It Continues

The Boy is sleeping worse than ever.  He's battling some sort of virus so he's crabby and generally miserable, and I don't blame him a bit, but man....It's exhausting.

All this exhaustion has turned my mind to mush, but here are some things I've been wanting to write about lately:

1.  In case of illness, what is your criteria for going to the pediatrician?  We've paid two sick visits already with this particular virus (and I wager to say we would have been more if I didn't have a college friend in pediatrics who is generally willing to answer my questions).  I don't want to be an alarmist pain in the ass, but I also don't want The Boy to suffer. 

2.  I've all but decided not to go for VBAC and have a repeat c-section instead.  I've done my due diligence and have my reasons that I'll go into when I've had more than 3 consecutive hours of sleep.  I have been surprised by the hostility with which this decision has been met when I've discussed it with my generally crunchy, pro-woman friends, who are sure that I am being duped by my doctor into doing something that is unnecessarily risky to accomodate her schedule (of course, I am not).  Why does the rhetoric around c-sections (from the pro-vaginal birth camp) tend to be so nasty (to wit, Tina Cassidy's Op/Ed in the Times from January)?

Comments

[Melissa]

If all goes as planned, I will be recovering from my third c section 3 weeks from today. Would I prefer a vaginal birth with a shorter recovery time? Of course, but it is not in the cards for me. People sometimes say things that are just dumb. Even those that are our friends and family. In the end, this is a decision for a woman to make with the help and guidance of her partner (if she chooses) and her doctor. After my first child was born (rough labor, 3 hours of pushing, c section) my doctor came to check on me and said that he was sorry I did not have the birth experience that I had hoped for. I looked at him while holding my son and said, "I had a great birth experience...I have a baby now!" Good luck to you!

[heather]

I think that people are just generally oppositional. I am due in 8 days and I had an emergency c-section with my first son. I am attempting a V-Bac, but only if I go into labor naturally before my due date. My son was over 11-pounds, and I'm not going to risk that again by going post-date. Everyone I know thinks I am crazy and that my midwives are selling me something that isn't possible.

I made my decision based on my own criteria as well. I'm not comfortable with certain aspects of both, so I set my own timetable . I am being monitored closely for fetal size as well as position, and I can change my mind on the VBAC if I go into labor.

People just need to mind their own damn business. Good luck to you (and me.)

[Liza]

I have three special-needs kids, who catch every bug within a 100-mile radius. We are at the doctor for something for someone at least twice a week. Needless to say, I do not want to spend the co-payments or expose them to anything ELSE unnecessarily at the pediatrician's office, and I've probably spent more time in the company of various pediatricians and pediatric specialists than...well, dang-near anyone. Insert something witty there; I don't sleep much either. I've discussed the "do I really need to come in" question numerous times with countless doctors, and the general consensus is to come in for:
1. Fever over 100 for a baby under six months no matter what.
2. Fever over 103 for child over six months regardless of other symptoms; twice I've been told that a fever of up to 104 without other symptoms can be watched closely and treated with Tylenol or Motrin at home, but both times it was for a child over three.
3. A cough that keeps the child from sleeping, makes them gag, etc.
4. Fever accompanied by ear-tugging, throat sore enough that the child doesn't want to eat or drink, a stiff neck that causes obvious distress when you tilt the chin up or ask the child to look at the ceiling, or a rash of any kind.
5. Vomiting or diarrhea IF the child is refusing to drink or not urinating enough (six wet diapers or trips to the bathroom per day, minimum), or there is blood in either, or the vomit is yellow or green in a baby who is only on formula or breastmilk, or if the poo is white or mucousy.
6. Any fall or bumped head that knocks the child unconscious. If they are not knocked unconscious but are confused or start throwing up or crying inconsolably, or their pupils look uneven, take them in for that, too.
7. Common sense applies to cuts, insect bites, bites from pets, rashes without other symptoms, etc.
8. If it's borderline, go with your gut. You know your kid better than anyone else. Several pediatricians have told me that a child's behavior is a good tie-breaker--be more concerned about a lethargic, apathetic child with a temperature of 99 than an eating, drinking, playing child with a temperature under 103.

