Do I want a c-section?
October 19, 2016 2:34 PM Subscribe
Some complications have arisen as I reach the end of my pregnancy. I think I want to ask for a c-section. Will they let me do this? Is is a smart idea under the circumstances?
So, other than undergoing IVF (for male factor issues, my tests were all fantastic fwiw) I have had a pretty uneventful pregnancy---until now. Everything was humming along smoothly other than a small growth issue with the baby which was being monitored. I am now 37 weeks, and it's all going to pot. The issues:
1) My OB went on mat leave herself. The new one seems fine, but whenever I asked her a question, her answer was a shrug and 'well, you are 40, so...' (I am 39, not 40, but anyway...)
2) Diagnosed with gestational diabetes.I had a rocky first week where I had to figure out which foods didn't work for that. I did, have only been eating safe foods, and have had no high readings since. They did not put me on medication and told me I could monitor every other day now.
3) Positive on the GBS swab. Not sure how big a deal that is, but it's on my chart now.
4) High blood pressure while at the OB. They made very concerned faces and sent me for bloodwork. Called me the next day and said my kidney function wasn't optimal and to go straight to the hospital. Stayed at the hospital all afternoon on a monitor and then was sent home. They told me to come back if 'anything didn't feel right' but I don't really know what that means.
5) As a result of all the above, I am now at various doctor's appointments several times a week (ultrasounds for the diabetes, NST tests for the baby etc.) I have some anxiety issues I have been getting help for, and this is just ramping it all up.
My primary concern is that this 'watching and waiting' approach has been very stressful for me. I don't really understand what is a 'common thing that we keep an eye on but is generally fine' and what is 'an imminent crisis for you or your baby.' I am really scared that something bad is going to happen!
I understand that a c-section is surgery, and surgery means there will be recovery. But everything I have read about natural childbirth suggests that there will be recovery from that too. My nightmare would be that they 'watch and wait' for hours and hours of labour, then look at my chart, go '40, diabetes, high blood pressure, questionable kidney numbers etc' and do a c-section anyway, and then I have to recover from both things. If there is any chance that is going to happen, I would rather spare myself the hours and hours of labour (and stress and worry of something going wrong) and just go straight to the c-section.
Additionally, I have a husband who is immune compromised and has a chronic health condition. I can see there being some benefit to him of me being in the hospital for a few extra days to get the hang of things with the baby while there is help available. He can go home and sleep, and get some recovery time himself, before they dismiss the baby and me. If we had a regular delivery, I would be home much sooner.
I am scheduled for an induction in about a week. I'm strongly considering asking the doctor to just make it a planned c-section right from the get-go. Will they do this, given my reasoning? Am I crazy for thinking that this will be the best way to have my baby?
So, other than undergoing IVF (for male factor issues, my tests were all fantastic fwiw) I have had a pretty uneventful pregnancy---until now. Everything was humming along smoothly other than a small growth issue with the baby which was being monitored. I am now 37 weeks, and it's all going to pot. The issues:
1) My OB went on mat leave herself. The new one seems fine, but whenever I asked her a question, her answer was a shrug and 'well, you are 40, so...' (I am 39, not 40, but anyway...)
2) Diagnosed with gestational diabetes.I had a rocky first week where I had to figure out which foods didn't work for that. I did, have only been eating safe foods, and have had no high readings since. They did not put me on medication and told me I could monitor every other day now.
3) Positive on the GBS swab. Not sure how big a deal that is, but it's on my chart now.
4) High blood pressure while at the OB. They made very concerned faces and sent me for bloodwork. Called me the next day and said my kidney function wasn't optimal and to go straight to the hospital. Stayed at the hospital all afternoon on a monitor and then was sent home. They told me to come back if 'anything didn't feel right' but I don't really know what that means.
5) As a result of all the above, I am now at various doctor's appointments several times a week (ultrasounds for the diabetes, NST tests for the baby etc.) I have some anxiety issues I have been getting help for, and this is just ramping it all up.
My primary concern is that this 'watching and waiting' approach has been very stressful for me. I don't really understand what is a 'common thing that we keep an eye on but is generally fine' and what is 'an imminent crisis for you or your baby.' I am really scared that something bad is going to happen!
I understand that a c-section is surgery, and surgery means there will be recovery. But everything I have read about natural childbirth suggests that there will be recovery from that too. My nightmare would be that they 'watch and wait' for hours and hours of labour, then look at my chart, go '40, diabetes, high blood pressure, questionable kidney numbers etc' and do a c-section anyway, and then I have to recover from both things. If there is any chance that is going to happen, I would rather spare myself the hours and hours of labour (and stress and worry of something going wrong) and just go straight to the c-section.
Additionally, I have a husband who is immune compromised and has a chronic health condition. I can see there being some benefit to him of me being in the hospital for a few extra days to get the hang of things with the baby while there is help available. He can go home and sleep, and get some recovery time himself, before they dismiss the baby and me. If we had a regular delivery, I would be home much sooner.
I am scheduled for an induction in about a week. I'm strongly considering asking the doctor to just make it a planned c-section right from the get-go. Will they do this, given my reasoning? Am I crazy for thinking that this will be the best way to have my baby?
Can you switch practitioners and get some different opinions? (I switched at 41.5 weeks, quite do-able, and it ended up being a very, very good call.)
posted by kmennie at 2:51 PM on October 19, 2016 [3 favorites]
posted by kmennie at 2:51 PM on October 19, 2016 [3 favorites]
I don't know if they will do this, but it's worth asking. I don't think you're crazy considering asking for it, but I can't say if it's the best decision. I had a perfect pregnancy and had the kind of birth you're hoping to avoid (long stressful labour ending in CS). I empathise with you a lot. The CS was honestly not that bad, but my husband did have to help out a lot when we were home while I was recovering. Good luck!
posted by hannahlambda at 2:53 PM on October 19, 2016
posted by hannahlambda at 2:53 PM on October 19, 2016
Hey, I don't know if this will make you feel better, but basically even if your pregnancy was perfect and you were five years younger, they'd be having you come in to the doctor two or three times a week anyhow at this point in your pregnancy. And I don't see anything in your post that indicates you would be better served by a c-section - it wouldn't necessarily happen earlier than your induction next week, for example.
