The Time to Think

Luckily I had some time to think and process between doctor's appointments.  I was very upset with my last post and just about ready to run off to a midwife.  Luckily Dad let me vent on him when I poured my heart out and he listened very carefully and empathised.  He really is the most amazing man on this planet!

Having my baby with a midwife at Genesis is an option that I don't feel is very feasible.  It really is just too far away from home.  There are other midwifes I suppose if I look hard enough in the area but to be honest I really don't feel the need to go to another hospital or get another care giver.  Anyway, so when I had that sorted in my mind I decided that I would go to my next appointment armed with all sorts of questions and what if's and why not's.  I also thought I needed to go armed with proper facts, not crap I read off websites, personal experiences and statistics from surveys conducted on other continents.

I found a research document done by a student at WITS university, and I am still getting through it - it is alot of reading and information.  The more I thought about it, the more I narrowed my questions down that I had for the doctor, and the less defensive and self absorbed I felt.  I just made one really big circle...and came back to what I wanted from word Go;  should I go into labour prior to 40 weeks and all is healthy I would like to have a TOLAC, but am very happy with an elective cesarean booked at 40 weeks - on my due date. I have simply decided that the doctor will not convince me otherwise unless there really is a worrying complication or valid medical reason for having to do a cesarean sooner.  And once again I feel happy, content and calm and am enjoying my pregnancy.  I think about VBAC and all my options often but I also know what is best for my and my family and what everybody feels comfortable with.  What are the odds really of me going into labour prior to 40 weeks anyway?  I am not fighting for something that might very well not even happen or be worth the stress and reproaching feelings.

My next doctors appointment is on the 18th of December and I really am just looking forward to seeing my little man on the sonar screen again.

The Upset

After my fetal anatomy scan and realising that I have a very healthy baby and pregnancy I have been feeling a bit upset about the discussion I had with my Dr at that time.  I really feel like I am not being given a choice between cesarean and VBAC and that is not sitting right with me.

I even went and vented on the VBAC support forum.

Here are the posts:

Re: VBAC SUPPORT 1 week ago

• Widget
• ( User )
• 

Hello everyone!

Kiewiet I really look forward to reading your stories when you have the time. In the mean time hope you are enjoying your beautiful new bundle of joy! 

Just an update from me; I am feeling rather vulnerable and upset after my last visit to my gynecologist.

We had the fetal anatomy scan & everything is perfect. I have a very healthy pregnancy, thick uterine wall, placenta is well out of the way. Baby boy is 500 grams already!  

So we sit down again after the sonar and doctor asks me if I have decided on a birth date for baby yet?  And I just blink at him in surprise. So he goes ahead to say that well, I will be having a cesarean again this time and we usually do it 10 days before due date....I couldn't believe what I was hearing and my heart just sank. It was like we never even had the discussion about TOLAC two months ago!

I told him that I strongly feel that the baby needs to stay inside until his due date and he agreed to only schedule cesarean for the 26th of March next year, which is right on my due date.

When I asked him again then about trying for natural should I go into labour before my due date he was definitely not for it at all!  And what's worse is he now scared my husband into believing the absolute safest and best way to deliver is by repeat cesarean.  When we got home my husband said to me he was under the impression that we had agreed and decided on having a cesarean and he just straight out told me "no more natural birth". I understand his concern and I need to respect his feelings as well, so I don't know how I am going to convince him otherwise.

To be very honest now I don't trust my doctor anymore. I asked him if I need to book the cesarean with his secretary and he said not to worry he sorts that out with the maternity ward....I don't know so much about that. Come 38 weeks he is going to find some reason to convince me to have the cesarean earlier.

So this morning I e-mailed midwife Hennie from Growth spurts again asking to book an appointment because I need to talk to someone about the facts and someone who can be very honest with me about my chances of actually achieving VBAC without any damage to me or baby.  I feel like I could just burst into tears. I was so happy and confident the last two months and now I feel like my gynea are just like the majority of others - promoting c-section! He is a surgeon trained in child birth, why did I not see the warning signs before? 