Other than that, I've always been told that the color of snot is irrelevant, and that the correct way to handle a child who wakes up with a fever of over 104 is to immediately give Tylenol and put them in a room-temperature bath (NOT cold or icy, which is mean and might drop their temperature fast enough to bring on a febrile seizure, which is usually harmless but scary, and has to go to the ER--about half of kids under two have one at some point although none of mine ever have) while you are calling the pediatrician's pager or answering service and waiting for them to call you back. If your child ingests a medication or chemical, do NOT induce vomiting or give ipecac--activated charcoal is now the treatment of choice for ingested toxins; if they are in immediate distress or have ingested something like rat poison or furniture polish, or sleeping pills or cardiac drugs, either call 911 or grab them and the container and haul ass for the ER. If they are not in obvious distress and/or it's a plant that you don't know to be toxic, or a pill that isn't something that you KNOW is very bad, call Poison Control first--they can tell you how to proceed. One of my kids took a day's worth of my supplements--a Vitamin E softgel, several flaxseed oil softgels, a chewable vitamin C, and a super B-complex (YUCK) as a toddler, and Poison Control said the worst that would happen was that the kid might have diarrhea and no treatment was necessary. One time when I thought a child had taken an adult houseguest's prescription medication, they said that the number of pills the package would hold wasn't enough to warrant even a trip to the pediatrician's office and that symptoms of an overdose were X, Y, or Z but if they went eight hours without any of those they'd be fine--I was going to take them to the ER anyway, but then it turned out they only had an empty non-childproof pharmaceutical sample foil-pack that the person meant to throw out but left on the bed after taking the last pill from it instead. Copper (pennies, etc.), mercury from old-timey thermometers, or any vitamin containing iron are really bad and you should call 911 or haul ass for the nearest ER if you even think your child has ingested any at all.
That's the sum total of my medical knowledge right there. I'd be interested to know why you're leaning toward the repeat section. I don't know why women get so nasty about issues like vaginal birth/c-section or breast/bottle. You know the benefits of vaginal birth and breastfeeding when medically possible I am sure, and it makes me sad when women attack each other for not trying harder to give birth vaginally or breastfeed when they try and it doesn't work, or not questioning medically-advised c-sections for reasons other than physician convenience, or choosing to have a section if offered or bottlefeed because they find breastfeeding painful or really hard to do while working fulltime to support their families. I've never felt the need to attack someone for having a c-section or bottlefeeding their baby; it's not what I would do unless I had no other choice but if it's not my body or my baby I don't feel like it's my place to say anything unless asked.

[mindy]

take junior to the chiropractor. it works wonders.

[Camille]

I just had my second C-section six weeks ago. I think anyone who schedules a C-section purely for anyone's convenience or any other non-medical reason is an idiot. But I believe that having had a prior C-section is a medical reason for having a second. I was very close to VBACing but decided that a repeat was better for me, and I'm not going to let anyone make me feel bad for that. Actually, most people I know thought I would have been crazy to VBAC since my son was over 11 pounds when born, like Heather above, except that he was 9 days EARLY. After 18 hours of labor plus 3 hours of pushing I had an emergency C-section. I actually had a hemorrhage, too, because of all the labor and pushing. I was so against C-sections that I refused three times before we actually made it to the ER. This time, my doctor did not try to persuade me either way but did want to monitor the baby's size closely. We thought she'd be in the 10-pound range. She ended up being 9 lbs. even. Could I have VBACed her? Probably. But would if have been worth having complications a second time? No. In my opinion, having had a prior C-section is a totally valid and medical reason for having a repeat. And I know you had medical reasons for your first (I read your birth story.)

[Chickenpig]

It can be terribly nasty, can't it? I had to have MAJOR surgery to remove a giant fibroid, and I was told at the time of recovery that I would not be able to have a vaginal delivery IF I should ever become pregnant due to the risk of uterine rupture. And when I did become pregnant, it was with twins, which only increased the risk. Do you think that was enough for the pro-vaginal camp people? Noooooo....I was supposed to get second opinions, third opinions...talk to mid wives...do a fertility dance. It's not like I didn't ask, but the look of total horror on the faces of all the OBs and midwives in the practice convinced me that a scheduled C was the way to go. I think that people forget that before the 1950's childbirth was THE leading cause of death for women in the US, and that if it wasn't for C sections and antibiotics, that would still be the case. Getting you and your baby home alive is the most important thing...period.

[Suz]

After having the pediatrician tell us "it's a virus" for the 1,000 time and there's nothing he can do, my criteria for going to him have risen dramatically. Now, it's gotta be a high fever or vomiting more than two days.

[Cat, Galloping]

you are going to *love* the planned c-section! best decision i ever made, and i call bullshit on the longer recovery time. :)

[Jill]

Maybe call and say, "It has been X days and he isn't better, so at what point do I bring him in?" I usually get good advice from the nurses.