A c-section has MUCH LONGER recovery time than a vaginal birth. With a c-section you are going to be flat on your back in bed for a week, getting up to go to the bathroom and nothing else. A c-section incision makes it more difficult to nurse. A c-section incision can result in permanent numbness on your abdomen (ask me how I know!). And a c-section is a major surgery with all that entails in terms of post-operative complications: one friend of mine ended up back in the hospital for 3 weeks with a weird lung thing, another had to do complicated wound care that I'm not even going to describe because it's so gross that when she told me about it I said 'I would just lay down and die rather than do that'. She was like, 'that's what I told the doctor, she said I would in fact die, I changed my mind.'
Meanwhile, a vaginal delivery, you're probably up and walking around an hour later, there are definitely potential problems with the original exit plan, but they're not as life threatening.
Also, a vaginal birth has certain advantages to the baby, babies born 'naturally' have less incidence of asthma and some other stuff.
I also had a long stressful labor followed by c-section, and it was not great, but not awful, but I would definitely choose the other way if I could.
posted by bq at 3:05 PM on October 19, 2016 [13 favorites]
A c-section has MUCH LONGER recovery time than a vaginal birth. With a c-section you are going to be flat on your back in bed for a week, getting up to go to the bathroom and nothing else. A c-section incision makes it more difficult to nurse. A c-section incision can result in permanent numbness on your abdomen (ask me how I know!). And a c-section is a major surgery with all that entails in terms of post-operative complications: one friend of mine ended up back in the hospital for 3 weeks with a weird lung thing, another had to do complicated wound care that I'm not even going to describe because it's so gross that when she told me about it I said 'I would just lay down and die rather than do that'. She was like, 'that's what I told the doctor, she said I would in fact die, I changed my mind.'
Meanwhile, a vaginal delivery, you're probably up and walking around an hour later, there are definitely potential problems with the original exit plan, but they're not as life threatening.
Also, a vaginal birth has certain advantages to the baby, babies born 'naturally' have less incidence of asthma and some other stuff.
I also had a long stressful labor followed by c-section, and it was not great, but not awful, but I would definitely choose the other way if I could.
posted by bq at 3:05 PM on October 19, 2016 [13 favorites]
Best answer: These all seem like great questions for your new OB. I know you mentioned that she's pretty hands off or maybe doesn't have the world's best bedside manner, but you are allowed to ask questions like "does having gestational diabetes mean that I'll ultimately need a c-section?" and then see how you feel after she answers them.
I also think switching OBs would be a good idea if you ask practical medical related questions which have answers, and your OB is rude about it or refuses to answer clearly.
Nothing you've said indicates, to me, that you should ask for an elective c-section rather than waiting to find out if you need a c-section. I'm an anxious person, myself, so I get wanting to seize the reins now, and feel more in control, rather than continue spinning out in an anxiety cycle of "wait and see". On the other hand, I'm not sure having an invasive medical procedure is actually going to help your anxiety. If nothing else, having a c-section isn't going to make the frequent doctor visits and monitoring for various health issues go away.
posted by Sara C. at 3:09 PM on October 19, 2016 [8 favorites]
I also think switching OBs would be a good idea if you ask practical medical related questions which have answers, and your OB is rude about it or refuses to answer clearly.
Nothing you've said indicates, to me, that you should ask for an elective c-section rather than waiting to find out if you need a c-section. I'm an anxious person, myself, so I get wanting to seize the reins now, and feel more in control, rather than continue spinning out in an anxiety cycle of "wait and see". On the other hand, I'm not sure having an invasive medical procedure is actually going to help your anxiety. If nothing else, having a c-section isn't going to make the frequent doctor visits and monitoring for various health issues go away.
posted by Sara C. at 3:09 PM on October 19, 2016 [8 favorites]
If you have a c section, don't count on your husband going home to recover. He'll need to help you AND take care of the baby,
posted by otherwordlyglow at 3:22 PM on October 19, 2016 [9 favorites]
posted by otherwordlyglow at 3:22 PM on October 19, 2016 [9 favorites]
Best answer: I was diagnosed with preeclampsia at 32 weeks and had an unscheduled (but not emergency) c-section at 34 weeks. In my experience, I went to the high risk OB for an appointment in the morning and she told me to go home, pack a bag, and come back so I could be in surgery by 5:00 pm.
My two cents: a lot of the horror stories about long recovery times and such I've heard about c-sections are from people who labored and attempted a vaginal delivery first. That's a different situation than a planned or even unplanned c-section.
I had a baby in the NICU after my c-section so I definitely was not on my back for a week. I had surgery on Friday and left the hospital Monday. I live in a third floor walk-up and did those stairs at least twice a day. It wasn't ideal but it was doable. I also nursed though as I mentioned, baby girl was in the NICU so it was more like, I tried to nurse about once a day. But I did pump. I don't have any pain or numbness by my incision. It was painful and getting out of bed was hard for the first week or two but I don't think labor is exactly a happy fun time either.
I'd ask your doctor about a c-section but keep an open mind. If they think it's the best option, they will not be shy about suggesting it. I didn't even really have a conversation with my doctor - it was more like, here's what we're going to do now.
I will point out since you may be headed towards preeclampsia yourself, I had to be on a magnesium drop for 18 hours post-surgery, which made me feel generally lousy, plus then I was confined to my bed. They usually do it for 24 hours but my blood pressure quickly dropped back to normal after delivery so they stopped it early. The worst part about that was not seeing my daughter but honestly, I was too out of it to be upset. Good luck!
posted by kat518 at 3:26 PM on October 19, 2016 [3 favorites]
My two cents: a lot of the horror stories about long recovery times and such I've heard about c-sections are from people who labored and attempted a vaginal delivery first. That's a different situation than a planned or even unplanned c-section.
I had a baby in the NICU after my c-section so I definitely was not on my back for a week. I had surgery on Friday and left the hospital Monday. I live in a third floor walk-up and did those stairs at least twice a day. It wasn't ideal but it was doable. I also nursed though as I mentioned, baby girl was in the NICU so it was more like, I tried to nurse about once a day. But I did pump. I don't have any pain or numbness by my incision. It was painful and getting out of bed was hard for the first week or two but I don't think labor is exactly a happy fun time either.
