Method of Delivery?

[Charisse]

Did anyone read the pregnancy article in the most recent IC Optimist? I thought it was good but I was disappointed in the lack of info the author gave on her choice to have a c-section . . I know this decision is between me and my dr but it's such a hard decision that it would help me to hear from others how they feel about this? I'm my OB's first and only pregnant IC patient. The rest of his IC patients are all menopausal and did not develop IC until after they had their babies. He doesn't seem to think a c-section is necessary and I really don't want one . .however I am starting to get really freaked over the idea of pushing a baby out past my urethra and either way, if I want an epidural my dr thinks I will probably need a catheter which will flare me for weeks. . .

So my current plan is to try for a natural vaginal birth . . if I can't handle the pain I will request an epidural and try to urinate on my own in a bedpan before I let them use a catheter. And then either way I am going to ask for narcotic pain meds afterwards if I'm flaring. . anyone else thought about their "birth plan" as far as IC??

[Krisi]

I am not pregnant yet, but I had the preconception counseling with an OB that has had one other patient with all pf my problems. That person chose a csection. Like you I feel uncomfortable with deciding on that because the csection they will move your bladder out of the way. That is bad in my opinion, but on top of that I also have PFD and vulvodynia. If you want to go natural I recommend you looking into the bradley method or something similar. They seem to have good success rates in going natural. I was considering trying something like that. The one thing that makes me apprehensive with the OB I talked too was that she seemed to be almost for a csection. That was the vibe I received at least.

I hope whatever you decide to do is great! It is just a really hard decision to make and no one really knows what to do with us because we have more concerns than the average pregnant women. Good luck! Please inform us on what you decide to do.

Krisi

[Claredale]

Charisse, time seems to be flying by...maybe not for you! I hope you are feeling well.

Hugs, Tracey

[LeeAnn]

Charisse, I had a c-section (unplanned) but I didn't think it was that bad. They used pediatric sized caths for me. I did have some blood in my urine from the cath. It didn't hurt like I thought it would. I felt it for a couple hours at most, but it honestly paled in comparison to the soreness from my incision. But even then, I didn't think a c-section was all that bad. I asked for vicodin b/c all other pain meds seem to give me retention or bladder pressure.

I had an epidural after being on pitocin for like 24 hours. I was dilated to 6 cm when I got it. It took away the pain of contractions away but it definitely intensified the bladder pressure I was feeling. The doctors felt it was possible that the epidural meds did in fact intensify that pressure sensation.....anyway, that bladder pressure hurt a lot more than if I had just never gotten an epidural.

Once they decided to give me a c-section (fetal heart distress) whatever they put in my epidural made me totally and completely numb, so numb that I could not move from the neck down. I could not move my arms or legs and then AHHHH finally relief. That probably sounds scary not to feel anything and to be paralyzed but I was so exhausted by that point that I was just thrilled I wasn't in pain anymore. And I actually fell asleep during the surgery over and over. I was soooooo drugged........Do other people get that sleepy? I have no idea if that was normal or not, women on TV don't look like they are struggling to stay awake!!! My hubby had to keep waking me up so I wouldn't miss it.

I had myself really worked up and nervous about the bladder pain from delivery lasting weeks past the actual delivery date but it didn't. It was temporary and then I felt great again.

[Charisse]

Thank you ladies for talking to me about this.

LeeAnn I have the same fear about flaring for weeks afterwards. That is so interesting that you felt more bladder pressure with the epidural. I never would have guessed that would happen but maybe because you had less pain with the epi you were able to feel the pressure more? I had another appt with my OB today and we talked about this a bit more. He said some women do opt to have a c-section if they are concerned about pelvic damage/trauma. So it sounded like he would be open to an elective c-section if I wanted one but I told him I really would like a vaginal birth if I can. I just want to make sure I have good pain control afterwards and he said he could give me Vicodin. I've never taken Vicodin and am scared of it making me feel loopy or sick to my stomach but he said we could start off with a lower dose. Also it sounds like maybe they gave you some additional meds to help you relax during the c-section. I know sometimes they do that and don't even ask you if you want them. Or if you were nauseated sometimes the medications they use for that can make you tired too. Were you sleepy afterwards too?

