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Scooby :hug:
If i were ME in your situation (i can't really pretend i understand you as fully as you do! ;)) i'd be thinking about the following:
Does the scoliosis mean future bubs will present OP too? Sometimes labour doesn't start because babies are not descending well and sometimes they do not descend well because they are posterior.
The perineum i honestly wouldn't (as me) be concerned about because as we now know, ;), mine is also very short and i only had a little nick that i didn't even bother getting stitched. I would however be VERY concerned about being cut, because as i found in the articles we discussed on the other thread, it is considered by many to be inexcuseably bad clinical practice to perform an epi on a woman with a short perineum. So i'd want to have an ob who would NOT cut me. This might be hard to find if the baby is indeed going to be OP and not descend...
How afraid do i feel? How much does vaginal birth (as opposed to un-traumatic birth) matter to me at this point in time? After a very traumatic experience perspectives can change. Women who had a successful and even easy vaginal birth like me cannot HOPE to understand how it feels to have been through what you have, and equally a woman who lost her baby, or a year of her health, will have entirely different views of what to her makes a "good" birth.
The newborn pneumothorax i wouldn't think about - why? It can happen. It can happen after a straight-forward vaginal birth, after a section, after forceps. It's caused by the huge pressures inside the chest during those initial first breathing efforts rupturing the small airsacs of the lungs and allowing the air into the chest cavity. It happens to 1-2% of babies, and nothing much makes any difference. Some babies need no treatment beyond oxygen and time, others need a needle aspiration to re-inflate the lung. It is hugely unlikely to happen to your next bub and nothing you can do or not do will make any difference.
So, if this were my decision to make.... I'd wait and make no decision yet.
I would wait for labour to start and see how things went.
IF bubs was still OP by term despite my best efforts to turn them, i'd wait and if i went overdue enough that i needed an induction i would ONLY allow a Foley's catheter induction (which is reversible and needn't progress to full-blown chemical medical induction). If the Foley induction failed but the placenta was failing (and i'd want to check it WAS and not assume it from the dates) i'd have a section rather than risk the induction.
If progression was slow during labour and baby was OP and not descending well i'd definitely walk and crawl and NOT have an epidural. If it came to me needing an epidural i'd have a section to protect my perineum from the damage made FAR more likely by not being able to push well and possibly needing an instrumental delivery again (which i believe was what was at the root of many of your difficulties post birth).
Basically hun i would plan for and aim for as unmedicated a vaginal birth as possible, avoiding epidural/narcotics/back-laying/coached pushing/ALL intervention and IF and when i was forced to deviate very much from that path, i would have a section.
Lots of good thoughts and love
Bx
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If I were in your shoes I would def go the CS. No question.
My vaginal birth was a little traumatic too (long 1st stage, prolonged 2nd stage, episiotomy, tear, shoulder distocia & vac extraction) even though I'd gone into labour spontaneously. I did not have any of the problems you had post birth (back to normal 3 weeks later) yet I still think I'd be leaning towards CS if I found myself UTD again.
I think you've done extremely well to face your fears and actually get pregnant again, it's something I just can't face even though I'd love another child and my clock is well and truly ticking.
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Thanks Satya and Hoobley. :hug:
Saw my ob again and voiced my concerns/ opnions as she did hers. I must admit she was very understanding and said at the end of the day its my descion and she will do everything necessary to support that. But (isnt there always a but) she really pushed the CS again, saying that she has never seen such a short perineum and what would be a graze to someone else would be at least a 2nd degree tear with me. She also said an epi is just not an option as there is no where to go with it! She said if i labour before scheduled cs (16th of Jan, EDD 26th Jan) she is more than happy to let me go, not sure if i want to be wishing for a pre term bub though. So as for now im leavin it at that, i seriously cant have anymore sleepless nights over this :wall: i look at both ways and i just see no way out. And Satya, i do often wonder if my need for fertility assisstance this time had something to do with a psychological effect of my previous experience, as with DS i fell preg straight away, who knows how the mind works and they never could find any reason for my sub fertility?
Hoobley, KWYM about the pneumothorax, was just one of those things, it was more the 4.5 hours of them trying to stitch me up that was the worst because i couldnt be with DS and they really didnt know at that stage what was wrong with him.
Well i aslo had a scan and placenta hasnt moved from right over the top of my cervix so maybe i wont have to make a choice? ( But still very hopeful of it moving ;))
Again thanks so much i do really appreciate such educated opnions. Thanks
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Hi Scooby,
For my two cents worth, I reckon that if in your heart of hearts you want to try for a VB, then you should give it a go (depending on whether your placenta has moved). I think that's what I'd do, anyway. You had a really traumatic first birth, so it's understandable you're hesitant to go down the same path. However if your thoughts/emotions keep taking you back to another VB, then maybe that's the way you should go. Just make sure your support team is 110% behind you.
Good for you on doing your research - I take my hat off to you. Nothing beats being informed and knowing your choices/options.
Just wanted to add one other thing. I know zip about short perineums but has your OB given you any idea about how likely is it to tear if you don't need any assistance? Is your bub likely to be larger than average? Could lots of perineal massage/hot compresses during labour help it to stretch for your bub therefore minimizing tears? Sorry if this is naive thinking, like I said, I'm not sure about all the implications of a short perineum. Just a thought, anyway.
Good luck, but for me the bottom line is you do what you feel is right for you and your bub.
Andie
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i am so sorry you experienced that birth, you are a very brave woman to even think of having another baby! Without a doubt if i were in your situation there would be no choice, i would have an elective c/s. I wish you all the luck in the world with this birth, i hope you have a positive experience this time round.
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Just wanted to say Hoobley good thinking on the op thing must ask ob if the scolosis could be a cause for that position, i know last ime it wasnt mentioned, only when they tried to get the epidural in.
Andie: i did ask the ob about prep of the perineum as she seems quite a big promoter of epi-no, but she said there is just so little skin to stretch that it wont make a huge difference. I did do some prep before DS, but i think the circumstances had more to do with it than prep but so confused i really dont know. As for the support team family and friends are very much of the "why would you want to go through that again" opinion including DH. ( i think he was more teriified than i was during the whole thing, plus the great lack of sex for almost a year after the birth :lol:)
Widdy; thanks for such kind thoughts.:hug:
