Dilemmas ahead....37+2, not sure what to do re birth if given choice?!?

[Elibean]

Sorry in advance if this is confusing - I'm confused! Am hoping a bit of MN brainstorming might help
Have been booked in for section on Friday at exactly 38 weeks, because baby was transverse lie for weeks and weeks. She suddenly turned head down two days ago, and I think is still head down. My first dd was also transverse, turned at 36 weeks, but turned back to oblique lie when induction started at 39+3 (due to rising bp)...so my OB has said for a trial of labour (VBAC) she wants to see this baby not only head down, but head down and stable. Whatever that means, not sure how they can tell. They won't induce, or let me stay in active labour for more than 12 hours, due to previous section.
Other issues...I'm an older Mum (mid forties), I had a section due to failed induction last time around, and my bp is rising again, just as it did last time. Not pre-e, just PIH - but it needed medicating for six weeks postpartum last time, and almost certainly will again. Its currently around the 140/82ish range but rising daily. Oh - and I've had dreadful pg itching this time, which means I'm being monitored in case it develops into cholestasis, and, more practically, that I'm starting to feel very, very tired from lack of sleep over the past few weeks.
I see the OB on Tuesday, and will talk it all through with her, but....dh and I are feeling we should have some idea of what we want if given a choice, and we're stuck! Part of me would like to give trial of labour a go, but doubt that I'd go into labour naturally before due date and not sure I can last that long. Part of me would like to get on with it and stick to original plan.....help!

I know no one can decide for me, but it has always helped me to chew it over with anyone here who has time to chuck a few thoughts in

I'm not sure what I'd do in your situation.
How was your recovery from a C section last time?
If you have a C section this time, will you get the help you need afterwards and time to recover?
Is having a natural birth very important to you - would you be disappointed if you never experienced this?

Recovery was not painful, but slow...partly because I bust a few stitches and got a slight infection, partly because I was re-admitted with the bp issue. It wasn't awful, by any means, section-wise.
Yes, I have help lined up - was anticipating a section - but also have a nearly-3 year old dd!
I feel wistful about not experiencing a natural delivery (make that a vaginal delivery, imagine with all the various issues it would be fairly medicalized anyway) but not devastated. I learnt last time that the most important thing is my child, and a year on from the birth it didn't matter anymore at all.

Thanks, Belgo, this is exactly the kind of chat I needed

You probably want opinions other than our general talk from the December board, but here's my penny's worth.

1. your itching has been driving you mad and it's easy to see why you wouldn't want to be pg any longer than you have to!

2. us older mums don't tend to labor as effectively as the younger ones

3. although there is a risk with any surgery, i.e. section, there is also the small risk of uterine rupture with a trial of labor. My OB phrased it this way, "When a VBAC goes well, it goes very well. When things go bad, they go bad in a hurry."

4. from what I have been able to glean from other MN'ers, recovery from a scheduled section is generally much easier than an emergency section, which is basically what you would be looking at again if labor stalled.

#'s 2 - 4 are the reasons I chose to have a section in addition to my problems with PTSD from my previous birth experience.

Hey Jabber

No, value your opinion absolutely - just didn't want to bang on and on about this on the Dec thread! That all makes sense. I just wish I didnt' have the choice back (if I do by Tuesdsay, that is) because it means overriding my wistfulness with what is probably common sense.
Though if my bp goes on rising, they may say 'out she comes' anyway - even if its a bit later than originally planned.

Jabberwocky - 'When a VBAC goes well, it goes very well. When things go bad, they go bad in a hurry'

Could that phrase also be applied to a c -section?

Sorry Elibean - I'm not sure if my last post is helpful to you! Yes it would be easier if the baby was still in transverse and your decision would be made for you! You have to trust yourself to make the right decision, and I think you will do.

now why does it always work better when someone else (ie not me) tells me to trust myself?!
Thanks, B - tbh, the scar rupture thing is not the bit that is going to affect my decision, because I know how tight the monitoring is at my hospital on that. Its more the BP, I suppose - and second, the Itch from Hell (though I feel I should tough that one out ) - and third, I hate to admit, my fear that I'd be a total wimp at labour, and/or wreck my middleaged pelvic floor/bladder beyond recognition
But I do know that last one is just normal fear, and everyone worries about that!

are you likely to recover more quickly from the blood pressure issue if you have an early section?

Elibean - those are relevant fears and they do and should effect our decision making for how we choose to give birth. Only you are experiencing what you are feeling, no one else.

There are pros and cons for what ever decision you make, but it's what's important to you that counts. The wellbeing of the baby comes first of course - but given the right monitoring and intervention if necessary then the well being of your baby shouldn't come into question. Which means that the decision you make should be based primarily on you and of course your three year old and your dh.

Yep, B, you're right. Just so much to take into account! I feel a bit more prepared already, though obviously what the OB has to say on Tuesday is bound to impact decision.
With dd, my bp spiked up a week postpartum - so no, it won't avoid bp problems. But OB did point out that its easier to treat someone once baby is out - less worry about sudden drop in bp affecting baby, etc. Its doable, but not as straightforward. Or at least thats what I understood.
Edam, you're right - small bikini line cut much less likely to rupture, about 1-2% risk. But in any case, would be monitored, plus only allowed to labour for limited period of time, so really do feel in safe hands on that score

hi honey!! tranny baby no more!! wow!!

you know my thoughts on vbac v c.s so i won't repeat them all

if you have a longing to experience a natural birth, give it a go..risk of rupture is low and you will be monitored very carefully......

see what OB says on tuesday...but might well be worth a shot...and do some pelvic floor excercices! never too late..!!

Stresses and strains to the pelvic floor can be improved by pelvic floor exercises like Lulumama says, but also with the help of a specialised physiotherapist - I live in Belgium where all new mums are entitled to physio therapy post birth to improve their pelvic floor -and I wish that this was a service provided by the NHS.

Hi Eli. I've not got much useful to offer, but I can't imagine how difficult it would be to have NOT had choice up until now and then to have it given back to you(maybe?) The way I'm feeling I'd(personally) go for "give me my baby as soon AS."

But that's due to how I'm feeling at 35 weeks,no other reason.So that's not my suggestion for you!

i'm sure those with much more useful advice will come along to help(as have the rest of the replies you've already received)

Thanks all....hmm, thinking I need to clarify the bp bit most of all. Other than that one, you are all, between you, voicing my own thoughts!