Friday, December 19, 2008

Some c-section Q&A

The blog is actually an answer to some questions from the previous blog's comments. As most of you know, I will be having my 5th c-section coming up here in March, so this is in relation to all of that. My on-line friend is preggo with her 4th baby (w/ 3 previous c-sections). Just to let you know what's going on....(hope this helps!)

Thank your for the advice on breaking the news to others- you are experienced in it I'm sure.

I am trying to decide what to do about birth. I have at times greatly desired a vbac, in fact the third one was supposed to be but the doctor put me in a rock and a hard place. I am wondering why you've always chosen c-sections (I know you had to have the first one) and how do you prepare yourself for it.

I get nervous and sweaty just thinking about the process. The last one was the best, but still, all the needles and surgical stuff and that crazy feeling when the drugs wear off etc...I can imagine it could be just as scary with a vaginal birth as well, but still...

And not to pry, but how do you guys pay for it? If I go back to the same OB it will cost about $3000 total, which breaks down to $150 something each month, plus extra for the glucose tests and the Rhogam shots I take at 28 weeks, which are at least $130 plus a pop. Not to mention driving out there, ultrasounds etc. We are going to be moving next month for sure, either to MI or back to the other house down the road, so that will free up extra money. Still...just wondering...

It's just such a touchy thing with me and I'm praying for God's perfect plan.
Thanks busy woman!

I'll have to check on the exact $$ stuff, but we don't have to pay anything during the prenatal time (at each appointment). For the hospital, OB, surgery, etc. while I am at the hospital, we have to pay our portion of the total bill (once our insurance pays their part). I'm guessing it's a lot, but we just have to pay whatever our yearly out-of-pocket is. Not sure exactly, maybe $1000.00 or so (could be wrong).

Whatever is it, I know that we never feel like, "oh, we have *so* much medical bills from that kid" kind of thing. I'm betting it's just differences in our insurance plans - and there's really not a lot you can do about that (unless your dh is getting a different job in MI, then maybe his insurance would be better in this area).

Here's the basic breakdown of the c-section situations:

#1: very conservative OB, didn't want to try a version (turn the baby since he was breech). He did end up turning at the last minute, but he turned to a transverse position anyway - which always leads to a c/s.

#2: we were in a fairly small town w/ a small hospital. They didn't even *allow* VBACs there. I might have tried to go somewhere else, but we were pretty poor at the time and I was on state insurance - so I went whereever they gave me coverage. Not the smartest decision, but I guess I just didn't think ahead. As a side note, she ended up being breech as well (butt-first).

#3. This baby was actually head's down - probably my best bet for a VBAC, but I never did find anyone willing to give me a TOL (trial of labor). I had never actually been in labor - ever - and had never delivered a baby vaginally. No one was willing to let me try and I was kinda scared by all the "statistics" (thanks to the nurses - they are like walking "doom-sayers"...ugh...not all nurses, I know, but all the nurses I came across).

#4. We moved cross country when I was about 8 months preggo. I actually found a GREAT OB here, who is very well respected by other OBs and patients alike. She told me I *might* be able to find someone in the COUNTRY who might let me try a VBAC after 3 other c-sections, but I would have to pay for it myself (my insurance wouldn't cover that), plus go to all the trouble of actually *finding* a willing OB. Not likely. At this point, my c-sections had always been fairly positive, with my recoveries getting easier and easier. I knew my risks were also going up for a VBAC. I had also read lots on women who have had numerous c-sections. My research and my OB confirmed that each woman is different. Some women can deliver MANY c-section babies with great healing and no problems. Some women can not. Some women have bad scarring or thin areas......etc.etc.etc.

So right now, we simply take it baby by baby. I trust my OB, I like her a lot. I have talked openly with her about our beliefs, and that I would like her HONEST opinion after each birth - how do things look in there: are there thin areas, is the scarring bad, are there lots of adhesions, what is her medical opinion???

Then after each birth, my dh and I will have to make a tough decision as to how to procede next. We are not willing to head into another pregnancy if my OB says I and the next baby will be in great danger. I know some QF families would "trust in God" no matter what, but my dh and I believe we are supposed to use the medical information He has supplied to us.

I guess it's an individual call for each family - that's just how we look at it. It's not an easy situation, and I always encourage those who can avoid c/s to do so - absolutely!! Yet I also wouldn't go to extreme measures simply to have a perfect, vaginal birth. That just may not be what God has for you. Maybe it is. Just don't let "the perfect birth" become this idol that you *must* obtain. At least, that's how I feel about it.

