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Old 01-09-2011, 08:31 PM   #1
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sblakeley
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Join Date: Feb 2008
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Need help with birth plan!!!

I am a high risk patient (which we will get into below) and have an appt to meet with Maternal/Fetal to discuss my care and birth plan. I'm due 8/9 and I know right now your thinking crazy lady you have months! This is what I had though as well and was surprised to have the first question at my OB intake be "do you want a c-section or vbac?" which launched into a thirty min discussion on this and the M/F appt.

There are multiple factors that make me high risk and I'll break them down into bullet points any and all help is appreciated!!

* I'm kell positive (DH is not a carrier) I guess in rare cases this can still be an issue.

* I had ovarian cancer when preggers with DD. I was DX at 16w. They found the tumor on the first ultrasound (think cantaloupe) and I had surgery at 16w to remove it due to size and location (I was closing my uterus off from my cervix). DD was born at 34w with a scheduled c-section, I also had four other procedures that day (I'm a one stop shop type gal). I have a scar from public bone to rib cage, no abdominal fat pack, missing a bunch of lymph nodes and a right ovary. The incision in the uterus was done horizontally so I could have the option of a VBAC with another. I then had four rounds of BEC chemotherapy. And have been cancer free since December 2, 2007.

* I have a congential heart defect, an aortic coarctation with a bicuspid aortic valve. I had this corrected at age two along with a PDA repair (the valve they left alone). Last winter they discovered the coarc had become and aneurysm and I had that repaired in June with a graft.

* I now take beta blockers and will for the rest of my life to control blood pressure and decrease pressure on the repair site. This also causes low birth weight babies so a big baby would not be an issue.

* From my initial visit with the OB this was what they said, we are willing to let you do a VBAC if interested, however, it would be an assisted second stage of delivery. They defined this as giving me a super epidural and then doing a forceps or vacuum delivery. The basis for this is they don't want me pushing. They based this on research on Marfan's patients (which I do not have!) as my repair is similar to the one they have done. Marfan's is a genetic disorder of the connective tissue so no pushing makes sense for this, not for me.

What I want, is to be able to make informed decisions as I did not get to make any decisions last time. I want a VBAC with the option of being unmedicated. I do not want to be induced specifically no pitocen. I do not want an assisted second stage. And then after baby is born I have a whole nother list but right now I have to focus on the birth process portion.

Help please!!

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