Krisi are you TTC right now? I had never put much thought into a c-section requiring moving your bladder. Are you certain about that? I teach childbirth classes and I haven't heard of anyone having to move your bladder . . . there is a risk of a dr. nicking it with the knife when they open you up but even that is very rare. I'm not an expert on c-sections though so let me know if you find out anything more about this. My dr is definitely not pushing me towards a c-section. . . in fact he seems very open to all my concerns and whatever I want to do which I've really liked since the very beginning with him. My Uro-GYN would probably be a real expert on this issue but unfortunately he has retired due to a brain tumor so I'm not sure he's even available to consult on these issues now . . I am with another office now and love my dr. I just wish he had more experience with IC and pregnancy. I guess I'm the test rat! So do you think you'll use this OB when you get pregnant Krisi? I interviewed a couple different OBs too . . . it is a tough decision like you said on what to do.

Tracey actually time is going by fast and yet slow at the same time. There is so much to mentally prepare for!

[anniemac18]

Hey Charisse - I've been thinking a LOT about this too in the past couple of weeks. I think I've settled on trying for a natural unmedicated birth. You might remember that my daughter was born vaginally with an epi (but no catheter) and I had a great experience overall. I know I can't count on things going that smoothly again, though, so I want to avoid all unnecessary interventions as long as I can which might lead to a C-sec.

I'm pretty set on the fact that I don't want to risk the complications of a c-sec and would prefer to risk the aftermath of flaring from a natural birth. If I find I can't take the birth without paid meds, I will also try to get the epi without a catheter and hope for the best. With a C-sec, a cath is a given, so I'd like to at least go for the option with the best shot of avoiding all of that!

GL with your decision!

[Charisse]

Anne good to hear from you! It sounds like you and I are on the same page with our birth plan. Have you discussed it with your dr? I talked to my dr about not having a catheter and he didn't seem too confident about that. He said the risk of retaining urine in my bladder and becoming overdistended is quite high and than that could cause me more pain and trouble urinating afterwards so that is why I really would like to try for a natural birth. I agree if I could have some pain meds afterwards than maybe it wouldn't be so bad. I had a hydro last July and I was in some wicked pain for a few days and then after that it wasn't too terrible. I figure the large tube they jam up your urethra for that procedure has to be better than a pediatric catheter. . that's if they lube it up and have an expert inserting it. My entire birth plan is going to be dedicated to catherization . .ha ha. So how have you been feeling? Remind us of your due date. I think it's coming up here pretty soon isn't it?

[anniemac18]

Nope, haven't really gotten to have the "birth plan" talk yet, but I'm not even sure how to go about it! There are any of 7 doctors who may deliver me based on when I go into labor. I'm a little nervous about that, but I think I'll just make sure that my husband and I are on the same page and are very vocal about our choices when it happens.

I'm nearly 30 weeks so I still have a little way to go - been having some pre-term labor scares, but my FFN tests keep coming back negative so I guess we're good for the next week or so. This baby will probably be overdue like my first - he's just trying to scare me!

I've been feeling pretty well. I think the pressure of the baby really has my frequency up, but how could it not? So far, so good!!

[Krisi]

We are TTC or will be trying in the next month or so. I just came off bcps and am waiting to have my first real period. I always had very long cycles. I have been charting though. Here is some of the information I have seen on the csections and the moving of the bladder.

"After incising the skin, the doctor cuts through the layers of fat tissues (which are present in all women, although in varying amounts) and then through a thick fibrous layer called the fascia. The doctor then makes an incision through a thin, filmy layer called the peritoneum (the sac lining the abdominal cavity and containing the organs). The uterus and bladder, among other organs, are now visible. The bladder usually sits on top of the uterus and must be carefully moved before the doctor can make the incision on the uterus and deliver the baby. After the uterus is opened, the delivery can proceed."

I had also made that comment to my doctor about being concerned and she understood my concern but also reassured me that vaginal deliveries push on your bladder, so who really knows what is best to do. Some people, I have heard, have adhesions that make the bladder stuck to the uterus and they have to seperate them. I would prefer to not have any IC, PFD, or vulvodynia pain from any of the options. It will be a hard decision to make either way.

What kind of childbirth classes do you teach? That sounds really neat. I do not know if I will go with her or not I haven't visited any others yet. It really depends on where I want to deliver too. There are so many hospitals in the area. The closest to me supposedly has the best atomosphere it has the title family birthing center and they do a lot of VBACs etc and seem to have some midwifes. The other one I am considering is much further away from my home but is between mine and my husbands work. Though he is looking for a new job closer to downtown which is closer to the other one. The one that is farther away does have a level 3 NICU which the one closer to my house doesn't, but the local childrens hospital is less than 5 miles away.