I'd ask your doctor about a c-section but keep an open mind. If they think it's the best option, they will not be shy about suggesting it. I didn't even really have a conversation with my doctor - it was more like, here's what we're going to do now.
I will point out since you may be headed towards preeclampsia yourself, I had to be on a magnesium drop for 18 hours post-surgery, which made me feel generally lousy, plus then I was confined to my bed. They usually do it for 24 hours but my blood pressure quickly dropped back to normal after delivery so they stopped it early. The worst part about that was not seeing my daughter but honestly, I was too out of it to be upset. Good luck!
posted by kat518 at 3:26 PM on October 19, 2016 [3 favorites]
I would open up a conversation with your doctor where you say: "At this point you're recommending induction at 38 weeks, but not a C-section. What circumstances would warrant a C-section instead?"
(BTW, 38 weeks induction for a scheduled C-section used to be pretty standard, but they've pushed them out to 39 weeks at this point, to allow for further lung development .)
On the topic of:
My nightmare would be that they 'watch and wait' for hours and hours of labour, then look at my chart, go '40, diabetes, high blood pressure, questionable kidney numbers etc' and do a c-section anyway, and then I have to recover from both things.
that's kind of both not how things happen (in that they know the factors you mention ahead of time) and actually what happens a lot to a lot of people. So in the above conversation, it might be good to bring up your fear that you will labor for a long time and end up with a C-section anyways. I think there's a gray area where the recommendation starts to tip to C-section but the doctors will take what you want into consideration.
As for your blood pressure, in terms of "things don't feel right" - you should have close access to a BP monitor and be using it regularly. If your BP spikes, you should get seen.
posted by vunder at 3:28 PM on October 19, 2016 [2 favorites]
(BTW, 38 weeks induction for a scheduled C-section used to be pretty standard, but they've pushed them out to 39 weeks at this point, to allow for further lung development .)
On the topic of:
My nightmare would be that they 'watch and wait' for hours and hours of labour, then look at my chart, go '40, diabetes, high blood pressure, questionable kidney numbers etc' and do a c-section anyway, and then I have to recover from both things.
that's kind of both not how things happen (in that they know the factors you mention ahead of time) and actually what happens a lot to a lot of people. So in the above conversation, it might be good to bring up your fear that you will labor for a long time and end up with a C-section anyways. I think there's a gray area where the recommendation starts to tip to C-section but the doctors will take what you want into consideration.
As for your blood pressure, in terms of "things don't feel right" - you should have close access to a BP monitor and be using it regularly. If your BP spikes, you should get seen.
posted by vunder at 3:28 PM on October 19, 2016 [2 favorites]
Yes, your husband will not really be able to leave for too long (or want to, I think) unless you have other support. Which you might! Option that if you do!!
IANYD, just another mom who had a situation very very similar to yours... induction is a nightmare and I think it does not work for most people unless you are already dilated. Dr's seem to love to induce if you are near 40. I personally hate that...
I was in labor for like 23 hours w/ induction and then a c-section. If you can avoid the induction and you find a great doctor I think you should wait for natural labor to occur. If you really want a c-section, get the c-section. Do not get the induction, In My Humble Experience it is useless.
Recovering from a c-section was really awful for me and my body is not the same. Like, it will never ever be the same. I know women who found it to be the bees knees and they don't seem to have lasting problems with some things I'm happy to memail about but will not print here.
In the end it is really up to you. IANYD. Just telling you what happened to me and how I feel now and what I wished I had known (basically that induction is extra painful and often does not work. studies may show something different? other people in our shoes had my experience, too, so IDK.)
posted by jbenben at 3:34 PM on October 19, 2016 [1 favorite]
IANYD, just another mom who had a situation very very similar to yours... induction is a nightmare and I think it does not work for most people unless you are already dilated. Dr's seem to love to induce if you are near 40. I personally hate that...
I was in labor for like 23 hours w/ induction and then a c-section. If you can avoid the induction and you find a great doctor I think you should wait for natural labor to occur. If you really want a c-section, get the c-section. Do not get the induction, In My Humble Experience it is useless.
Recovering from a c-section was really awful for me and my body is not the same. Like, it will never ever be the same. I know women who found it to be the bees knees and they don't seem to have lasting problems with some things I'm happy to memail about but will not print here.
In the end it is really up to you. IANYD. Just telling you what happened to me and how I feel now and what I wished I had known (basically that induction is extra painful and often does not work. studies may show something different? other people in our shoes had my experience, too, so IDK.)
posted by jbenben at 3:34 PM on October 19, 2016 [1 favorite]
Best answer: Oh, my gosh! And congratulations!!
I know the constant doctors appointments are awful, just try to zen out about it. You are in the home stretch, you're going to love motherhood and I promise you you'll forget this bs after your baby is born. Thank goodness.
Please try to enjoy this last stage. I'm writing to tell you that you will get through it!!
posted by jbenben at 3:36 PM on October 19, 2016 [5 favorites]
I know the constant doctors appointments are awful, just try to zen out about it. You are in the home stretch, you're going to love motherhood and I promise you you'll forget this bs after your baby is born. Thank goodness.
Please try to enjoy this last stage. I'm writing to tell you that you will get through it!!
posted by jbenben at 3:36 PM on October 19, 2016 [5 favorites]
Upon preview: Reading what kat518 wrote, I labored a long time w/ induction and then had a c-section anyway. Can confirm that recovery and longterm side effects ensue in that scenario.
posted by jbenben at 3:39 PM on October 19, 2016
posted by jbenben at 3:39 PM on October 19, 2016
You're going to get a wide variety of answers about if a c is the right thing. From women on their feet right away to those with complications.
My own experience was a wait and see as well. GD controlled by insulin, bordering high BP and a baby who was in breech. We tried a procedure to turn him which failed, labour was triggered and off to a c we go.