Things that he said before like: "80% of women who try for VBAC end up having a repeat cesarean again" - that's probably in his hospital because I know this fact not to be true! But I didn't argue, I just sat and nodded my head. "You're baby will be big and you're a small mommy, now you want to try and push him out." "When you get closer to your due date you might want the baby to be born earlier because you'll be tired and uncomfortable so you could ask to have the cesarean sooner." 

I just really need some emotional support, because I know in my heart that I need to give natural birth a fair chance again and I will always be sorry if I don't! I cannot talk to anybody who understands, no one in my family and not even my husband.  It is just this unheard of dangerous thing that I want to attempt in their heads & I am being selfish for wanting to put myself and my baby and the rest of my family at risk. But doesn't normal childbirth in itself do just that?? Someone once said that a women is never as close to death as when she gives birth to a child! Just because I have had a cesarean before I now have to wear this label, where has people would not even have thought twice about it if this was my second natural birth.

Re: VBAC SUPPORT 6 days, 2 hours ago

• Widget
• ( User )
• 
• Thank you for all the support everyone.
  
  Zee welcome!  Hope you find answers here to your questions, but only you will know what is right for you and your family, as long as you make an informed decision. In hindsight I blindly trusted my doctor with my first baby, which is why I think I struggle so much to come to terms with my c-section, because I now know things could have been so very different...
  
  Futhermore, I had good talk with Dad last night explaining how I feel and what upsets me and how I feel I am now being forced into a decision that I am not comfortable with. He suggested I phone the doctor to see if I can go talk to him about all my concerns as well as get someone else to talk to for a second opinion.
  
  I contacted Henny from Growth-spurt but she can only consult in the the mornings and I cannot take time off from work in the mornings since I only work half day. We are simply too busy this time of the year. She is also too far away. I had a look at where Genesis is to see if any of the midwifes consult from there, but Genesis is also too far away. 
  
  I phoned the doctors office and he couldn't see me before my next appointment which is on the 18th of December, but the receptionist assured me that I must not worry about time with this appointment and I can talk to him for as long as I want and ask all my questions. 
  
  Does anyone know of another gyneacologist in the Sunninghill area that I can consult for a second opinion? 
  
  Interresting though, someone mentioned that they were with Peter Koll and referred to him as being very pro-natural. I know of 5 people (all friends and family) that are with Dr Koll and everyone says he is a very good gynea but renowned for c-sections and he told my sister in law that VBAC is too dangerous. When she rushed into the hospital with her second child after having gone into labour spontaneously she was already 4cm's dilated and progressing quickly. Her husband hardly had time to make it to the hospital, the doctor just said that we are having a c-section right now. I thought she was the perfect candidate for VBAC....but again every labour and situation is different and I never know if you really know the full story.

The Elective Cesarean Date

We went for the fetal anatomy scan on Friday.  I was, according to my calculated due date, 21 weeks and 3 days the day of the sonar.  I am not so sure if this is 100% correct.  I keep having the feeling that I am further along already, but luckily the doctor is sticking to the due date being the 26th of March.  The baby is already 500grams, with long arms and legs.  We could see the little face so clearly even though it was only a 2D sonar and it just made me fall in love with this new little member of our family so much more!  I cannot wait to see him for the first time, and hold him.  I think that I will have a lot of hard work and little sleep ahead of me, but for now I just want to stay blissfully ignorant of what is to come and savor this wonderful feeling of excitement.

After the scan the doctor asked me if I had decided on baby's birthday yet, and I blinked at him in confusion.  Then he continued to say that I will be having a cesarean this time and we normally book a cesarean 10 days before due date....it was like we never even had a conversation about this two months ago.  Fair enough the doctor cannot remember everything about all his patients but I thought he would have made a note of what we had discussed.  Did he not take me seriously.  Anyway, I was adamant that baby should stay in until 40 weeks and luckily Dad backs me 100%.  I then, again, asked the question about trying for vaginal birth should I go into labour naturally before this decided date.  This time he sounded like he did not support it at all and completely advised against it.  Dad was also a bit blind-sited and very suprised at my question as he thought that we had decided and agreed that cesarean was safer!  What on earth?  Am I living in my own little world here?  I wasn't upset with anyone or anything, I just felt a little put out that now, should I do into labour I will definitely have a cesarean anyway.  Look for some reason I don't think the chances of that happening before 40 weeks is very good but still, it is now a change of mind set for me now again, and one that I am not sure that I am comfortable or happy with.  