I saw your comments about the Vicodin and I don't know how you do with narcotics, but I don't do well. I had to take a Vicodin last week and took it with phenegran and was still nauseas, plus I was loopy and the pain was still there. I hope it works better for you, but I think that is the last time I will take Vicodin. I have had others though for my knee surgeries etc. that aren't as bad, but I still have to take phenegran with all of them no matter what. Pain wise Tylox seemed to work better for my surgeries.

Good luck on your descision and keep in touch!
Krisi

[Charisse]

Annie I'm glad you are doing so well and that there are not other preterm issues . . .that must be scary. I plan to type up my biggest concerns on 1 piece of paper (no longer or the medical staff won't bother reading it) and then have my dr place it in my chart and I'll take a copy to the hospital. There's no guaranteeing anyone will read it so I will need to be vocal as well but I feel better if I can at least have my dr review it and place it in my chart and am hopeful that someone "might" look at it. Otherwise I worry I'll be lost in labor-land and I don't feel it's really the best time for either me or my husband to be reminding medical staff of all my issues when I'm just trying to cope . . also I'm having a doula and so she will be helpful with reminding them as well. Oh and I'm not going to entitle it "birth plan" but maybe "birth wish list" or "Getting to know Me" list or something because it's more about informing the staff about my concerns. I have heard some of the nurses laugh when they see birth plans (as in who thinks they can plan their birth?)

Krisi I hope you conceive right away. . that is pretty exciting. I have always gotten pregnant on my very first try and this time it was my first month off the pill so I wish you the best of luck. How many mg of Vicodin did you take? My dr suggested I start off with just 1 pill instead of the standard 2 they prescribe but I have no idea how many mgs that is. I'm super sensitive to medications as well so I will plan to take Phenergan or Zofran with it. I teach Lamaze style classes although I'm certified through ICEA which is an organization very similar to Lamaze. Right now I teach either an all-day Saturday or 5 session series that covers labor, birth and postpartum including anatomy of pregnancy, coping techniques for labor, variations of labor, common hospital interventions & procedures along with c-sections. I also teach a one night Refresher for second-time moms and a Mid-Pregnancy class which focues on discomforts and nutrition. I really enjoy it and it's fun to be pregnant along with the class.

[Krisi]

That is really neat about the classes and stuff. I started charting my cycles but they are going to be long because they were before I went on BCPs. Anyway I am on like day 37 so far. At the beginning I used a regular thermo which through the numbers off some because it always reads high and then I switched midcycle and it looks like I have ovulated but I also had an infection (bladder) so who really knows but I don't now and my temps have been up for awhile since. I guess AF should start based on the charts 42-45 but who knows. I wasn't really planning on trying this past month but it could be possible that I am but I don't know.

About the Vicodin they come in different numbers ... I believe like 1-10 usually with a / of how much tylenol is in them. Mine were 5mg/500mg. I only took one but it said I could take two. I don't know but it made me feel horrible and I won't even take them, so I don't know what they are going to be able to do if I am in pain. I find for some reason that Tylox actually makes the pain go away but makes me sick but not as sick. It has oxycodone vs hydrocodone. But they equally make me sick. Which sucks. After my crash they gave me lots and lots of morphine that didn't seem to work and forgot to give me my phenegran just once and I vomited. Phenegran is best in an IV. They can also give you the other type that aren't pills so you can't throw them up.

When are you due in October? I know like 3 people due around then. Three sisters! I hope all goes well with your plans. I know doctors and nurses generally don't read things. I had a nurse grab my leg in the wrong spot after my surgery, because she didn't read all of what was written in my chart. I had 2 surgeries at once so two different types of stitches and staples in different locations. Lets just say, I asked if she knew what type of surgery I had and she said yes this type and I said politely "and I also had my lcl and fibula bone reattached." Lets just say she didn't touch me there again and apologized.