From a recovery perspective, in the hospital I was not bad - the beds raise and lower there which makes it easier. Once at home, I couldn't get into bed without a stepstool and help for the first couple of weeks. Sneezing is hell. Sometimes even just picking up the baby was hard. If you are planning on breastfeeding, know that with a c it can be a little longer for milk to come in.
I definitely have numbness around the scar now and am sporting the c-section pooch. Minor to me, but maybe not to others.
At the end of the day, this is a conversation worth having and know either way, your decision isn't wrong.
Best of luck and congrats.
posted by MandaSayGrr at 3:41 PM on October 19, 2016 [1 favorite]
My own experience was a wait and see as well. GD controlled by insulin, bordering high BP and a baby who was in breech. We tried a procedure to turn him which failed, labour was triggered and off to a c we go.
From a recovery perspective, in the hospital I was not bad - the beds raise and lower there which makes it easier. Once at home, I couldn't get into bed without a stepstool and help for the first couple of weeks. Sneezing is hell. Sometimes even just picking up the baby was hard. If you are planning on breastfeeding, know that with a c it can be a little longer for milk to come in.
I definitely have numbness around the scar now and am sporting the c-section pooch. Minor to me, but maybe not to others.
At the end of the day, this is a conversation worth having and know either way, your decision isn't wrong.
Best of luck and congrats.
posted by MandaSayGrr at 3:41 PM on October 19, 2016 [1 favorite]
I've had two c sections. Both after hours of labor. Recovery varies for everyone, but my experience was that they want you on your feet ASAP and doing as much as you can- I was up and walking within hours, bathroom by myself well within 24 hours later, and was not flat on my back for anything except sleep within two days. There is lots of sitting and less hiking, but that's true for anyone caring for a newborn. You WILL need support because there are things you can't do, and it's not best practice to be the only person caring for a baby within 72 hours post major surgery anyhow.
I think the risks from least to most are vaginal-->scheduled c section -->"surprise" c section. If you are concerned that the complications that have arisen make you a likely candidate for a surprise, talk to your doctor about scheduling. If your doctor is dismissive of your concerns, find a new doctor if at all possible. By dismissive I don't mean says it's not needed, I mean won't hear you out and address your concerns.
posted by pearshaped at 3:46 PM on October 19, 2016 [2 favorites]
I think the risks from least to most are vaginal-->scheduled c section -->"surprise" c section. If you are concerned that the complications that have arisen make you a likely candidate for a surprise, talk to your doctor about scheduling. If your doctor is dismissive of your concerns, find a new doctor if at all possible. By dismissive I don't mean says it's not needed, I mean won't hear you out and address your concerns.
posted by pearshaped at 3:46 PM on October 19, 2016 [2 favorites]
" I can see there being some benefit to him of me being in the hospital for a few extra days to get the hang of things with the baby while there is help available. "
If you're in the US, the standard is 3 days in the hospital for a vaginal delivery, 4 for a C-section. So not a whole lot longer.
I've had 3 C-sections for three different reasons (badly malpositioned baby, routine scheduled, emergency rupture), so if I can answer any questions for you about the process of C-sections, feel free to memail me. In my worst surgery it was 2 days before I could get out of bed; in the "best" one it was like 12 hours. In all cases I went home after 4 days and was climbing the stairs the day I went home.
Laboring + C-section does seem to be the worst case scenario in terms of recovery, in terms of what my friends and I have experienced. Either vaginal delivery or quick decision to section seem to be better.
posted by Eyebrows McGee at 4:15 PM on October 19, 2016
If you're in the US, the standard is 3 days in the hospital for a vaginal delivery, 4 for a C-section. So not a whole lot longer.
I've had 3 C-sections for three different reasons (badly malpositioned baby, routine scheduled, emergency rupture), so if I can answer any questions for you about the process of C-sections, feel free to memail me. In my worst surgery it was 2 days before I could get out of bed; in the "best" one it was like 12 hours. In all cases I went home after 4 days and was climbing the stairs the day I went home.
Laboring + C-section does seem to be the worst case scenario in terms of recovery, in terms of what my friends and I have experienced. Either vaginal delivery or quick decision to section seem to be better.
posted by Eyebrows McGee at 4:15 PM on October 19, 2016
Just anecdotally: I had 48 hours of labor and then a c-section. At almost the same time my best friend was having under 24 hours of laber and then a vaginal birth. We recovered side by side. After the first few days the only difference was me saying "It hurts when I stand up" and her saying "It hurts when I sit down."
posted by BlahLaLa at 4:17 PM on October 19, 2016 [6 favorites]
posted by BlahLaLa at 4:17 PM on October 19, 2016 [6 favorites]
I went into labor on a Monday evening. Labored overnight at home. Tuesday morning, went in to the birth center. Labored all day Tuesday. Decided on a C-section Tuesday evening (24 hours after labor started). Baby was born at 9pm. I was back in my hospital room with the baby at midnight. Fitful night of dozing/nursing attempts. Wednesday, my immunocompromised husband went home to sleep. I was alone with the baby in the hospital room all day, recovering from surgery, having had about 20 minutes of sleep since SUNDAY NIGHT. Please, have someone on hand to help you, if you're sending your spouse home. It's not just the baby, the nursing, the surgery. There's also the emotional impact of being alone with the tiny helpless baby, plus looking in the mirror at yourself as a deflated sack of flesh. You send out a text, get a flurry of responses, and then you're alone again.
I went home Friday morning, so it didn't really feel like four days resting in the hospital, even though technically I was there on four calendar days.
posted by xo at 4:47 PM on October 19, 2016
I went home Friday morning, so it didn't really feel like four days resting in the hospital, even though technically I was there on four calendar days.
posted by xo at 4:47 PM on October 19, 2016
They told me to come back if 'anything didn't feel right' but I don't really know what that means.
These are the things they told me to watch for: Severe headaches, sudden swelling, shortness of breath, vision changes (All of those are signs of preeclampsia.) Baby stops moving the way it normally does. Your intuition just tells you something is wrong.
Positive on the GBS swab. Not sure how big a deal that is, but it's on my chart now.
Generally this means they'll put you on IV antibiotics when you come in for delivery. There are a few other things to watch for, like a fever during labor or your water breaking many hours before the baby is born.