I asked the Dr if I need to book the cesarean date with his secretary and he said not to worry he will sort that out with the maternity ward, and sort of brushed it off. Which is suspicious to me because last time I had to arrange for the induction a week prior with his secretary.  She then phoned the maternity ward and booked.  Perhaps elective cesareans work differently.  Will he try and convince me otherwise closer to date to have the cesarean earlier?  Al of a sudden I am feeling very unsure of my gynea.  We have so much going on a the moment and I have had my fare share of stress so far so I really now don't want to worry about this now also.  Come a year after baby is born I really don't want to wish like I had done things differently, I want to be completely at peace with how things happened and fell into place.

You know what, I  am only 22 weeks along now, I still have lots of time, and right now I have got a good care giver that can take care of me and baby now.

The Halfway Mark

I am halfway with my pregnancy now, and we found out that we are having a boy this time! :-)  We are of course very happy with that - one of each - and I am so excited about having this baby that I almost want to start packing my hospital bag already!

With regards to VBAC, I continue thinking about it, following and contributing to the forum that I have mentioned before, even though I do not agree with a lot of things that these uninformed women believe and come up with.  Some are are having successful VBAC's, others are having to book elective cesareans, oh you know, whatever works out for that person's pregnancy.  There are no guarantees, that I learnt very quickly.  I am definitely not as obsessed about this as I was when I just found out that I was pregnant 15 weeks ago.

I do however still feel very strongly about the fact that this baby needs to stay inside until 40 weeks.  I just really hope that my gynecologist allows this.  I realised that I don't really have Dad's full support for VBAC, which was actually not that much of a surprise.  He is very skeptical about it, which I completely understand. Point is that if my gynecologist insists that I have an elective cesarean before 40 weeks for whatever reason, I don't know if I will have it in me to argue, especially if Dad is on the Dr's side as well.  I know he just wants me - most importantly - and then the baby to be safe.  Which is exactly what I want too.  Basically if this little one decides to come on his own before the 26th of March 2013 I would like to try and have a normal birth, but with careful medical supervision.  Anything after that I would like to book a cesarean.  I am not playing the waiting game again just to have a cesarean.  Plus it becomes more dangerous, statistically, after 40 weeks gestation.  I do know for sure that I don't want to force anything that is not going to happen on it's own.  I don't need to traumatise every one involved.

I also only have 4 month's maternity leave this time as well as whatever part of March is left when the baby comes.  That is why, all going well, I want to work literaly until the day before I have the baby.  Another reason why I don't want to go overdue - that will make the time in March that I have with my new little on so much shorter every day that I wait.  That said though, I really don't think that the Dr will allow any waiting.  We haven't discussed anything further with regards to VBAC and going to 40 weeks, but I don't feel the need to.  I don't want to obsessively and continuously talk about it, there are too many unknowns.  It will come up again when it has to closer to date.  Perhaps this time baby might be breech or some other complication could arise and decide for us what the safest way of delivery is...you never know.

The 13 Week Gynea Visit

We went for our 13 week visit at Dr H on Tuesday.  

Everything is great with the new babba, growing nicely & Dr said it will be a tall baby again - the legs are again measuring taller than average. 

He tried very hard to get a look but he couldn't tell us if it was a boy or a girl.  So now I have my fingers crossed again that it might be another girl.  I would love to have two girlies.  

At the end of the consultation, he asked if we had any question and this was the perfect opportunity for me to bring up my concerns about having an elective cesarean and VBAC.  I was overjoyed to hear that he does support VBAC and if I feel I would like to try than he will give me a trial of labour.  He said we could see how far we are willing to push out booking a cesarean and if it is safe to do so we can go to 40 weeks.  

