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Old 03-09-2011, 11:48 AM   #11
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Re: Need some delivery thoughts - protecting perinium at all costs!

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I'm sorry you are stuck between a real rock and a hard place.

Are there any options that result in the passive descent of the baby without using the epidural? I'm thinking... hypnosis perhaps? And maybe something more substantial than just hypnobabies... something that could really put you in a state of passivity. Maybe I'm talking science fiction here or something!

Or, is waterbirth an option? This could not only help the perineum, but probably relax you quite well. Perhaps even a combo of these--hypnosis (of some sort or another) and water during the pushing phase.

If was in your place, and there weren't options for naturally increasing relaxation during birth, I might just go with the epidural. One of the positives I can think of with that option is pain relief in the (sounds like rare) event that the vein does rupture. I'm not sure what they would do to treat it, but if it involves any surgical procedures, at least there is no "wait time" for pain relief.

I'm sure you've already thought of this, but... are there any ways to actually treat the vein beforehand? Are there any specialists you could consult with?

I really hope some good options become available to you, and that your birth goes smoothly!
I wish they would allow water birth! But that is one thing they are pretty strict about. In general they have been very open with my wishes with my other births but they do say no way to birthing in the tub.

I was wondering about having the vein treated before hand. All I've heard of before is taking vitamin e but I wonder if I can actually have it taken care of by a vascular surgeon? I don't know how they do it but I think they can just inject something into the vein that basically "kills" it. I don't know?

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Old 03-09-2011, 11:51 AM   #12
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Re: Need some delivery thoughts - protecting perinium at all costs!

Hmm...If I were in your situation I *think* that I would consider birthing in water to protect the perineum...but I'm not sure that it's an option for you. I'm sure they will want to keep a close eye on you as the baby is being born....but positions that make that easy might make for more tearing. Maybe consider using the squatting bar if there is one and if it feels okay to you? But probably trying to slow down the crowning of the baby is your best shot of keeping everything intact.

But I'm not a midwife or anything! I would be worried if I were in your position, though. When pushing I personally felt best squatting (toilet seat!), but that's not for everyone.
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Old 03-09-2011, 11:56 AM   #13
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Re: Need some delivery thoughts - protecting perinium at all costs!

Well I will just give my
I am NOT against epidurals at all (in fact quite the opposite) which I know is different from you but I will give my experience.
I had an epidural with both of my previous births and I did get an episiotomy at the last minute with DD because things weren't looking good. With her I started pushing as soon as I could and didn't let my body do any of the work really.

With DS I also had an epidural but decided to let my body take control and not push until the last minute. So in 2 pushes he was out. It was a very nice easy birth and I didn't have and episiotomy or a tear.

Given your choices I think going the epidural route may be best because well if you have a c section you are going to end up not only drugged up but also cut open which just sounds like no good to me.
I just feel like as a natural birthing mama you are already going to be a bit upset (maybe not the right word) about having to have an epidural so it would seem that having a c section would only compound that.
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Old 03-09-2011, 03:42 PM   #14
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Re: Need some delivery thoughts - protecting perinium at all costs!

The birth tub things seems sorta weird, but I think that might be a good thing bc warm water will only dilate the vein anyway.

What about discussing with her different birthing positions that will decrease the pressure to the area? Such as- sitting on a toilet increases, kwim???

Also, you might look into some of those options for treating beforehand- I don't know anything about those, but even if they didn't "work" they might help??

I actually have no ideas for you other than that I'd be worried too....
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Old 03-09-2011, 04:30 PM   #15
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Re: Need some delivery thoughts - protecting perinium at all costs!

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The birth tub things seems sorta weird, but I think that might be a good thing bc warm water will only dilate the vein anyway.
Are you aware of the benefits of water birth, for both mother and baby?
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Old 03-09-2011, 05:36 PM   #16
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Re: Need some delivery thoughts - protecting perinium at all costs!

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Are you aware of the benefits of water birth, for both mother and baby?
I see Hillary's point - the warm water WILL cause the vein to dilate and thus potentially have more blood pulsing through the vein... something to think about - and I would be wary of making such blanket comments, what's good for some is not the best option for others.

To op: one of my best friends dealt with this very same issue, a vaginal varicose vein... although she also had another issue (a neurological issue) that led to the suggestion of a passive decent, they didn't want any extra pressure put on her neurological situation from pushing. At first glance they went right to the thought of c-section, but after further research found a vaginal birth in this manner would be safe.

The varicose vein was of worry to them, even with a history of smaller babies (this was her 3rd) and not much history of tearing. She did not have to push, really just breathed her out, BUT her vein burst anyway... she didn't lose a lot of blood but it was significant enough that they worked quickly to get things patched up. She had her 4th daughter last July, which ended in a c-section due to a breech presentation.

So my point, despite using the passive decent to get her out, the vein still had issues.

Could you approach your mw about a possible epi cut in a different area than the perineum, like off to the side (I KNOW that is not ideal) but with the alternative, it might be an option. Hopefully it would take the pressure off the perineum.

I hope someone is able to give you advice that will help you out
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Old 03-09-2011, 07:50 PM   #17
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Re: Need some delivery thoughts - protecting perinium at all costs!

Eek, sounds like you're in a tricky spot!

I'm going to say, and I know this won't be popular, that I MYSELF would probably consider the section. I am not at all recommending that for you as it's a very personal decision. But. On my 3rd kid I would probably be done anyways, so future sections wouldn't be a big issue for me. Also, while with my first I terrified of a section and thought it would be the end of the world, I did end up having one and it turned out ok. Not ideal, but I healed well and don't have any emotional lingering issues. I am going for a vbac this time, so I'm certainly not all about sections all the time.

Good luck with your decision, it looks like you've received some great advice already!
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Old 03-09-2011, 07:53 PM   #18
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Re: Need some delivery thoughts - protecting perinium at all costs!

The varicose vein is not a big deal. I have one, it can be treated prenatally with supplements and herbs. I'm having a home water birth.
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Old 03-09-2011, 07:57 PM   #19
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Re: Need some delivery thoughts - protecting perinium at all costs!

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I see Hillary's point - the warm water WILL cause the vein to dilate and thus potentially have more blood pulsing through the vein... something to think about - and I would be wary of making such blanket comments, what's good for some is not the best option for others.
Oh goodness, seriously? I'm pretty sure the OP is intelligent enough to do her own research on the alternative methods I mentioned that I'm using to treat my own varicose vein to see if they are suitable for her.

Perhaps it would be more PC if I told her just to follow her providers misinformed advice at all cost and not do any research of her own.
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Old 03-09-2011, 08:54 PM   #20
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Re: Need some delivery thoughts - protecting perinium at all costs!

cali4niachef - I was simply adding my opinion, and just because all those herbs work for you, does NOT mean they are for everyone... and you are NOT the only one who is allowed to share your opinions on DS.

I happen to care a lot about the op - we were in the same ddc with our last children and what I told her was well meaning and not ignorant. Perhaps her varicose vein is a big deal, some are worse than others.

I don't like drama, but I do not like being treated the way you treated me... i am not a doormat. I am done with this convo, but I was not able to leave without my opinion being defended.
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