Vbac schmeeback. Do what works for you.

[Linda]

Don't worry about being a pain in the ass bringing your kid to the doctor. Follow your gut, and if you're not sure, err on the side of caution. We just had a two year old die in our city from dehydration and his fever was only 102 for two days. He was a fourth child with obviously an experienced mama. It was very tragic and I think made a lot of mothers around here reconsider our feelings of worrying about being a pest- who cares- pester away!

[LEB]

What Cat said - I *adored* my elective, recovery was easy, worlds apart from an emergency section. It was fantastic :)

[dish]

I hear you about people giving unwanted opinions on c-sections. I had a vaginal birth with Gabe and tore so badly that I had stiches in the ying-yang, hoo-ha, and every other region of that region. Ouch. I have had follow-up visits with a surgeon to perhaps fix the mess. For now we are holding off on surgery, but I was told in no uncertain terms that I should never ever again have a vaginal birth. At the time I chuckled because we had no plans for ivf in the future and I'm *infertile*, so without the needles, there would be no kid. As you found out, too...WRONG. So, with this baby, I will have a c-section to preserve the last shred of the shreds I have left. And it never fails that if I tell someone that I'm having a c-section, they get right in my face with, "well WHY? You had the last one naturally?" And I just want to slap them in the head.

[DD]

If someone wants an elective C-Sec for their first child, who is ANYONE to judge that decision, calling them "idiots", even if it's based on "convenience"?

As for VBAC vs. Not, again, that's a decision best made between yourself and your doctor. Outside flak be damned, regardless of their intentions.

The younger my son was, the more inclined I was to see my Ped, and any Ped worth their salt will encourage you to do so. I use to take him in with colds because of the potential for ear infections, but now we treat with OTC. I have certainly made more than one visit per illness, especially when I didn't like what the one Ped of the group told me, so I went back for a 2nd opinion.

[AmyinMotown]

Funny how the earthy-birthies claim to be all pro-woman, but sure don't show a lot of respect for the decision-making skills and self-advocacy of those of us who didn't give birth vaginally, huh? I had an urgent, probably not technically emergent C-section, and I swear that anyone who could hear their baby's heart rate drop to nearly nothing and not be screaming to GET THEM OUT NOW is not someone I'd want to hang with. I *asked* to be induced a week after my due date, which didn't happen because I went into labor on my own, and while I didn't ask for the C-section I sure as hell didn't argue with my doctor when he said he wanted to do one because he didn't like the ever-slowing heart rate. Had it not been for monitoring and good old Western medicine, I'd be grieving my dead daughter and struggling with secondary IF, not the happy and harried mother of a two-year old. I am NOT someone who goes along to get along and would have had no qualms telling my doctor that I did';t give a rat's ass about his schedule if that's why I thought he was suggesting it.

[MotherLawyer]

VBAC smeeback. Ignore the butinskies. They clearly speak of what they do not know. A brief chat with a perinatologist about a ruptured uterus when the baby is your own, then talk to me about my choice.

You are smart and informed and have made an intelligent decision THAT IS YOURS AND ONLY YOURS to make!

Dr visits for sick kiddo: my standard is way high. BUT my big sister is a ped and my little sister is a ped nurse practitioner, I can't tell you how much I have bothered them in the last two years. I'm a wuss. I do know that hydration and length of fever are the big things to watch.

[midlife mommy]

Sorry to hear about the lack of sleep. We are going through a rough patch ourselves, though it's not due to illness. My daughter is just being a general PITA.

I know what you mean about the hostility toward C-sections. I had a voluntary C-section with my daughter, and people were pretty uncomfortable with that. I even read comments that women who would choose C-sections don't deserve to be mothers! Fortunately, no one said this to me. Frankly, I'm glad that I had a C-section and would do it again. The heck with what everyone else thinks. The most important thing is the baby at the end of the rainbow anyway.

[jax]

A healthy mummy and baby is the only acceptable outcome. After the birth of our son, my doctor apologised to me whilst stiching the episiotomy up (dropped heart rate meant having to speed it along) ... I remember telling him that to the contrary, it was an amazing experiece and mission accomplished.

[Tertia]

3 Paed visits in one week. Including 1x after hours appointment.

All sleep routines shot to hell.

Exhausted.

I feel your pain

xxx

[Christine]

I cannot do a VBAC because there's no OB on staff at the hospital I'm delivering at this time. If something were to go amiss, it would take too long to get someone in there. So, if you need to shut someone up, use that excuse.