I understand that a c-section is surgery, and surgery means there will be recovery.
Recovering from a c-section after many hours of labor was much harder for me than after one that is either scheduled or happens as soon as you go to the hospital. They will have you up and walking within hours of surgery if at all possible. I went home less than 48 hours after my second one, which was earlier than the doctor recommended; I think insurance would have paid for one more day, but I felt I'd get more rest at home.
Congratulations & good luck!
posted by belladonna at 4:52 PM on October 19, 2016 [1 favorite]
These are the things they told me to watch for: Severe headaches, sudden swelling, shortness of breath, vision changes (All of those are signs of preeclampsia.) Baby stops moving the way it normally does. Your intuition just tells you something is wrong.
Positive on the GBS swab. Not sure how big a deal that is, but it's on my chart now.
Generally this means they'll put you on IV antibiotics when you come in for delivery. There are a few other things to watch for, like a fever during labor or your water breaking many hours before the baby is born.
I understand that a c-section is surgery, and surgery means there will be recovery.
Recovering from a c-section after many hours of labor was much harder for me than after one that is either scheduled or happens as soon as you go to the hospital. They will have you up and walking within hours of surgery if at all possible. I went home less than 48 hours after my second one, which was earlier than the doctor recommended; I think insurance would have paid for one more day, but I felt I'd get more rest at home.
Congratulations & good luck!
posted by belladonna at 4:52 PM on October 19, 2016 [1 favorite]
I had severe complications(pre-e) with my first born when I was 26, which resulted in an emergency C-section and a weeklong hospital stay. After that first one, I went on to have three more elective C-sections. Recovery wasn't really too bad for me. Obviously it's uncomfortable and you have to take it super easy for about 6 weeks, but on the whole it was something I could tolerate (haha, obviously, since we have 4 now!). Because I have a VERY touch blood pressure at the end of my pregnancies, I felt it was worth it to have elective C-sections a little early (around the 39 week mark), instead of trying to go to term and possibly ending up with some complications. In your case, a talk with your doctor is the way to go. I know plenty of people in your situation who have gone on to have normal vaginal deliveries, even with the high blood pressure (my doctor even tried to induce me when I had pre-eclampsia, but it was because my platelets started dropping that we rushed off to the OR).
Also, to echo what a few other people have mentioned here, a scheduled c-section is easier than an emergent one. But your OB can talk to you more about that. You're almost there now, and I hope the rest of your pregnancy is uneventful and healthy, and that you have a wonderful birth, however it happens! :-)
posted by I_love_the_rain at 5:33 PM on October 19, 2016
Also, to echo what a few other people have mentioned here, a scheduled c-section is easier than an emergent one. But your OB can talk to you more about that. You're almost there now, and I hope the rest of your pregnancy is uneventful and healthy, and that you have a wonderful birth, however it happens! :-)
posted by I_love_the_rain at 5:33 PM on October 19, 2016
I've had two c-sections (one emergency, very premature and one planned at 39 weeks), and was walking around within 24 hours both times. I can't compare it to a vaginal delivery but I didn't think it was that bad. I didn't labor beforehand and like someone else said laboring for hours beforehand probably drastically increases the recovery time. If it were me I would ask for a scheduled c before an induction. At least find out what your new ob thinks about it. Birth plans so often change right in the middle of things, so no need to try to plan out all the particulars now anyway.
posted by peanut_mcgillicuty at 5:54 PM on October 19, 2016
posted by peanut_mcgillicuty at 5:54 PM on October 19, 2016
I am not a doctor. I did have a baby in July. If I were in your position, I would not rush right to asking for a c-section based on the points in your post. But I would talk to your OB and lay out everything you've said here. We were very frank with my doctor towards the end - asking her to tell us the exact reason she was recommending things, telling her our concerns, getting her to pin down the serious-ness of various risks and outcomes. It was some awkward/hard conversations (she has a terrible bedside manner...) but I'm glad we persisted.
As you can tell from the responses here, c-section experiences vary drastically. For what it's worth, I labored for about 24 hours (half at home, then half at the hospital) before having an unplanned, but not emergency, c-section. My recovery was completely fine. Definitely walking within 24 hours, going up and down stairs no problem, back to 100% normal within a few weeks. For about the first two weeks at home there were positions I couldn't sit in for long periods and it was hard to get out of bed if I was lying on my side. But it was nothing like I had feared or read about.
posted by cpatterson at 6:53 PM on October 19, 2016
As you can tell from the responses here, c-section experiences vary drastically. For what it's worth, I labored for about 24 hours (half at home, then half at the hospital) before having an unplanned, but not emergency, c-section. My recovery was completely fine. Definitely walking within 24 hours, going up and down stairs no problem, back to 100% normal within a few weeks. For about the first two weeks at home there were positions I couldn't sit in for long periods and it was hard to get out of bed if I was lying on my side. But it was nothing like I had feared or read about.
posted by cpatterson at 6:53 PM on October 19, 2016
Just a quick response to someone above-I haven't heard of anyone having 3 days in the hospital with a vaginal birth in the US in the modern era-with no complications, I've never heard of anyone spending more than 24 hours after birth.
3 quick and easy deliveries, the last an hour start to finish at age 39. Crazy and intense labors-but almost as soon as baby was born I felt amazing. If there's any chance you can have a birth like this rather than a surgical recovery, I'd sure take the chance.
posted by purenitrous at 10:29 PM on October 19, 2016 [1 favorite]
3 quick and easy deliveries, the last an hour start to finish at age 39. Crazy and intense labors-but almost as soon as baby was born I felt amazing. If there's any chance you can have a birth like this rather than a surgical recovery, I'd sure take the chance.
posted by purenitrous at 10:29 PM on October 19, 2016 [1 favorite]
I guess I want to know why you're scheduled for induction in a week? You're not overdue so what's the benefit of inducing vs. going straight for the C-section? That's the question you need to ask your OB. Induction is NOT fun. Like, seriously not great. Anecdotally, I was induced (I was 10 days overdue, though) and then ended up having a C-section anyway and I would have MUCH rather have had the C-section straightaway. Every woman I know who has been induced and then later went on to have a non-induced labor has said that induction SUCKS.
