prayer to include a prayer of thanks and request for him to stay put. I sincerely appreciate you all! I have some mighty prayer warriors and I am so blessed to have you petitioning on my behalf!

We were in the office with him for over an hour. He was just great. Very very supportive of VBACs and my desires to deliver naturally. The appointment went better than I imagined, thanks to your prayers. I received an unexpected blessing at this appointment, outside of the baby turning down. Dr. Dorn said he felt bad for us having to drive so far to deliver a VBAC. He couldn't believe there were no hospitals in our area who would support that. He asked how well I worked with my current OB, Dr. Horton. Dr. Dorn said he would be completely fine if Horton continued seeing me until 37 weeks since the checks would be mainly vitals until then. And then at 37, he said he would see me every other week as he is not a huge believer in frequent cervical checks towards the end - because you're dilating doesn't mean the baby is coming any sooner. People can walk around at 4 centimeters for weeks. I just couldn't believe that he would support that, meaning he would miss out on the money he would receive for those appointments.

Another blessing was his open communication with Johannes. When he found out Johannes is from South Africa, he immediately started in on the rugby chat as he lived in New Zealand at one time. That was the moment I knew that Johannes was completely sold. ;-)

So the concerning factor: He did an ultrasound to take a look at baby Slabbert because I had mentioned he was positioned breech and said he may be able to turn him easily at this point. So obviously, that part wasn't the worry. The measurements were a little concerning, though - at least for mama. The thigh bone is how they accurately measure the gestational age at this point. He was right on target at 31 weeks. The head and torso, however, were a different story. He is measuring at 35 and 36 weeks for both!! At first I was thinking, he is disproportionate and something is wrong. But he said the measurements only indicate that the baby is going to be a big one. He is measuring 5 weeks ahead at this point and believes that I will have a 9 or 10 pound baby! Ahhhhhhhhhhhhhhh. At this stage, babies should weigh around 3 1/2 pounds. Baby Slabbert is measuring 4 1/2 pounds. Dr. Dorn wasn't much surprised based on Vivienne's weight and my mother's pregnancy history. They say that baby boys and second babies are both bigger, so that has definitely been confirmed.

And in regards to meeting the doula:

She was as great in person as she was on the phone. We heard her birthing stories and her comparisons of the hospitals in the area and doctors. It did nothing but confirm it for me AND Johannes. Johannes thinks I'm going to kick myself for not having an advocate and support in the room should things go south quickly. He knows me too well. His support of the doula was crucial for me because typically, the main people who have problems with the doulas are not the docs -- they're the husbands. I could write on and on about her... she was really great.

In regards to the new hospital policy on doulas. She believes it will not be a problem and said they can't kick her out if she is my "friend". She also works very well with Dr. Dorn and he was really upset about the new policy, so if anything, he would be the advocate for MY advocate. Dr. Dorn is very supportive of midwifery and labor assistance. Something that also impressed me about her is that she would give me a name of a DONA certified doula in case that was an issue for me. She said the important thing is that I have the support, no matter who it is. I feel this is especially important in an unknown hospital, and should Dr. Dorn be out of town when I go into labor.

I am so so tired that I am barely holding my eyes open. It's been quite a day. But I had to write about it while it's fresh on my mind. This is totally an answer to prayer and I recognize the importance of recording it. God has been really good to us. Even if things change, I am so thankful to really know and understand this process. I feel a great deal of peace and I'm so thankful for all the support.

30+ hour labor or not, this baby will come. I recognize the importance of physically being ready - I really need to walk more and exercise. I need to be on a healthier diet - not cutting calories, but cutting out junk. If the labor is long, I'll need stamina and energy. So here we go. I'll post again when there is something new to tell. :-) Hopefully that won't be anytime soon.

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