Probably unrealistic but... vbac? Anxiety is killing me.

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Probably unrealistic but... vbac? Anxiety is killing me.

Postby amberstrika » Sun Jul 15, 2012 06:04 am

Hello!

Lately I have been sitting at home freaking myself out pretty horribly. I'm 31 weeks into my 3rd pregnancy. My first was in 2003 and I was induced at 39 weeks due to my daughter being 10 lbs!! Unsurprisingly, I failed to progress and had a c-section. After having been in labor for 9 hours I couldn't care less what they did as long as it just ended. Unfortunately, about 5 days after she was born I had to go back into the hospital for what I thought was going to be bronchitis. Turned out, I had severe preeclampsia, pulmonary edema and pneumonia. I got to spend the first week of my baby's life in the ICU. After that I waited quite a while to have another baby. Last March, yes - March of 2011- I had my second child. After having had preeclampsia with my first my doc was vigilantly monitoring me for a re-occurance. The pregnancy was pretty meh, until all of a sudden at 37 weeks my blood pressure shot up and my office dipstick resulted in a +2 for protein. I had been tossing around the idea of a vbac, but once the preeclampsia hit it was obviously off the table. I had a c-section the next day. My doc decided that to be safe, I needed a mag drip after delivery. Unfortunately, the drip caused my uterus to be unable to contract and about 24 hours after surgery I had a post-partum hemorrhage. It was like the scene in the shining.. you know, the elevator doors parting and all the blood came pouring out.. Anyways! Sorry TMI, I know. :shock: I was given pitocin to stimulate contractions and spent a horrid few hours with a full medical team hovering over me debating whether to give me a blood transfusion of not. Thankfully, the pitocin worked and I immediately recovered.

So here I am.. 16 months later and 31 weeks along. And let me tell you.. I am NOT doing well at all. And I believe, as does my doc, that I am doing this to myself. Ever since finding out I was pregnant I have developed severe anxiety and the panic disorder I have been struggling with for the past 15 years has escalated to monumental proportions. Every time I so much as see my blood pressure cuff at my OB office I start to feel like I can't breathe and can't stop shaking. I stay up at night having night terrors the night before an appointment. I am so terrified that I will develop preeclampsia and have to have an emergency c-section every time I walk into the office. I'm just not ready. I am so afraid of having another c-section that I hyperventilate and cause my BP to shoot up. When I am at home, and relaxing in bed, I will check my BP and will often find it runs about 100/55. Then, I start to think about the c-section and the preeclamspia and my office appointments, and in about 2 MINUTED after having a low/perfect reading my BP will be in the 160's/80's. Then I go and sit in my closet in the dark and force myself to breath and calm down. Sure enough, it plummets right back down to my normal 100's/50-60's.

EVERY single time I go to my OB office my reading are so high my doctor fears that I am getting preeclamptic. She put me in the hospital last week and was stunned to see my automated pressure readings being so low when I'm left alone and have a chance to calm down. She says she feels that if I was given BP medicine, I would bottom out for sure. She says she has never seen someone with white coat hypertension as badly as mine. Lately, after being hospitalized, and having my due date drawing closer, I am doing so much worse at home. The periods where I am freaking out are getting worse, and my panic attacks have become debilitating. My husband has taken leave from work, and stays by my side 24/7. If he is not within visual contact with me I start panicking. I am TERRIFIED of being left alone. He even found me sleepwalking (something I have NEVER done before) to the bathroom with my blood pressure monitor screaming that I had to kill it. As it stands, I am certain that I am slowly building up my stress levels to threat level midnight.

I am just at such a loss as to what to do. Sometimes I feel like I would give anything to run away to some hotel somewhere and give birth in a bathtub. The thought of the hospital, and the epidural is more than I can take. Funny thing is, it's not the pain. I laugh in the face of pain! My pain tolerance is epic. But I absolutely. cannot. under. any.circumstances. handle. numbness. It's not the surgery, or the after effects I am worried about. It's the epidural and the buildup I know is coming when I lie there waiting for them to give it to me. With my daughter last year the anesthesiologist was worried I was having a heart attack when he was giving it too me. My heart rate jumped to the 200's and my oxygen levels dropped dangerously low. I have a known heart murmur that I need to pay close attention to, and the medical staff was unsure of what to do with me. With hidden reserves of strength I had no idea I had I managed to calm down long enough to go into surgery. And then as soon as my daughter was out I started panicking to high heaven and couldn't stop screaming at the surgical team. Last thing I remember, my anesthesiologist gave me a super strong sedative without asking me for my "own protection". I barely remember the rest of that day. And I honestly don't mind.

