I guess I have been more worried about this breech baby than I cared to admit. I know deep down that there is a very good chance that the baby will turn, but still the doubts come. I worry that since the baby is a little bit large for gestational age that there might not be enough room, and mostly I worry about being forced into being cut again simply because no doctors around here will deliver breech babies anymore (although my midwife and her partner do deliver frank breeches provided the head is tucked in). There are a lot of dangers to a breech birth, but there are also a lot of dangers to a cesarean section! I am not sure which I worry more about. A study recently came out showing that breech babies fare better with scheduled c-sections. I have, however, seen many arguments that this one study should not be the basis for all hospitals to refuse to allow breech vaginal deliveries. The study is flawed according to these critics. I have read up as much as I can and am still torn on the subject. I'm putting it off longer and concentrating my efforts on getting this baby to turn!
I have started doing the slant board. Basically you prop an ironing board on the couch and lie on it so your feet are in the air and your head is lower. This is supposed to raise the baby up out of your pelvis and encourage her to move around so that when you stand up again the baby is free-floating so to speak and then decides to somersault to a head down position. Usually they recommend doing this around thirty-two to thirty-four weeks as it is during that time that the baby's head becomes much larger and tends to float down to the pelvis. It can't hurt to do it earlier so I have started. The slant board has its own dangers. Aside from not being that comfortable and needing a lot of help to get into the right position, I am also very vulnerable when on it. Last night I guess Tommy decided I was thirsty and brought me a full glass of ice water. As I was trying to say no, he decided to help mommy drink it. I got a face full of extremely cold water. It went up my nose, in my ears, and soaked my hair! It essentially went everywhere possible but in my mouth! He also has decided that while mommy is lying like that it is the perfect time to climb on her tummy and give her bear hugs. It is very sweet, but again, outright painful. I have also heard that shining a flashlight at the bottom of your belly can help. Supposedly the baby will move his head toward the light. I decided to try this one night. Tommy now insists on helping with that and every time I get on the slant board he runs and finds the flashlight and holds it on the bottom of my belly. Well, he holds it there until he gets bored and then he starts running around the house shining it on everything including shining it directly into my eyes!
My doula also referred me to a chiropractor that specializes in the Webster technique. Webster was a chiropractor who lived in Atlanta who developed this technique for turning breech babies. He had something like an eighty-four percent success rate. I have never been to a chiropractor before and was a bit nervous about finding a good one. I had called around to a few places before I got the referral from my doula. I'm not sure how I feel about chiropractic care in general. I am not quite convinced that it is good for more than muscular and skeletal issues, but I do agree that the baby's position could be very well related to my alignment so I figured I'd give it a shot. The chiropractor takes no insurance, but she is having a special on a first time consult. In addition she is offering me a ten percent discount because someone in her birth professionals group referred me. For now I am planning on charging the visits to my credit card which I hate to carry a balance on, but it's more important for us to save our cash right now for rent. Tom has had a few interviews by the way, but no job offers yet. We're going on five weeks now.
The same day that my first chiropractor appointment was scheduled, I had my interview with the new OB. She isn't perfect, but overall I felt good about the visit. I will still switch back to the midwife if this whole insurance mess and finances allow for it.
The OB was very talkative and just plain nice. The interview was very relaxed, especially after her children barged in (she tried to gently scold her son and told him to leave, but I said it was fine I didn't mind)! They were visiting her for lunch, a two-and-a-half year old boy and a twelve-month-old girl.
She will respect me; I have a good feeling about that. We discussed a variety of things. There are a few things I didn't like. She feels that larger babies have a greater risk for shoulder dystocia (I have seen and heard much evidence refuting this), and she also feels that inducing a very large baby can increase your chance of a vbac whereas I have seen numerous studies that show just the opposite. I made it very clear that I would not agree to any induction before 40 weeks and that I would only agree to an induction after that if it were a very serious situation! She said that is my choice and she will not try to force me into anything. She refuses to use cytotec, but she will use prostaglandin gel and pitocin if needed. She technically can't deliver frank breeches (the hospital frowns on it), but she has been known to sneak them in. She just did one last week where the mom showed up ten centimeters dilated and wanting to push. The baby had been head down and had flipped in the last two weeks. She told the mom to push and easily delivered the baby and just kept it quiet that the baby was breech! She personally is a little nervous to deliver a breech baby if the baby is large as she feels that it is more likely the head will get stuck. Basically it comes down to if she knows the baby is breech she will not allow a vaginal delivery, but if the baby surprises us and I'm fully dilated and the baby isn't huge she'll do it. She's also excited that I found a chiropractor that does the Webster technique and said to go for it!
The things I liked about her were that she does not require continuous EFM. They have telemetry monitors and she would monitor me more closely than a non-vbac and wants them on through the pushing phase, but during labor it's just intermittent (for a few contractions every hour or two - I'm ok with this). I can labor in and out of water; she encourages me to get up and about, etc. She said she has found that most of her patients don't want to be in water after their water breaks because they don't like being in the mess, but she is fine with it if I like it and the monitors can go in water as well so I don't need to get out to be checked on them. She loves it when moms have doulas! She personally has witnessed two ruptures during pushing phase and she said they weren't pretty so I guess she is a little on the cautious side. She said she will do a c-section quickly (within ten to fifteen minutes) if things look bad, but is confident that everything will be fine.