So ask your OB why you're being induced and why that would be better than just scheduling the C-section, given your history and the way your pregnancy is progressing right now.
posted by cooker girl at 6:13 AM on October 20, 2016 [1 favorite]
So ask your OB why you're being induced and why that would be better than just scheduling the C-section, given your history and the way your pregnancy is progressing right now.
posted by cooker girl at 6:13 AM on October 20, 2016 [1 favorite]
Best answer: In terms of vaginal delivery vs c-section recovery, it's totally a crapshoot. I know women who've had (scheduled) c-sections and were up and about a couple days later with no lasting side effects and I know me, who couldn't sit down for at least 4 weeks after a vaginal delivery and a third degree tear. For my second vaginal delivery I was playing on the floor with my toddler the day I came home from the hospital and felt like I could have gone on a hike right then and there. Anyone who tells you it's definitely easier one way or another is lying, there are too many individual variables to know beforehand.
I know full well the end of pregnancy anxiety. I know how stressful it is to be told "come in if anything changes," as if ANYTHING CHANGES is something you can just intuit on the spot, as if that didn't make you second guess yourself every time the baby moves or doesn't move or you get a headache or it hurts to get out of bed or or or or. Big big big hugs from me, it was the worst part of pregnancy, by far.
My advice would be to get a second opinion from another doctor in your practice. Your OB went on maternity leave and whoever you're seeing now is not making you comfortable. Schedule your next visit ASAP and with a different doctor and see if you can get more comfortable with your options, including potentially a scheduled c-section, and what you should be on the lookout for.
posted by lydhre at 6:30 AM on October 20, 2016 [1 favorite]
I know full well the end of pregnancy anxiety. I know how stressful it is to be told "come in if anything changes," as if ANYTHING CHANGES is something you can just intuit on the spot, as if that didn't make you second guess yourself every time the baby moves or doesn't move or you get a headache or it hurts to get out of bed or or or or. Big big big hugs from me, it was the worst part of pregnancy, by far.
My advice would be to get a second opinion from another doctor in your practice. Your OB went on maternity leave and whoever you're seeing now is not making you comfortable. Schedule your next visit ASAP and with a different doctor and see if you can get more comfortable with your options, including potentially a scheduled c-section, and what you should be on the lookout for.
posted by lydhre at 6:30 AM on October 20, 2016 [1 favorite]
ALSO anecdotally, I was induced at almost a week overdue due to high blood pressure and the experience was completely fine. Incredibly positive, even.
As you can see, labor and birth outcomes are all over the map and there's a million factors at play and there's just no way to know which way it will go. And I agree with what others wrote above that this period is going to be fraught with anxiety and tension anyway, whether you have potential complications or not, because that's just the nature of the beast with the last few weeks of pregnancy. I am a massive control freak and the last few month or so of pregnancy, not knowing how or when something is going to happen, fuck with your mind like nobody's business. I concur that if your OB thought there was a serious problem, they'd have already sent you to the hospital. When my doctor decided that my blood pressure numbers meant I should be induced, I thought, "Surely she means sometime in the next day or two, or possibly this weekend" but no, she meant it as, you are leaving this office and going home to tell work and pack your bag and I am calling the hospital to tell them you will be there this afternoon.
If your OB is not making you comfortable and you're not getting good answers, I strongly encourage you to see another OB in your practice. Often that can provide all the clarity you need. I switched caregivers more than once in my last pregnancy until I found someone I felt comfortable and happy working with, and it's 100% okay to do that right up until the end if necessary. I dumped one particular midwife because she was just like *shrug* to all my questions and wouldn't answer anything definitively and I was just like OMFG, *you* are the medical professional here and I need your medical opinion, not for you to ask me what *I* think (and also, she was an asshole about pregnancy anxiety, whereas my new OB was a gem and totally "got" why a pregnant woman would be anxious, and treated it respectfully and accordingly).
Hang in there. This time is hard hard hard but you're going to be on the other side so soon. Best wishes to you!
posted by anderjen at 6:43 AM on October 20, 2016
As you can see, labor and birth outcomes are all over the map and there's a million factors at play and there's just no way to know which way it will go. And I agree with what others wrote above that this period is going to be fraught with anxiety and tension anyway, whether you have potential complications or not, because that's just the nature of the beast with the last few weeks of pregnancy. I am a massive control freak and the last few month or so of pregnancy, not knowing how or when something is going to happen, fuck with your mind like nobody's business. I concur that if your OB thought there was a serious problem, they'd have already sent you to the hospital. When my doctor decided that my blood pressure numbers meant I should be induced, I thought, "Surely she means sometime in the next day or two, or possibly this weekend" but no, she meant it as, you are leaving this office and going home to tell work and pack your bag and I am calling the hospital to tell them you will be there this afternoon.
If your OB is not making you comfortable and you're not getting good answers, I strongly encourage you to see another OB in your practice. Often that can provide all the clarity you need. I switched caregivers more than once in my last pregnancy until I found someone I felt comfortable and happy working with, and it's 100% okay to do that right up until the end if necessary. I dumped one particular midwife because she was just like *shrug* to all my questions and wouldn't answer anything definitively and I was just like OMFG, *you* are the medical professional here and I need your medical opinion, not for you to ask me what *I* think (and also, she was an asshole about pregnancy anxiety, whereas my new OB was a gem and totally "got" why a pregnant woman would be anxious, and treated it respectfully and accordingly).
Hang in there. This time is hard hard hard but you're going to be on the other side so soon. Best wishes to you!
posted by anderjen at 6:43 AM on October 20, 2016
I laboured for 8 hours after induction before they called it and did a c-section. I'd do the induction again; I'm convinced that at least some of the issues with early breastfeeding were due to the c-section. My recovery was fine.
Maybe you could talk to the doctors and see if you could consider a c-section at 8-12 hours into labour instead of 24+? Those long labour plus c-section stories sound like the worst.
You've a week to go before getting induced, I know all this medical stuff is a nuisance, hang in there. You're doing great.
