The Debate Continues...

I've been meaning to write this post for over 24 hours but I was pretty down-in-the-dumps after my appointment yesterday so I really just avoided writing it. I've finally pulled myself up by my boot straps and pushing ahead, so here I am, writing this post.

After my ultrasound on Monday I was so very hopeful about getting the VBAC that I so badly want and then at my appointment yesterday when I finally got to meet with Dr. L and discuss the ultrasound with him all of my hopes kinda came crumbling down.  I figured it was time for another candid discussion regarding my desire to have a VBAC and so I raised a few questions regarding the risks involved.  Well he kind of dropped a bomb on me.  You see, I've done a little reading up on VBACs because I want to know what I'm getting myself into and based on these readings I had pretty much made up my mind that I was going to attempt a VBAC.  The bomb that was dropped on me though, is that I am a high risk patient so the risks I was reading about in these other stories and books aren't really applicable to me.  Well, I guess it's more like those risks are applicable to me...but having Gestational Diabetes and Chronic Hypertension open up an entire new world of risks that I had no clue about.  Just talking about those risks intimidate me.  In the end I just want to make the decision that is healthiest for me and Baby Q and hearing about the possibilities really makes me question what the best decision is for us.

I guess before I was focused on VBAC vs. C-Section.  I knew the risks of a VBAC as well as the risks of a C-Section and in weighing them VBAC always came out on top.  What I never fully accounted for in my previous analysis was what happens if I choose VBAC and I'm unsuccessful in that attempt.  That was the discussion I had with Dr. L yesterday and ultimately that is the discussion that really has me wondering what path is the right one for us.  He also gave me a copy of the consent form that I'll have to sign regardless of which choice I make.  When he handed it to me to read over he forewarned me that it was going to be a shock to the system, and he was right.  It put me even more in a funk even though it was written to be unbiased and gave risks of both. I'll type it up below so you can all read how delightful it is for yourselves!

In reading and talking to other people on message boards and such I always get such a negative vibe when they refer to Obstetricians and everyone seems to scream that I should just switch to a midwife.  Well, being a high risk patient makes that decision for me, I pretty much have to see an OB and to be quite honest, I don't think I'd change even if I could.  I like my doctor and I can always rely on him to give it to me straight.  And so, with all the OB bashing that I hear and read about I have to hand it to Dr. L he hasn't tried to coerce me into making a decision either way and I know that regardless of what decision I make he'll go with it and do his best to make sure that both I and Baby Q come out of it healthy.

Here's the lovely consent form I mentioned above:

Statement of Informed Consent

For Patients with a Prior Cesarean Birth

1. I understand that I have had one or more prior cesarean(s).
2. I understand that I have the option of undergoing an elective repeat cesarean or attempting a vaginal birth after a cesarean (VBAC)
3. I understand that approximately 70% of women who undergo a VBAC will successfully deliver vaginally and that the remaining 30% must have a cesarean.
4. I understand that VBAC carries a higher risk of harm to my baby than a cesarean and these risks have been thoroughly explained to me.
5. I understand that the risk of a uterine rupture during a VBAC in someone such as myself, who has had a prior incision in the noncontracting part of my uterus is around 1%.  I understand that if my uterus ruptures during my VBAC, there may not be sufficient time to operate and to prevent the death of, or permanent brain injury to my baby.
6. I understand that if i deliver vaginally, it is likely that I will have fewer problems after delivery and a shorter hospital stay than if I have a cesarean section
7. I understand that VBAC carries a lower risk to me than does a cesarean delivery and the risks of each procedure have been thoroughly explained to me.
8. I understand that during my VBAC, the use of oxytocin (Pitocin) hormone to make my uterus contract may be necessary to assist me in my vaginal delivery and the potential effects of this drug have been thoroughly explained to me.
9. I understand that if I choose a VBAC and end up having a cesarean during labor, I have a greater risk of problems than if I had had an elective repeat cesarean and these risks and potential problems have been thoroughly explained to me.
10. I understand that in having a vaginal delivery I am exposing myself to the future risk of symptoms of pelvic relaxation including urinary and fecal incontinence and these symptoms have been fully explained to me.
11. I understand that the decision to have a VBAC is entirely my own, and the option of an elective repeat cesarean has been discussed with me
12. I have read or had had read to me the above information and I understand it.
13. I have had an opportunity to ask any questions I would like to ask regarding all of the matters described in 1 through 12 above.

I have received all the information I want.  After discussing the matter with my doctor:

It then has 2 spaces for signature, one above "I want to attempt a VBAC" and another above "I want a repeat cesarean."

On behalf of myself and my baby, i agree to accept the risks associated with the procedure I have chosen and release my physician, nurse, hospital and other health care providers from any and all damages related to any injury, illness and/or death resulting from the risks associated with the procedure I have selected.

There is another space for signature and date as well as a space to print my name.

Doesn't all that sound depressing to you too???