I suppose the moral of my story and my question is this: I truly feel that if I was given a choice, I would choose to do a vbac with a midwife, and in a birthing tub. With a doula with me to help keep me calm. I'd do it Au-natural as well. No epidural. Things done on my terms, with me in control. The thought of that calms me down and makes me feel strong. Like I could put my chin up and have some sort of control of my own body. I'm trying to reach out to this community, because every woman here can relate in some way to my situation. Maybe not the panic attacks of my level, but the fear of preeclampsia. We all know how truly terrifying it is. I feel like it's ruining my life right now. I wonder though, vbac after 2 c-sections aside, what are the chances of being able to accomplish something like this with the preeclampsia risk. I know if I told my doctor about this she'd laugh in my face. And trust me, she's a GREAT doctor. She takes all of this very seriously. I just don't think she can put herself in my shoes and see how much this c-section is killing me. She see's things from her physician perspective and not from a terrified patient's.

Does anyone know the chances of a successful vbac after preeclampsia twice? I just can't help but feel that the preeclampsia is creeping up on me quickly because of my fear. Am I insane for even considering exploring this option? As a reference point, my mother tried to vbac with my sister and had a full uterine rupture. She almost died and my sister still has heart problems. Poor thing was in the NICU for 2 months!! She was the biggest baby there. Even after experiencing this rare occurrence second-hand, I would still rather vbac. I just don't know what to do... I wish someone would sneak up behind me, douse me with ether and I'd wake up post-op. I just can't handle the fear and waiting. I believe in my heart that this time I won't be able to keep it together, and I will have a full blown panic attack right before.

Hopefully you ladies can relate, or give me some good advice. No one else in my life seems to get it. I am breaking down more and more every day and I just keep getting worse. :cry: :cry:
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Re: Probably unrealistic but... vbac? Anxiety is killing me.

Postby kat82 » Sun Jul 15, 2012 10:50 am

I don't really count as one of "the experienced" but I do have a few thoughts for you. First, I am very sorry to hear about the difficult experiences you've had in your previous pregnancies and births and during this pregnancy. It sounds very scary and I can see how it would bring up a lot of anxiety.

I too am 31 weeks into my pregnancy now. My instinct is toward natural birth as well, although I actually think I would feel safer being in a hospital. I don't know how much it will be possible for me to really have a natural birth, but it's the overall approach I want to take, no matter what ends up happening. I do have a doula, and I am trying to take the approach of thinking more about natural alternatives to relieve pain instead of about how much I don't want the interventions. That makes me feel slightly more empowered and in control.

I have not yet had a conversation with my doctor about my hopes for my labor and birth -- that's planned for next week -- so I don't know what his response will be to all of this. But he does know that I am planning to work with a doula and he's been supportive of that.

If you have the means and are not doing so already, I think you might benefit a lot from talking to a therapist or counselor about what you've been going through. Anxiety, in general, is quite treatable, often in just a few sessions. You may or may not have time to get into the details your past experiences or your general feelings about your body and your health, but you can at least learn and practice some good psychological strategies to reduce your anxiety. As someone who has dealt with anxiety, and specifically anxiety around my health, I just really feel for you and hope you know that there are some solid, empirically validated forms of help out there.
First pregnancy, due September 2012. Chronic hypertension, no signs of PE yet...fingers crossed!
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Re: Probably unrealistic but... vbac? Anxiety is killing me.

Postby jenh » Sun Jul 15, 2012 11:27 am

I'm so sorry you're going through all this. I second the suggestion to talk to a counselor if you can. I would also have a very thorough discussion with your doctor about the risks and benefits of a VBA2C and a repeact c-section. Both options carry some risk, and those risks can be managed to some extent but not eliminated. One of the problems with attempting a VBAC with a history of PE is that any method of induction raises the risk of uterine rupture. If you need to deliver due to PE before you've gone into labor naturally, you have to seriously consider the risks of induction on a twice-scarred uterus. I wouldn't say it's out of the question, but you need to think about whether the risk of needing an emergency c-section during a trial of labor is better or worse than a planned c-section.

I would also consider, if you do need to have another c-section, whether going under general anesthesia is an option. Of course, none of us want to sleep through the birth of our child, but it may be the best option for you.

((HUGS)) and prayers coming your way.
Jen
Wife to Brett 6/30/02
Mom to Ethne Joy 10/12/03, 35 weeks, severe PE
Mom to Catie Grace 12/8/06, 37 weeks, mild PE
Mom to Riley Faith and Gavin Arthur 7/7/09, 36 weeks, PIH 22 weeks, PE 31 weeks, severe post partum PE
Mom to two angels 12/05 and 7/08
Running a Marathon for the PF: http://www.whatyourunningfor.blogspot.com
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Re: Probably unrealistic but... vbac? Anxiety is killing me.