I was overjoyed to hear this because if my doctor would allow me to at least try then I would feel much safer doing it under his nose than going to Genesis.

I am still comfortable with booking an elective cesarean as the doctor said the risk for baby and mom is less than with an emergency cesarean.  He also said the danger with VBAC is of course the 1% chance of uterine rupture, and even though it is small, if it does happen that puts baby and my life in a lot of danger and the emergency cesarean then will be much more traumatic.  

It's interesting though, before I even said anything about midwifes, he said that he knows Genesis is one of the places that does do VBAC and he knows that they have lost babies with their attempts.  He said he does not know if they have got an NICU now but he has heard of cases where mom and baby have to be rushed to Parklane hospital.  So bottom line he would not recommend I go to Genesis.  

I am just too happy that should I go into labour before 40 weeks and the conditions are right I can still try to have a VBAC.  I really was very apprehensive about leaving my gynea should I really still wish to persue a TOLAC and wether or not I would be willing to trust a midwife above an obstetrician.  I just never quite felt at ease with the idea.  Midwifes are assistants, and sure they might have a lot of experiences etc, but they do not have the knowledge and the background that I believe an obstetrician has.  I know my gynea is very good and I trust him with the most important thing in our lives.  I am even more happy to stay with him now as he definitely is as understanding and accommodating as I perceived him to be.

The Birth Disappointment

I came across a blog yesterday that I even shared in the VBAC support forum.

It is about birth disappointment and for the first time I felt that someone was acknowledging the way I was feeling and that my feelings were legit!  And that has made such a big difference to me!  I will highlight some parts of it as I don't like to post links.  Links are always gone when you want to click on them years from now.

Dealing with feelings of anger, shame, sadness, or disappointment regarding your birth can be difficult.  Well-meaning family and friends remind new mothers that they have a healthy baby despite the experience, and while the sentiment is meant to make the mother feel better - after all, what better prize is there? - it generally only makes her feel worse.  Often the mother feels judged, as though others see her as ungrateful or selfish.  However, the feelings associated with birth disappointment are valid.

 I remember trying to explain to Dad how I felt after Isabella's birth, and this is exactly what he said to me:  "but look at what we've got!"  referring to our perfectly happy, healthy and beautiful daughter.  Yes, I know but...I didn't know how to explain it further so I left it and never mentioned it again.

Having birth disappointment means:
- A mother experienced unplanned, and often undesired, interventions.
- A mother may have experienced an undesired outcome, such as a cesarean section or episiotomy.
- A mother's birth memories elicit undesirable emotions such as anger, fear, or sadness.

It does not mean:
- The mother does not love her child.
- The mother was uneducated or poorly informed.
- Interventions were not necessary.

Now that I feel like I am allowed to feel what I have been feeling, well it takes so much of the hurt and guilt away! I realise that it is not only  moms who have undergone emergency cesareans after having their hearts set on normal birth, but anyone may feel that the birth went a way that they did not plan or want.  That takes me back a few posts ago (remember The Doula that gave birth?) where I judged a mom for saying that she felt disappointment for giving up her hypno-birthing method and pushing, causing her to tear.  I didn't understand it because if you had natural and normal birth you were not allowed to feel disappointment with you birth, because it is something that I will never experience!

Its funny, I never felt anger, fear and sadness when it comes to my first birth story.  I always tear up remembering it because I felt like it was beautiful and I definitively did not hate the experience.  What I do feel though is disappointment that I did not dilate or have a chance to try and push out my baby like I always believed I was meant to, or even the chance to experience a somewhat normal progression of labour.  Mentally I was so ready for this! I feel like my body failed me somehow.  I felt frustrated when I thought that I am stuck with cesarean forever now and I do not have a choice.  Now I know it is not true and I do have the option of again attempting a natural birth.  That alone makes the decision of rather having a repeat cesarean easier because I feel like it is my choice.

Thank you to theconnectedmom.com for sharing her birth disappointment and writing the post.

The Tiredness

I have continued reading articles, reading blogs, reading forums and talking to people, and now I am tired.

