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The new OB.

2008-01-31 - 10:15 a.m.

Yesterday I met my obstetrician for the first time. She seems alright, I suppose, though time will tell. Her style was comfortingly reminiscent of my family doctor in that she seemed up on the latest stats and information and advised accordingly. Her nurse, however, seemed nice but kind of a ditz: she asked me the same questions several times and seemed to get flustered pretty easily.

As a side note, I’d like to know if I’m the only one who researches their potential doctors online. I made an impression on this OB, but unfortunately I think that impression was “stalker” after I mentioned that she too made an effort to keep in shape – she ran 10Ks didn’t she? She was definitely startled and asked how I knew that and I explained that some of her race results popped up in a Google search. She eyeballed me a little strangely, particularly when I mentioned that it seemed a lot of the OBs ran 10Ks, since I’d also found race results for two of her colleagues. But I digress…

The subject of “to repeat, or not to repeat” the c-section naturally came up. She did not advise me either way, but the numbers she gave me were definitely sobering: given that I only dilated to 5 cms last time, the odds of my having a successful VBAC this time are about 60%. That may be better than 50/50 odds, but is by no means reassuring to me at all, because what I want to avoid at all costs is another long, painful, fruitless labour followed by a emergency, worry-fraught c-section, and a 40% chance of that happening is, quite frankly, much higher than I would have liked. Odds of uterine rupture are, fortunately, quite low, but the threat is certainly present with a VBAC and the numbers she quoted me on fetal/maternal injury and death if it does happen (low though the chances may be) are extremely disconcerting, not to mention the other complications like almost certainly needing a transfusion, etc.

So, while we’re going to wait until my next appointment on the 29th of February (when we’ll hopefully have the OR notes to tell us whether they did a single or double closure on my uterus during my first c-section, which apparently has some ramifications as well) to make a decision, I’m leaning towards the repeat Cesarean. In fact, I can almost guarantee that that’ll be my decision in the end. If I planned to have more children I might consider a VBAC more carefully so as to leave future options open, but, with our history of fertility problems, and with one girl and one boy, and me turning 36 this year, I’m pretty sure we’re done. For all you VBAC proponents out there? You can make that decision for yourself based on your own situation and statistical probabilities of outcomes.

I guess I’m a little defensive about this whole issue. Maybe I should have simply said that “it was discussed and decided that in my specific medical circumstances a repeat C was safer and preferable”. Certainly by giving all my stats and reasoning I’m tempting someone to say that they’d go a different route with the same information. To this I say, fill your boots and have that VBAC. Fortunately, this is a tiny little journal with a tiny little readership who is, for the most part, pretty silent when it comes to commenting, and the rest are always very respectful of other’s views, so I can’t imagine some huge flame war starting up in my comments section over this.

Go ahead, surprise me. I dare you.

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