Postby sam10 » Sun Jul 15, 2012 01:42 pm

I am so sorry you are plagued by anxiety and panic attacks, it can be very debilitating. I do suffer from anxiety and panic attacks since I had PE with my last pregnancy, and I can relate very much how horrible it can be. My fears are not so much about a c-section (I don't even have a choice due to my classical c-section), but in the realm of anxiety it does not matter, it just sucks and once you are in it, it is so hard to get out of it. As has been said, I also strongly suggest to find counseling or a therapist who can accompany you through the rest of this pregnancy. I see a therapist who specializes in all things of child birth, child loss and birth trauma . We work on strategies on how to handle my anxiety and I also know that I always have the option to take some medication to help me through if needed. Have your doctors mentioned any medication that you could take to reduce your anxiety? If not, perhaps you want to ask them? I also would discuss VBAC with your doctor, so you will have a clear picture of what your options are.
I truly hope you can find some relief soon. Sending you hugs.
~Julija (40)
MC 3/2009 and 3/2011
Henry (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
Matilda (Nov. 2012, born at 35.4 weeks) - severe PE


Our pain has been put into words, placed into empty cradles, to remember that all our babies lived, that they mattered and always will. - Field of Cradles http://www.fieldofcradles.org/
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Re: Probably unrealistic but... vbac? Anxiety is killing me.

Postby alexis » Sun Jul 15, 2012 05:52 pm

I would also suggest speaking to your doctor and a therapist. As well as counseling, there is anti-anxiety medication that can be taken during pregnancy if you are not doing so already. A consultation with an anesthesiologist might also be helpful. They generally don't want to use GA unless they really have to, but if you found the experience easier with a tranquilizer last time, they may be able to do that again. A friend of mine had to plan a Caesarean for her second due to fetal issues (she had originally planned a home birth until this was discovered). She was extremely anxious about the anesthesia and surgery but with the help of her team, she was able to make it go smoothly.

Induction and VBAC is a little complex. Prostaglandins are contraindicated, period. Some OBs will use pitocin, some will not. A Foley catheter does not raise the risk of rupture (since it manually dilates the cervix) but is only appropriate under specific conditions. Personally, I preferred not to count on this possibility because it is so much less likely with a VBAC. A lot also depends on timing—for my second, I considered a VBAC. I ultimately opted for an RCS for several reasons, but when I had it at 39 weeks, my cervix was still completely unready and I had never had a contraction. While I'll never be able to say for sure, I don't think I was going to go into labor soon and if my BP had begun to rise (it was a little bit flaky but within normal range at that point) I would have had no option other than an RCS.
Chronic hypertension
Aliza - 01/05/2007 - Severe preeclampsia, emergency CS 37 weeks
Isaac - 09/26/2011 - controlled on 150mg Toprol, NO PE, 39 weeks!
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Re: Probably unrealistic but... vbac? Anxiety is killing me.

Postby mom29 » Sun Jul 15, 2012 08:47 pm

I agree with the other moms that you need to tell your doctor how seriously debilitating this is getting for. Ask about anti-anxiety meds. and seeing a counselor.

How did the idea of a homebirth with a midwife become such a calming idea for you? Home births are not safer than hospital births. A shoulder dystocia, cord wrapped around baby's neck, maternal hemorrhage, uterine rupture, high blood pressure, and other complications cannot be adequately treated at home. If your baby suddenly goes into distress, being ten minutes away from the hospital isn't going to be enough. How long can you hold your breath? Your baby won't be able to hold his/her breath for long without permanent damage.

Please don't think that having your baby at home will be the cure for your anxiety. Things can go terribly wrong, being in a hospital with experienced staff able to handle complications and the ability to do an emergency c/s can mean the difference between life & death for your baby and for you. Hopefully talking with your doctor, anesthesiologist, and L&D staff can help calm your fears.

Please keep us posted on how you are doing. I wish you all the best.
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Re: Probably unrealistic but... vbac? Anxiety is killing me.

Postby mom29 » Sun Jul 15, 2012 09:00 pm

Please don't take my question about home birth as an antagonistic question. It's meant in a sincere and gentle manner because a high risk mom delivering at home is a risky thing to do. Viewing a risky option as a good thing can't be helpful when you are already struggling with fears about you baby's birth.

I've had some scary things happen with some of my children's births and it has made me feel safer in the hospital because life threatening complications were safely treated. I'm the mom who reminds the staff that I had a cord prolapse so they know to be extra vigilant.
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Re: Probably unrealistic but... vbac? Anxiety is killing me.

Postby blythe » Sun Jul 15, 2012 11:09 pm

Thanks mom29 for clarifying. Homebirth can be such an emotional topic, and in many ways it's just not our area. I've read about it but for me what is comes down to is that homebirth might be safe for low-risk pregnancies (I know the research goes back and forth and each side will interpret the studies a bit differently), but if we're here, we're not low risk. Having PE or having a history of PE means that we would not be included in those studies, and therefore the results don't apply to us. We're high risk, or even fully medically complicated with PE.