Tired of the over-thinking, tired of the obsessing, lying awake wondering, arguing with myself, Dad & debating with others.  I am done now.

I am now just going to enjoy the rest of my pregnancy and my growing baby.  I hope that I will be healthy in this pregnancy & that baby will be perfectly healthy as with my first pregancy.  I love telling people I am pregnant & I love the fact that already my tummy and midriff is expanding!  I look forward to our doctors appointment in less than two weeks time so I can see how much our little peanut has grown!

 

The Reason Behind Wanting a VBAC

This is the part where I ramble on a bit.....

I have been wondering, within myself, why is it that I along with so many other women feel the desperation, like I felt at first, to have natural labour and birth a baby vaginally?  Why do we feel cheated out of having a natural birth?  Why do we so desperately want to be in control of this birth experience like we felt we weren't the first time?

Many moms that I have spoken to that had emergency cesareans felt exactly the same way I did.  They all had repeat cesareans which they felt were a much much better and fulfilling experience than their first birth.

Perhaps it has to do with your mind set and the fact that you really wanted to birth naturally but then something happened and it was better and safer for baby to be born via c-section.  There is the disappointment.  Not because you gave birth a certain way but because it wasn't what you expected or how you imagined it would be.  Enter depression & self-reproach & feelings of being a 'failure'.  It is really silly isn't it?  You are holding your healthy beautiful newborn yet you feel guilty for somehow failing to live up to what you had in your mind to be perfect.  You will always opt for the emergency cesarean; not because you blindly obey what your doctor suggests or 'bullies' you into as some women put it, but because instinctively you will want to protect and do what you also believe is safest for your unborn child.

Perhaps it has a lot to do with me feeling like the choice was taken out of my hands and all of sudden I felt like everything was out of my control!  And that is I think what makes the experience so terribly disappointing and frighting.  You had no time to prepare for this!  Neither mentally nor physically and therefore a lot of what-ifs came in the few months after I had had my little angel. What if I had been induced differently?  What if I had waited longer?  What if I had gone to an active birthing clinic instead of a hospital?  What if I used a midwife instead of a obstetrician?    

I suppose giving natural birth, from what I have heard and read, gives a woman a feeling of self-fulfillment in the sense that you feel you are strong for enduring the pain of labour (if you do it without any pain medication), feeling like you are capable of doing something that is unique to being a women (other than baring a child and breastfeeding?).  The question is though, is your baby capable of handling the birth like you and your body is?  Sometimes not.
 I hate it when people say "but women have been doing this for centuries, we are made to birth a baby vaginally, you cannot grow a baby too big...."blah blah bah.  Women and children mortality rates were a lot higher in the old days.  With modern medical intervention people are surviving!  People had 15 children because chances were that all your offspring would not survive.  Why do people then not have so many children anymore if they have been doing it for centuries?  People also forgot it has a lot to do with genetics & there are a lot of factors beyond our control....anyway that is a debate for another page.

I am still a firm believer that, should you have a normal uncomplicated and healthy pregnancy and be capable of having a normal birth, it is best. There is merit in some theories surrounding how and why natural is best for baby and mom, but it is not healthy to build your entire belief regarding birth around this.  It is ridiculous how some women condemn cesarean & women who have had it - elective or emergency.  Should a mother feel she would rather opt for elective cesarean first time round she must be free to choose so without judgement from others!  Natural birth should never ever be at a cost of the mother and/ or baby!  Do people realise this??  I just recently read again about a baby dying due to uterine rupture & another where a mother died bleeding to death following a home birth.  With the first case the doctor said she would make the same choice again.  She said the mother's uterus was salvaged and can bare another child easily.  So, that makes it okay then?  With the second, the midwife said the mother had a wonderful pregnancy and a beautiful natural birth and she hopes the husband (and motherless baby?) can appreciate this.  It just blows my mind how some people forget what it is about!  "I would rather have a damaged mom and baby and have a natural delivery than opt for medical intervention."  It truly is bizarre to me.