Good luck!!
Krisi

[LeeAnn]

Charisse, Yes I was nauseated so that is why I was so drugged. But is nausea all that uncommon? My husband said most women aren't that sleepy....he's in a CRNA program at Pitt right now (nurse anesthesia) and said that a few women appear that tired, but it's different when it was his own wife and he KNOWS that falling asleep outside of my house on my pillow is hard for me. I can't EVER fall asleep on an airplane or in a car. I have a hard time falling asleep in hotels while on vacation. So for me to fall asleep repeatedly like that during the birth of my child for crying out loud!!! ....he knows was completely out of character. Plus my labor lasted a long time so I was exhausted, but probably no more than anyone else. It must have been the drugs. Anyway, as far as the bladder being moved around, my husband has seen many many c-sections (in nursing school 8 years ago and now again he's seen more in anesthesia) and he has never seen the bladder be manhandled in anyway. He said there's a risk of it getting nicked but I don't think the bladder sits ON the uterus at nine months pregnant. I think that's an accurate description pre-pregnancy but not at the end when the uterus is fully occupied. I guess it might clear it up if someone asked an OB.....

[Charisse]

Krisi what is Tylox? I've never heard of that. I am definitely nervous about taking Vicodin. I think I took it years ago when I had my wisdom teeth pulled and I do remember feeling a bit nauseated from it around the third or fourth day. But since then I've developed a lot of sensitivity to drugs and I've been known to take the child's dose of everything and cut things into quarters. Phenergan along with it would probably help though. Let us know how your charting goes. My friend had really long cycles but once she started using those ovulation prediction kits she got pregnant right away. I was just coming off the pill this time and used an OPK and got pregnant the first try too. I was trying to track my cervical fluid and had I relied on that alone I would have totally missed my window. My temps have never been reliable due to sleep and allergy issues so I was never too confident with the charting.

Leeann yeah nausea is not all that uncommon with c-sections but who knows what or how much they gave you. Have you taken Phenergan before? Maybe they gave you some anxiety medication like Xanax or something in your IV? I wish I knew what they gave but it seems like the anesthesiologists don't always explain what they are giving you. My friend had a c-section and was given a hallucinogenic and what she described feeling was like an acid trip. .talk about a horrible experience when you are wanting to experience the birth of your child. When I had my hydro I had such a jerk of an anesthesiologist. I wanted to know exactly what it was he planned to use and he wouldn't tell me. The most I got out of him was "I have an idea for you that will work perfect". It's like he thought he was God or something and it really upset me. When I had a d&c with my miscarriage 2 years ago the anesthesiologist was really nice and listened to my concerns. I checked my records later and I had a combo of fentanyl and anti-inflammatory along with Zofran and Versed in my IV. I woke up with no nausea so that was nice. Honestly as much as I fear the pain and the drugs, I don't want to be nauseous either.

[an0bgobeloba]

hi there, congrats on your upcoming baby. i hope that you are feeling good..or as good as you can feel when pregnant. you have some tricky decisions coming up for you...a good practice round for parenting i guess you decision is completely personal but it always helps me to hear other women's stories because it gives me hope. you need to make the choice that makes YOU feel confident...feeling confident is what will get you through delivery no matter which method you choose. i developed IC symptoms between my 1st and 2nd babies, but it wasn't until after the 3rd that the symptoms were bad and i got diagnosed. keep in mind that you are designed to deliverer a baby and while IC might complicate it, it doesn't change it! it was very important to my husband and i to have a natural delivery. no iv's, no nothing! having that mindset going into it helps so much...for me i had to tell myself that pain meds are not an option before hand because it hurts so bad in labor that of course i would take them, because i would NEED them. so that was what we wanted and prepared for ahead of time. a bath tub realllllly helped along with learning that silly breathing. 7 to 10 centimeters is the part that i can't handle, but the tub really helped! if you decided to go the natural route discuss with your doctor about using nothing on you except water and a lube that you already know doesn't make you hurt. you had mentioned being scared about your urethra during pushing...that is a very scary thing, but it burns down there so much that i'm not sure if you would be able to tell burning from ic or just the normal stretching. and after it goes through all that down there, it will be sore for a while. but it will heal. i think ic patients are extra tough and i think you'll do great no matter what you choose. and even after you make a plan remember that it's ok if things don't go the way you've planned. getting you baby out healthy will be the most important thing on your mind and your mother instinct will enable you to tolerate anything. i wish you the BEST of luck. please let us know how it goes...i'm looking forward to seeing a picture of your new precious baby!

[stacym]

Hey -- just thought I would add my 2 cents. The labor was actually fine -- vaginal with epidural. It was when they put the catheter in that I screamed...please take it out..please take it out! Actually pushing the baby out did not bother my bladder/urethra. And once they drained my bladder they did leave the catheter out. Just remember it is YOUR body in there and YOU chose what you and your husband are most comfortable with! Godd luck! Stacy