Lastly, I get nervous too. Especially that morning, right as I'm going into the hospital and all the "medical stuff" is starting. The worst is when I get the catheter, then they wheel me to the surgery room where I have to get the spinal ALONE (they don't allow my dh in there with me - which is awful IMO). I usually cry a bit, with tears sneaking out (which is not unusual for me or for pregnant women in emotional situations). Once my dh is in there with me, I calm down and relax and try to actually "enjoy" the birth of my child, as much as possible. I talk to my OB, the nurses, asking them how things are going, what things look like in there, remind them I do *NOT* want a tubal, etc. ;)

I will be praying for you - for peace in your decision-making process. I know you and your dh only want God's best and if you seek His will, He will show you what to do. It may be a trying time, emotional, jittery, etc....but He can give you peace through it all (beyond ALL understanding).

I really am so happy for you, yet I also understand the many emotionas running through you as well. C-sections are not "ideal", yet praise the Lord for them!! Please keep me informed of how things are going for you in that area. Perhaps you will be able to find someone willing to let you try a VBAC, especially if you are already having to pay so much even *with* your insurance - money might not be such a factor in that case.

Luv you, sister


Morgan said...

I too am a 4 time c-section mom. I had all 4 of them in just a little over 4 years. My husband and I would like to try for #5 next year, which like you, would be our 5th. c-section.

There is a lady on one of my message boards (and blog list) that has had 10 c-sections. Outside of her, though, I haven't met many women (even on the net) that have had 5 or more.

So it's nice to meet you!

*Michigan Momma* said...

Nice to "meet" you as well!!

I know a lady that just had her 5th c-section a few days ago and things went fine! It *is* possible.

My babies have pretty much been coming every two years: Aug.'01, March'03, May'05, Feb.'07 & soon March'09. You have had yours much quicker than mine!!

Hope to hear more from you soon~

Anneatheart said...

Thanks for answering me Lori. I have been reading a lot lately on the subject, seeing what is current in on the subject. (you they change things every few years or so) I have found many women who have had vbacs after multiple surgeries.

However, at this point I just don't have that deep desire to pursue it. I am planning to contact all the midwives in the area and find out what their stance is on vbac after multiple c-sections though. That should help somewhat. We do have very good insurance, in fact, our second one ended up being free because we maxed out the year before on our special baby. (I can't remember the details)

It may be different with another doctor as far as costs. I just really dread the whole search for the right one. At least I have a long time to find the right person, or go it alone :) Isn't it amazing that we have several children and NEVER felt labor pains? Funny...

Anonymous said...

Great insurance is key! We are VERY blessed. I work for a health insurance company as a case manager. We have NO deductible, and $10 copays etc. ($10 copay due at first OB visit and that's it) And it's PPO, so we can choose which hospital to deliver. And our premiums are PENNIES. For our family it's $60/month.

If you have the right insurance you won't have the deductibles. Shop around!

Kelly said...

I'm late commenting on this, but I wanted to say that I was able to get my insurance to cover a birth at an out-of-network hospital for a vbac. The cost savings to them was considerable, so they agreed to do it. It involved me making a lot of phone calls, and having my doctor write a letter (really signing the one I wrote for her) detailing the medical benefits of vaginal birth versus surgery, etc.

I've been on medicaid, too, and they are all about cost savings. Just multiply the paperwork.

Anyway, I thought I'd mention it in case it helps anyone.


*Michigan Momma* said...

That's a great point, Kelly, thanks for sharing your situation. Insurance companies are all about saving a buck, eh??

Unfortunately, doctor's insurance companies are also all about helping their doctors, not the patients, so they tend to cause a lot of hassles when it comes to trying anything labeled "risky" or "high risk". Ask me how I know....ha....;\

Kelly said...

Well, I did have to have the letter from the doctor about why it was better medically for them to approve it. But since I only had one c-section, there is a lot more out there in the literature to back up the doctor.

It is the pressure of insurance vs. insurance, isn't it? My local hospital stopped doing vbacs because the hospital's insurer mandated they stop. There was only one doctor in town who did them, anyway. So we've got the hospital's insurance, the doctor's insurance, and our insurance . . . it's so easy for the best care to get lost in all of that.