I was just told that I'm probably not bonded to my son because I had a C-section. I don't know...I *feel* pretty attached to him...

[Emma B]

I had an elective C-section, but I didn't get much grief about it from others, since I was having twins. If I get pregnant again, I'll have another without hesitation. Mine wasn't bad at all, physically -- frankly, the OHSS at the beginning of the pregnancy was a lot worse -- and after infertility, I didn't give a rat's ass about doing things the "natural way".

My girls have bronchiolitis, and our current tally is five visits in five weeks, three of which have been in the last 10 days. I only go when I think the ped can actually do something for them that I can't, either by giving prescription meds or reassuring me that they aren't in danger of dying from dehydration or whatever.

[Amy]

To VBAC or not to VBAC? I debated it forever. In the end, I went for the VBAC, although I was completely unsuccessful. 20 hours of painful contractions, then an epidural for the next eight hours to bring me to a total of 28 hours of labor, barely 7 cm dilated, with some fetal tachycardia thrown in for good measure.

I say it's your labor. It's your decision. Do it how you want to do it and don't let anyone make you feel bad about it.

[Camille]

I would like to apologize for calling anyone an idiot on your blog. That was completely uncalled for and wrong. What I meant was that, as anyone who has had one knows, C-section recoveries are not easy and I can't imagine that the 4-6 week recovery period is the same for a vaginal delivery. But never having delivered vaginally, what do I know? So I personally would not have chosen one, but I certainly don't regret my two C-sections by any means.

[Leah]

Dr Visits: I give snot noses 7-10 days w/o fever, I give fevers 3 days (unless persistently +103), puking/pooping I give 3-4 days; I call the triage nurse too and ask her. I now go alot more on how my kid acts now - he can run around snot-nosed but happy for two weeks and I don't get too anxious.

32+ wks preg and find myself embarrased to admit (to others - not ya'll) that I'm going with an elect C-sec instead of VBAC. My excuse? It's only been 18 months between deliveries - Dr doesn't want to take chances! Of course if I'm 37+ weeks and go into labor before schedule, I'll give it a good try, but I'm not going to be devastated if I C-sec again.

And I second bullshit on the recovery time thing too. I'm keeping my eye on the prize - a healthy baby!

[Flo]

Wow, Liza! You've done your homework! I should paste that into a Word file for future reference...

I had a C/S after a failed induction with my first daughter and a VBAC with my second. This was really important to me, personally, emotionally, etc. But, (and maybe I'm in the minority here) my physical recovery from my C/S and VBAC were pretty much the same. I was up and walking at the same time, had pain somewhere below the belly button both times...really, no different.

People are jerks. Only you know what's right for you. Healthy baby, happy momma. That's what counts. Best of luck!

[FishyGirl]

I've had 4 c-sections, 3 planned ones. They're a piece of cake. Really. The first one was after horrid labor for 19 hours stalled at 4.5 cm. Took 3 weeks to really feel okay walking around. The other 3? Went shopping within a week, though I didn't drive myself. And they were all with other little ones running around, the first two were 22 months apart. It drives me crazy when other people don't respect someone else's decision about things, like we're all a bunch of idiots who don't know a thing about anything, least of all ourselves.

Sorry about the no sleep thing - I feel for you. Baby is teething and we've had a death in the family and haven't been getting a lot of sleep due to that persons battle with cancer. I got 1 hour last night. I hope The Boy feels better soon, for both of you.

[FishyGirl]

I've had 4 c-sections, 3 planned ones. They're a piece of cake. Really. The first one was after horrid labor for 19 hours stalled at 4.5 cm. Took 3 weeks to really feel okay walking around. The other 3? Went shopping within a week, though I didn't drive myself. And they were all with other little ones running around, the first two were 22 months apart. It drives me crazy when other people don't respect someone else's decision about things, like we're all a bunch of idiots who don't know a thing about anything, least of all ourselves.

Sorry about the no sleep thing - I feel for you. Baby is teething and we've had a death in the family and haven't been getting a lot of sleep due to that persons battle with cancer. I got 1 hour last night. I hope The Boy feels better soon, for both of you.

[agpie's mom]

i just happened upon your blog and am SO curious about your decision and this post. i am also electing (i think) for a second c-section. i feel guilty about it and i wonder if i am being "duped." if you have advice to give or suggestions on what to read i am interested. i hate feeling guilty and, even more, i hate feeling judged. i am comforted to hear your story (and maybe a little more nervous to tell people of my decision).