Midwife Appointment

I saw the midwife today, and it was awesome! My hubby got to come along, too, which was cool. I talked to the midwife about doing a VBAC. She had read the surgical notes and 100% agreed with me that VBAC was the way to go. (Yipee!) She said that the prior C-Section was totally fine and that the placental abruption was probably a "twin thing". (That's what I thought too.) She also assured me that we would do ultrasound cervical checks for as long as I wanted to, since we don't have a clear idea of whether or not my cervix is truly incompetent and when it might start to funnel (if at all). This way we will catch something if it happens early. Luckily, I don't have any history of pre-mature labor, since I didn't even really go into labor with the twins...although I might have been at 35 weeks, it doesn't count since that's in the normal range for twins. Also, the fact that I had no cervical change from 33 - 35 weeks with the twins (while holding out at 2 cm dilated) is a great sign. We also got to hear the baby's heart beat, which was a perfect 155bpm. All in all it was a fantastic appointment, and I am *so* glad that I'm switching over to the midwife practice.

Update from The Doc

I talked to the C-Section OB today. He was SO nice when he called, and talked to me for several minutes about my questions. Here's the scoop:

My C-Section incision is 100% normal. It's just like any other low transverse scar, and it doesn't extend outside of the normal range for that type of incision. So in terms of uterine rupture, my risk is no higher than any other woman doing a VBAC.

The vein that "sprung a leak" was not the uterine artery (hence it being a vein), and it was on the entire opposite side of the uterus from the incision. So that had nothing to do with my incision, and could've come from any number of places...he couldn't give me a straight answer because he had no idea where the "leak" came from, he just fixed it. :-)

Having had a placental abruption puts me at a higher risk for having another one, but I don't have any risk factors for abruptions with this pregnancy. In my last pregnancy the only risk factor I had was being pregnant with twins. I don't have that risk factor now, so I think my risk would be lower than any other woman who had a placental abruption with a singleton. The studies say the rate of recurrence is 10%, but mine is probably lower than that because I don't have any risk factors now (except of course the prior abruption). There is a higher risk of it happening during labor, since the uterus is contracting and all, but I would already be in the hospital and on monitors. I know what it felt like the last time, and with everyone watching me like a hawk they would probably catch it VERY quick. So, that's really the least of my worries.

Now that I have all of this info, I think VBAC is the best choice. Having a C-Section comes with its own bag of possible complications, especially when you have multiple C-Sections. Since I want to have a lot of kids, having several C-Sections would be *much* riskier than attempting (and hopefully being successful at) a VBAC. My risk for uterine rupture is as low as anyone else's, and that was my biggest worry. So with that gone, there's really nothing saying I shouldn't try it. I think you guys probably agree, right? :-)

26 Weeks & Doctor's Appointment

I had a great appointment with my OB today. First, I did my 1 hour glucose test (ewww). Then, the doctor checked my cervix & cerclage--which both look perfect. She measured my belly, which is currently 36cm (36 weeks), so I'm measuring 10 weeks ahead. No wonder I feel like a whale! She also checked the babies heartbeats and my blood pressure. So far so good! She also answered the gazillion questions that I asked. We discussed when the cerclage would come out & when I might go off of bed rest, and she said that most likely I could start increasing activity at 32 weeks and then maybe go off of bed rest at 33 or 34 weeks. As for the cerclage, if I make it to 35-36 weeks, we'd take it out then. If I go into labor before then, the cerclage obviously comes out when I go into labor. She also tried to convince me that a C-Section is a good option, but I want to avoid that at all costs, so it was no deal. :-) Obviously I want my babies born as safely as possible, so if there's a true medical reason for a C-Section I have no problem with that. But I am NOT going to plan a C-Section for any other reasons, and if I do have to plan one, it's going to be for like 38 weeks (so I can go into labor myself anyway). I'd also like to go epidural-free if possible, but because of the circumstances they would probably place an epidural w/ no medication or a very, very low dose (just to keep the line clear) in case something happens during delivery that requires an emergency C-Section. As much as I don't want an epidural, I don't want general anesthesia much more, and if they need to get either one or both of the babies out very quickly and there's no epidural already placed, they would have to put me under.

On another note, the doctor said I can drink as much herbal tea or decaf coffee as I want. So, I don't have to suffer through gallons of plain water to keep hydrated. Woo! She checked the results of the swabs that were taken after my ultrasound last week and I don't have any infections either. She also wants me to lower my dose of progesterone and then possibly stop it altogether if my cervix looks ok in a few weeks.

That's all! I took a new belly picture last night and posted it just now. It doesn't look so different from 24 weeks even though I'm a good 5cm bigger. Oh well, as long as it's growing!