PS - group b strep positive is not a big deal. All it means is that you'll get antibiotics at the time of delivery.
posted by crazycanuck at 7:07 AM on October 20, 2016
Maybe you could talk to the doctors and see if you could consider a c-section at 8-12 hours into labour instead of 24+? Those long labour plus c-section stories sound like the worst.
You've a week to go before getting induced, I know all this medical stuff is a nuisance, hang in there. You're doing great.
PS - group b strep positive is not a big deal. All it means is that you'll get antibiotics at the time of delivery.
posted by crazycanuck at 7:07 AM on October 20, 2016
I was in your spot 2.5 years ago, minus the GD - age 39, 37 weeks, high BP. I was induced at 37 weeks, it didn't really take and I ended up with a stat c-section when my son's heart rate kept dropping (he was sunnyside-up, don't know if that was why). My OB didn't offer a c-section as an alternative to induction and I didn't ask, so I don't know that it was indicated, and I don't think she would have agreed in my case. I liked and trusted my OBs, so I felt okay going in. We had a hospitalist model, so my regular OB wasn't part of the induction and didn't do the surgery, but I also felt extremely comfortable with the whole team (except one annoying med student that I wanted to throttle, but I digress).
In the end, though, for my n=1, induction sucked and the emergency aspect coupled with my personal reaction to the epidural meant that I ended up having to go under general anesthesia and missed my son being born. On the other hand, my recovery was very easy, you can't see my scar unless you look very closely and squeeze my belly a certain way. You will very likely need help in the first few days, though, so I'm not sure sending your partner home is a good bet, unless you have other people that can stay with you and the baby (assuming it's the rooming-in model, rather than the nursery model).
So, circumstances are always all over the map, and I don't think I can say that I would have made different decisions looking back (i.e. asking for a c-section), and the most important thing for me was that I trusted my OBs.
posted by Pax at 7:10 AM on October 20, 2016
In the end, though, for my n=1, induction sucked and the emergency aspect coupled with my personal reaction to the epidural meant that I ended up having to go under general anesthesia and missed my son being born. On the other hand, my recovery was very easy, you can't see my scar unless you look very closely and squeeze my belly a certain way. You will very likely need help in the first few days, though, so I'm not sure sending your partner home is a good bet, unless you have other people that can stay with you and the baby (assuming it's the rooming-in model, rather than the nursery model).
So, circumstances are always all over the map, and I don't think I can say that I would have made different decisions looking back (i.e. asking for a c-section), and the most important thing for me was that I trusted my OBs.
posted by Pax at 7:10 AM on October 20, 2016
Another option: going with the induction but planning to get an epidural as soon as it becomes uncomfortable. That will keep you from going through as exhausting a labor regardless of how it turns out.
posted by metasarah at 7:16 AM on October 20, 2016
posted by metasarah at 7:16 AM on October 20, 2016
Right around that time in my pregnancy I scheduled sort of a consultation type of appointment with my doctor to discuss all of my questions and concerns (so that she would know that this is a time to just talk and not a time to be doing tests and monitoring and forgetting that hey, I'm not just a chart, there's a real person here with impending new mom anxieties and all).
My first (via IVF) was born after I turned 40 and my second was at 44, so yes advanced maternal age is a thing but it is not a thing that determines whether you are a candidate for c-sec. The other medical concerns are more legitimate determining factors, regardless of age.
posted by vignettist at 7:58 AM on October 20, 2016 [1 favorite]
My first (via IVF) was born after I turned 40 and my second was at 44, so yes advanced maternal age is a thing but it is not a thing that determines whether you are a candidate for c-sec. The other medical concerns are more legitimate determining factors, regardless of age.
posted by vignettist at 7:58 AM on October 20, 2016 [1 favorite]
I had a pregnancy with no complications, but I was AMA and spent the last few weeks of pregnancy going to multiple appointments for exams, NST scans, and ultrasounds. Would it help your anxiety level to know that part is “normal”?
Why have they scheduled the induction for 38 weeks? Is it because of your high blood pressure and kidney function? I could see that, but I would want the doctor to spell it out, because it’s my understanding that the closer you are to full gestation, the more likely an induction is to “take.” I would want to hear a good reason for inducing before 40 weeks (there are good reasons).
What method will they use for the induction? I was induced starting with Cervadil (tiny oral doses over the course of 18 hours or so) to soften my cervix, and moving on to Cytotec, which jump started labor after just a few hours. We never had to go to Pitocin, which works more quickly and gives your body less time to prepare. The tradeoff was more than a full day in the hospital before labor even started. But my husband was able to come and go and sleep in his own bed. FWIW, my experience with induction was a happy one, and my labor went fine. It was a bit long, but I think that was more because my epidural was too strong. I’d still get an epidural if I were to do it again, but I’d know to ask them to turn the dosage down sooner.
I do think you should ask your OB about a C-section so that you can evaluate your options. There are some health benefits to a vaginal birth, but they don't necessarily outweigh other factors (including your mental wellbeing).
posted by Kriesa at 8:07 AM on October 20, 2016
Why have they scheduled the induction for 38 weeks? Is it because of your high blood pressure and kidney function? I could see that, but I would want the doctor to spell it out, because it’s my understanding that the closer you are to full gestation, the more likely an induction is to “take.” I would want to hear a good reason for inducing before 40 weeks (there are good reasons).
What method will they use for the induction? I was induced starting with Cervadil (tiny oral doses over the course of 18 hours or so) to soften my cervix, and moving on to Cytotec, which jump started labor after just a few hours. We never had to go to Pitocin, which works more quickly and gives your body less time to prepare. The tradeoff was more than a full day in the hospital before labor even started. But my husband was able to come and go and sleep in his own bed. FWIW, my experience with induction was a happy one, and my labor went fine. It was a bit long, but I think that was more because my epidural was too strong. I’d still get an epidural if I were to do it again, but I’d know to ask them to turn the dosage down sooner.