She noticed right away that I was well educated about pregnancy, birth and medical issues and asked if I had a medical background. I told her I have a degree in biochemistry and we had a little side conversation about science, education and related topics. She was very respectful of me and very impressed with how knowledgeable I was. She also says she would not consider me to be a gestational diabetic, but she is glad I'm following the diet and have things so under control. She is a little surprised at my large weight loss and will be watching me because of that. I know I could find worse! I have my first appointment with her next Friday.
I weighed myself on her scale before I had left and it said I had lost another eight pounds just in the last week. That's a total of thirty-four pounds this pregnancy now! I have a feeling her scale is just being kind and needs to be recalibrated! She said other patients have said the same thing. I don't doubt that I am still losing weight, as I feel much thinner. I weigh less now that I did four years ago when we moved out to California. Tom is noticing it as well. Mostly I have slimmed down in the face a lot and also in my back and sides. I am a little worried in the back of my mind about this weight loss, but I honestly am not trying to lose weight and I am not restricting my food intake. I am following the gestational diabetes diet, but that diet has a lot of food actually. Perhaps the timing of the portions is allowing me to metabolize the food in a more efficient way? I also think that this weight loss has helped my sugar levels even more though. I can't believe that just a while ago I was such a mess over this gestational diabetes thing. Now my values are not even close to diabetic values! I have been consistently between 78 and 87 in the morning and am usually under 100 or at the highest 110 one hour after meals. The only problem is I have been having horrible cravings. I desperately want a big slice of cheesecake with ice cream and topped with strawberry sauce! And to wash that down I want a Kahlua and cream! I never drink that drink, but I can't stop thinking about it this pregnancy. I know exactly what I will be requesting for my birthday if the baby arrives before then (my birthday is ten days after my due date). I have also told Tom that when he gets a job we are all going out for a celebratory dinner. I was hoping it would coincide with our anniversary (July 4). I figure we'll go to a nice steak place and I'll order a low carb meal with a big hunk of meat and side of veggies and then I'll splurge and split a piece of cheesecake with Tommy for desert! Tom much prefers a rich chocolate desert so he can have that. I'm sure Tommy will help him finish his as well!
Back to the chiropractor! I had my initial appointment in the afternoon and was much more relaxed after finally finding an OB that I can work with. The chiropractor did a posture and balance assessment. My weight isn't distributing evenly over both feet. There is a difference of twenty-five pounds with more weight on my right side. She determined that my sacrum is out and I also have a muscle spasm all along the right side of my spine. I could feel it when she was feeling around to check things out. These things don't surprise me because I have had lower back issues in the past, to be specific my physical therapist in high school told me that my sacrum rotated forward and down on the right side. She said it was due to the rotation of my last two vertebrae. She used to manipulate things back and also work on my sacrum with manual traction. She also put me on an exercise program to strengthen my stomach and lower back muscles. I was a little surprised to hear I was "out" because I haven't had pain at all this pregnancy. I also have a ton of tension in my right shoulder blade and rotator cuff that really surprised her. She said she would love to work on that, but that it wasn't affecting my uterus and sacrum so it will wait for another time. I have had these tense muscles there ever since my rotator cuff surgery in college. I was getting deep tissue massages along with my physical therapy post surgery to try to work it out, but I never fully recovered.
I was reassured that this chiropractor was legitimate during the posture assessment. After doing the scale standing thing and marking where my curve points are she had me walk to and away from her. As I did this she immediately asked if I have ever injured my left ankle. Now I did badly sprain my ankle three times over two years. I had completely forgotten to put that on my history, but she picked up on it! She said it looked very floppy and that I placed my left foot down a little differently than my right foot. I walk heel to toe on my right, but I tend to just plop down my left. Not all the time, but at least half of the steps I did that way. She didn't do any adjustments Thursday, but she did feel for the baby's position and easily found the baby posterior and breech.
I went back again on Saturday for my first adjustment. She was so incredibly gentle. I didn't feel a thing while she was doing it and afterward I didn't feel any different either. But at home later that evening I realized I was looser and that while I hadn't realized it I had been having a very low level of pain and that was gone! This feeling lasted through the weekend and just today, Monday, I started having pain in my sacrum area again. She also did the Webster technique. That felt similar to what my physical therapist used to do to my sacrum, but she only did it on one side and my physical therapist did it on both and wasn't quite as gentle either. She told me that some women notice no difference and others are in pain after this due to the extreme amount of stimulation it causes on the baby. She said the home has basically been jostled, and things have been released and new real estate just became available so many babies will want to explore. I guess my baby is the adventurous type because s/he has been moving non-stop since! The baby moved to transverse while at the appointment and stayed that way the rest of the day Saturday. Surprisingly the transverse position caused me very little discomfort. I remember when Tommy briefly went transverse I was in agony! I am feeling more confident now that there is room for this baby to turn. S/he has been doing it non-stop for the last three days now. It was so bad Saturday night that I just couldn't sleep! I believe the baby is back to breech right now, but the increase in movement has been unbelievable. It's as if the subtle and gentle adjustment woke the baby up completely! I'm feeling much better about my chances of this baby cooperating and taking the dive head down into my pelvis. That's another good thing. The baby is extremely far from engaging. Wonderful news as the last thing I would want was a bottom or foot to engage!
I have three more appointments scheduled and can add more if I need them. This chiropractor said the technique works in one to ten visits and most often in four or five. She has never needed the full ten. She would like me to continue with her for some other adjustment of my lower back as well. I don't know how much we can afford, but at this point I feel like I can't not go. I need to do everything possible to make the situation right for a successful vbac, and not having a breech baby is a pretty important element! I have another adjustment tomorrow so I'm hoping that this is the one that does it! Wouldn't that be nice?