Having a cesarean always scared me more than having natural yet painful labour.  It still does.  But this time I know what I am in for and my mind set is different.  Again all I hope for is for both of me and baby to come out after the birth healthy and without any complications. Now I know I would not have done anything differently the first time.  No more what-ifs.

The Comparison Between VBAC & RCS

I discovered the following list that I drew up while I was still reading through all the information the midwife sent me and seriously considering VBAC as one of my only options:

VBAC
PROS	CONS
Recovery is much quicker	Chance of epesiotomy/ tearing that will have to heal anyway
No major scar to heal	No guarantee it will be successful & could end up with a repeat EC with possible adverse effects
Pick up Isabella	Bigger risk of death of baby
Go home quicker	Unfamiliar surroundings & further from home than hospital
Less risk for future pregnancies	Chances of VBAC not very high
Less risk of baby coming out before ready (lung maturity)	No NICU care at Genesis should it be necessary

RCS
PROS	CONS
Will have Dr O'H as primary caregiver	Risks associated with surgery & anethesia
Hospital is much closer to home	Not being able to stand up straight away and care for baby
Birth can be planned better to some extent - care for Isabella	Longer recovery
Knowing to some degree what to expect this time
Less risk for baby
Hospital has NICU & facilities to deal with infant care
Extended rest time in hospital and with new baby

The Friend Who Recently Had a Baby

I went to go visit my friend yesterday who had her baby just over three weeks ago.  The most beautiful little boy that I have ever seen.  Really he is just so perfect.

She gave birth to him vaginally. Her doctor feared that the baby was getting too big and suggested that they induce the day before her due date, otherwise they would do a cesarean.  She went in on Monday morning, got induced, laboured for three hours until she got to 4cm's dilated, had an epidural, and two hours later she pushed out a healthy 3.4kg boy.  She had minimal tearing.

Two work friends of hers also came by while I was there, with their little ones in tow.  So we started talking about everyone's birth experiences, mostly because I asked.  One women has a 5 month old girl that was born via elective cesarean that turned emergency cesarean & the other women had a cesarean 10 days before her due date because her boy was getting too big.  He was 4.7kg when he came out.  Wow!

The women that wanted an elective cesarean was scheduled at 39 weeks.  She went in on the Wednesday before the scheduled date (the Friday) and the doctor saw that she had absolutely no amniotic fluid left, so baby had to come out right then.  She said that she was a little upset because the doctor had seen her two weeks prior and said she only needed to see her then again (which was two weeks later).  Next time she would insist that she go for weekly checks at the end.  She said her birth experience was great and she has no regrets, she never wanted natural labour.  She was able to breastfeed beautifully & she said she expressed so much milk she still has some in her freezer.  She stopped breastfeeding at 4 months when baby went to chréche and took a pill to dry up her milk.  She said it was three days of agony whilst waiting for her milk to dry up.  Her baby suffered from re-flux in the first 6 weeks and cried a lot but is good as gold now.

The other mom didn't really say too much, just what I had mentioned earlier.  She is in her late 30's already and quite a big and tall women.  She mentioned that in her family all the babies are 4kg babies.  She is from Dutch decent and she herself was a home birth in Holland.  She mentioned that, I'm not sure if it's an Aunt or someone else in her family, pushed out her 4kg + baby & it completely ruined her body because she was a smaller women. She apparently applauded her for having a cesarean & not trying natural like she was forced into. She mentioned it is very common practice in Holland to give birth at home with a midwife & the infant mortality rates as well as the rate of retarded and brain damaged babies are soaring.

I must mention that her little guy is such a good boy.  He is 11 months old and he sat there on the carpet playing and did not make a sound.  When you talk to him me smiles at you and carries on.  She said he just doesn't cry ever & is such a calm baby.  She didn't mention much about breastfeeding but I thought I heard her say that she wished that she could have breastfed because she wanted to.  She would sit and try and express for half an hour and get 10ml out, so it sounds like she gave it a good go...but I'm not sure.