That being said, I remember in my first pregnancy, the night before my induction, I was terrified and the only thing that made me feel better was the thought that I could leave the hospital and have my baby at home. It wasn't a rational thing, it was out of a sense of control - however false that sense is, since a PE birth is inherently very risky! But I still can relate to that feeling. Ah- and I just reread your original post, Amberstrika - you just said birthing pool with a midwife and doula - could you have meant that kind of birth in a hospital? :D

Amberstrika, I'm so sorry you're having such a rough time and I'll second what everyone else has said about therapists and medication and doulas and asking about the possibility of general anesthesia!

I have tons of thoughts about a VBAC after 2 c-sections and PE twice, but what it comes down to for me is that you can try, but your choices may be limited again when the times comes, so preparing for another c-section is really important.

That being said, we have had women have successful VBACs, (not V2BACs that I can remember though, sorry), and successful inductions without pain meds. If preparing for a VBAC helps your panic, I'd be in full prep mode ;). In your shoes, I'd just also be preparing for the other possibilities.

Does any of that help at all? Or have we made you more miserable? One thing to remember is that it sounds like you don't have PE yet. What has your doctor said about the risk of recurrence for you specifically?
Heather, mom to
#1 7-18-03 - 5#8oz 37 weeks PE/PIH
#2 8-11-06 - 6#14oz 37 weeks PE/PIH
#3 9-10-09 - 5#10oz 37 weeks PE/PIH
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Re: Probably unrealistic but... vbac? Anxiety is killing me.

Postby amberstrika » Mon Jul 16, 2012 03:28 am

Hello ladies. Thank you all so much for replying. Believe it or not, the idea of seeking a counselor had never even crossed my mind before.. It really helps feeling like I may have some sort of options in this.. Even if it's only therapy and some shoulders to cry on. When I meant an all natural vbac, I had no intention of anything involving my home. I live in *****, near ****** hospital. It's the single most prolific childbirth facility in the whole of the United States. They are the most preeminent facility for obstetrics in the south. It's the place that women and NICU babies are flown to from all the surrounding states. It's even where March of Dimes does their main work with new treatments and techniques for research and development. They also do vbac and tub births in house. I may be going insane but I'm not *that* off my rocker. When I was imagining trying something all natural I pictured myself in the best hospital in my region surrounded by the tools I would need if something were to go unfortunately wrong. That being said, I still don't see myself getting any support from my doctor. She even walked into my room with my c-section consent forms last visit. It's like it wasn't even a question as to what I'll be doing. :( I suppose with my history of preeclampsia I really have no other options. I hate feeling so trapped.Thank you all so much for the support. I will be looking into some kind of therapy this week.
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Re: Probably unrealistic but... vbac? Anxiety is killing me.

Postby amberstrika » Mon Jul 16, 2012 03:40 am

Blythe,

Thanks for yous response. As of right now my doctor doesn't know what to think of me. She has never seen WCH as bad as mine and is trying to figure out how best to help me. In the office, it's totally common for my BP to be 160's over high 90's. Then when I get home, like today, it went down to 93/48. Yes, in the 40's!! How does someone get treated with BP meds with that?? She's convinced I'm not a candidate for BP meds at this time. And rightfully so.

Here's another little conundrum. I recently posted that I had had a 24 hour Urinalysis this past week during my hospital stay. When my doc got my readings back, my husband and I both CLEARLY remember her saying that there was "only 1g protein in the whole catch." She seemed happy with this, but the nurse pushing me out to our car was much more concerned. According to her, that was higher than it should be at 30 weeks. Then I get home, and find out that equates to 1000mg, when the cut off is normally 300mg! I can't figure out if I heard wrong, or if for whatever reason it was safe enough that she wasn't worried. I've been pulling my hair out over it all weekend. Hopefully at my OB appointment tomorrow I will get some sort of clarification. Unfortunately, the OB seeing me is not my normal one who I feel really listens. He's that typical patriarchal physician that hardly listens to me and barely makes eye contact with anything but my chart. I'm so sure I will go in, have a super high BP reading and he will not really register the saga I've been going through. I'm just hoping I can get some real answer as to what exactly my protein readings were. That's my main mission for tomorrow. If it really was 1g, my OB has some serious explaining to do at my 32 week appointment. I know that would indicate I'm on a fast train downhill. However, if I was wrong, and my protein readings were great, that means that for the most part, my protein looks good, when I'm home and calm my BP is outstanding and all my labs look perfect. baby is also thriving and placenta and umbilical cord show no resistance.

I'll keep you updated, and cannot begin to express my appreciation at having someone just willing to listen.
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