I do think you should ask your OB about a C-section so that you can evaluate your options. There are some health benefits to a vaginal birth, but they don't necessarily outweigh other factors (including your mental wellbeing).
posted by Kriesa at 8:07 AM on October 20, 2016
I labored for 60 hours following an induction, until finally my doctor insisted on either a c-section or going home. Since my baby was at risk, going home sounded like a terrible idea. I was strongly against a c-section, which is why the holdout was so long -- and I often wish I hadn't been so stubborn about it. I guess my advice is to try to keep your options open all the time. Having a birth plan always sounds like a lesson in what it will be like to be parent: some things just aren't up to you and planning. Also, my other piece of advice is to try and find a doula that suits your feelings about childbirth, even now. If you are in Boulder or Denver, memail me and I will give you the name of a great doula who knows all about the medical stuff and is just the most wonderful support.
posted by freezer cake at 10:17 AM on October 20, 2016
posted by freezer cake at 10:17 AM on October 20, 2016
Vaginal delivery is safer for you and your baby. You are at risk for surgical delivery. Be fierce, and have your partner be fierce about every single person who enters your room washing hands. and ask lots of questions about the hospital's infection rate. I had induced labor, then a surgical delivery. Went home, then back to the hospital hours later with a fever and post-surgical infection. Really not fun at all. Some post-surgical complications that were unpleasant but didn't affect long-term health. C-section was not great at all, and I cringe when I read articles that suggest it's easy-peasy. Most women have better experiences, but not all.
posted by theora55 at 11:58 AM on October 20, 2016 [1 favorite]
posted by theora55 at 11:58 AM on October 20, 2016 [1 favorite]
I don't have experience with GD or high blood pressure during pregnancy but I can talk about C-section recovery.
My baby was breech so my surgery was scheduled. I was able to prepare (mentally, emotionally, and organizationally) for the surgery and recovery. I had my C-section was on a Sunday (baby delivered at 7:19 am and I was in recovery less than an hour afterward). Baby curls and Mr Curls were in the OR the entire time and Baby curls was held up to me for skin to skin contact.
There were some unpleasant things about the surgery. Not eating for 12+ hours beforehand is difficult depending on the time of the surgery. They taped my stomach to the table (I'm very overweight so they needed to get the extra tummy out of the way - I don't know if that's standard). During recovery I had to wear compression things on my legs and it made me warm. I had mild constipation for 5 days. Stairs were a challenge for a few days and I got tired after moderate physical activity (like walking around the mall for a few hours).
What I will say is that I was walking by 9 am the next morning and was out of the hospital in just over 48 hours. I had a slight wound abcess during recovery (which I was high risk for because of my weight) but it resolved very quickly.
If you go through with the infection, have a plan with your OB on when and why you'd switch to a C-section. The idea of an emergency C-section scares me (and is harder on the body, has a tougher recovery, and you may not be awake for it).
Best of luck with the delivery and new baby!
posted by toomanycurls at 12:44 AM on October 21, 2016
My baby was breech so my surgery was scheduled. I was able to prepare (mentally, emotionally, and organizationally) for the surgery and recovery. I had my C-section was on a Sunday (baby delivered at 7:19 am and I was in recovery less than an hour afterward). Baby curls and Mr Curls were in the OR the entire time and Baby curls was held up to me for skin to skin contact.
There were some unpleasant things about the surgery. Not eating for 12+ hours beforehand is difficult depending on the time of the surgery. They taped my stomach to the table (I'm very overweight so they needed to get the extra tummy out of the way - I don't know if that's standard). During recovery I had to wear compression things on my legs and it made me warm. I had mild constipation for 5 days. Stairs were a challenge for a few days and I got tired after moderate physical activity (like walking around the mall for a few hours).
What I will say is that I was walking by 9 am the next morning and was out of the hospital in just over 48 hours. I had a slight wound abcess during recovery (which I was high risk for because of my weight) but it resolved very quickly.
If you go through with the infection, have a plan with your OB on when and why you'd switch to a C-section. The idea of an emergency C-section scares me (and is harder on the body, has a tougher recovery, and you may not be awake for it).
Best of luck with the delivery and new baby!
posted by toomanycurls at 12:44 AM on October 21, 2016
Response by poster: I want to thank everybody for their kind responses. This was all extremely helpful to read. I went in for an NST yesterday and my blood pressure was high again, and there was protein in my urine. I was very frank with the doctor---they said it was borderline and five points less, they would have sent me home to wait and see and come in for monitoring, but my levels being what they were, they would induce if I wanted it. This close to due date, I decided I did. I can't see the benefit to the baby to go on with it if I am having health isssues which might affect him, and if I am so stressed about everything!
They would not allow me to go straight to c-section, but I am aware that is a possible outcome and have told them I am okay with that. I had a first helping of the cervical gel this morning and now we are waiting to see what happens next. Again, my sincere thank you to everyone. I think I really needed to hear that it was okay to stand up for myself and tell the doctor what my concerns were. I may yet avoid the c-section, or it might happen still. But things are underway and I feel like we all are following a plan to have a safe and healthy baby so that is all I really care about :-)
posted by ficbot at 9:30 AM on October 21, 2016 [3 favorites]
They would not allow me to go straight to c-section, but I am aware that is a possible outcome and have told them I am okay with that. I had a first helping of the cervical gel this morning and now we are waiting to see what happens next. Again, my sincere thank you to everyone. I think I really needed to hear that it was okay to stand up for myself and tell the doctor what my concerns were. I may yet avoid the c-section, or it might happen still. But things are underway and I feel like we all are following a plan to have a safe and healthy baby so that is all I really care about :-)
posted by ficbot at 9:30 AM on October 21, 2016 [3 favorites]
Good luck and congratulations! You'll meet your little guy soon!
posted by lydhre at 2:45 PM on October 22, 2016
posted by lydhre at 2:45 PM on October 22, 2016
Response by poster: As a final update, I truly want to thank everyone again. Induction was long needed slow over a two-day period but once they broke the waters, it was done within hours with surprising swiftness. Baby Charlie is safely here, and no c-section was required. With that said, I do truly want to thank everyone for helping me think this all out! Thanks again.
posted by ficbot at 10:41 AM on October 23, 2016 [9 favorites]
posted by ficbot at 10:41 AM on October 23, 2016 [9 favorites]
This thread is closed to new comments.
posted by inviolable at 2:51 PM on October 19, 2016 [2 favorites]