Monday, July 30, 2012

My thoughts over the last several days

I have been thinking a lot about the whole c-section thing since my doctor's appointment last Friday.  Pretty much all of Friday, I was in tears every time I thought about it.  A panicky, anxious kind of crying.  The idea of laying there awake while my guts are cut open and I can feel them pulling and tugging, oh God.  It's barbaric and scary.  I think I need to see a counselor or psychologist who works with overcoming fears if I am going to be able to go through this.  

Second, I keep questioning whether my doctor was insisting on the c-section or just trying to convince me and get my OK.  I feel like I need to schedule a meeting with him to go over it again.  Is there any room for compromise?

Third, I am so worried about the adhesions issue.  Dr. H did such great work last year taking care of my crazy adhesions. They were all over the place, so of course I am predisposed to getting adhesions.  I want more children in the future.  If I have the c-section, that is likely to leave me with adhesions, which will put me right back in my infertility fight.  If I could just have the adhesions issue out of the equation, I know that would make the conception of any future babies a lot easier.  So, I see two risks or options.  In the first, if by some chance I could convince the doctor to let me try a vaginal birth, there is the slight risk (I am guessing 3% chance), that there could be a uterine rupture, and he would have to perform an emergent c-section.  In such an emergency situation, he's not going to have time to take steps to minimize adhesion formation.  However, there would be a 97% chance he wouldn't have to do the c-section.  

Option 2, with a scheduled c-section, maybe I could get him to agree to follow certain techniques to minimize adhesions.  I did e-mail Dr. H's nurse at the beginning of my pregnancy to ask what I could ask my doctor to do to help minimize adhesions, and they replied back to ask the doctor to use a two-layer uterine closure and ask her/him to close all layers-especially the peritoneum and bladder flap.  That seems to be in accord with this discussion I found online:

I also found this website for an adhesion barrier product:

And, I came across a reference to a journal article describing Dr. H's research and near adhesion-free surgery.  The article is called "Near Adhesion-Free Reconstructive Pelvic Surgery: Three Distinct Phases of Progress Over 23 Years", but I can't find free access to it anywhere on the internet.  Anyone happen to have a copy?  I'd like to see if any of those techniques might be able to be used during c-section.  I'd like to discuss those things with my doctor, too.  I hope he doesn't get offended, but I just want to make sure we do everything we can to prevent me having to have another surgery (or surgeries) to correct damage done during a c-section.  

So, go with a scheduled c-section where hopefully my doctor will use techniques designed to reduce chances of adhesions?  Or, take the 3% chance that I will need an emergency c-section where precautions would be thrown out the window?  Of course, this all assumes that I even have a choice.  After Friday's appointment, I don't know what to think.  Was he insisting, or persuading?  If persuading, that means I have a choice.  But, I don't want to make a stupid choice.  


  1. Ugh, IF makes even just having the baby hard! So sorry you have to weigh these options so heavily. I say do what gives you most peace. Coming from my experience as a nurse, please DON'T worry about offending the Dr! You are your own best advocate and you have to look out for your best interests. Plus, the Dr sees so many patients, he's likely to forget if he ever was offended in the first place. Go with your gut, you won't regret it.

  2. I may actually have a copy of that article...I will look and get back to you. I agree with Ania that you are your own advocate. Just keep praying for God to show you the best way.