My friend stopped breastfeeding at around 3 weeks.  She didn't have enough milk at the beginning and after 10 days he was still only weighing 3kg (remember he was 3.4kg at birth but babies always lose a percentage of their weight in the few days after birth).  She started topping him up with formula & tried everything to increase her milk supply; expressing, tablets, some herbal thing I think she called Jungle Juice, feeding him more often, but nothing.  She said she really wanted to breastfeed him for as long as she could.  He has colic & was battling with constipation from after he passed his meconium, which was strange because at that stage he was only getting breast milk.   

I don't think I ever mentioned about me breastfeeding. I breastfed wonderfully up to 4 months.  Battled a bit, okay a lot, with latching & cracked nipples in the beginning but I got advise, read up and persevered.  At 4 months I wasn't producing enough milk for her needs anymore, even though I was at times feeding every hour, so I started topping up with formula (after talking to her pediatrician) & started solids.  My milk dried up completely within a couple of days.  I missed it and did want to breastfeed longer but on the other hand I was completely fine with not having milk anymore & being able to bottle feed her now.  This meant Dad could start doing feeds as well, because I was never able to express enough for him to do night feeds.  He really enjoyed it and still does the last bottle feed before he puts her down for the night.

Okay so, four different women in one room and four completely different experiences.  All very healthy and happy babies, except for my friend, who seems a little despondent about her boy's colic at the moment but we all assured her it does pass even though it feels like it will never end now.  Why I mention the breastfeeding is that this to me just proves once again that going through labour & having vaginal brith means absolutely nothing and has no relevance to how you will breastfeed & weather or not you will have a colic baby.

Another friend of mine, the one with the ADD theory, gave birth vaginally with the help of a midwife and Oxycontin after going into spontaneous labour at 39 weeks.  After 13 hours her 2.2kg baby girl was out.  She said she had lots of colostrum & a lot of milk, expressed lots, fed beautifully with the aid of nipple caps & at 5 months she told me her milk just dried up completely.  She does not have a drop left she tells me sadly.  At 4 months she wasn't producing enough for her baby's needs and started her on solids - the créche she started her at told her that she's hungry during the day & needs more food.  Now she has formula only & solid foods.  I remember her bragging about how she would exclusively breastfeed for 6 months and be able to do so because she had natural labour.  I won't remind her of this, that would be ugly.

Once again I conclude it does not make a difference in the large spectrum of things how your baby comes into this world; whether you push it out through your vagina, choose to have a cesarean or end up with an emergency cesarean or a planned cesarean despite the fact that you actually wanted natural birth, your baby will still be the same baby.  It is your unique body and the way it functions can never be predicted, your capabilities and instincts as a mother as well as the nature of your baby that counts.  Women seem to forget that genetics have  a lot more to do with reproduction than how you birth your baby.

My baby slept through at 8 weeks (from 6pm to 5am, no jokes!) and now sleeps from 7pm to 7am and 8am on weekends sometimes.  Everyone with kids tells us how jealous they are of us.  My ADD theory friend still gets up twice a night for her baby (who is almost 6 months) & battles to get her to sleep. I thought baby's pushed through your vagina are suppose to be little perfect angels.  Their not, they're babies, just like everyone else's.

The Information Overload

My head is going to explode!

For the past two weeks, every opportunity I get at work I google VBAC, C-section, Repeat C-section....forums, articles, research....

There are so many stories & so much information out there.  I've also come to quite enjoy Dr Amy's blog http://www.skepticalob.com/

I have come to the realisation to TOLAC or not to TOLAC is a very personal decision.  A lot of women out there, it seems to me, are looking for other women in exactly the same situation as them, with the same circumstances, want to know what they decided and how it turned out.  Unfortunately a lot of Forums are one-sided and incomplete and you never get to know how things turned out.  Even the VBAC support thread I am still following on moomies.co.za; I have asked two women who previously posted on the thread, for their stories whatever it my be, with no response.  I can only assume they do not check the forum anymore or do not get the correspondence.

So here is my decision.  I am very much at peace with having a repeat elective cesarean and was almost tempted today to cancel my midwife appointment.  I still think, however, that it is a good idea to talk to her and get yet another point of view.  The biggest reason for me for going with this decision this is I am not really prepared to accept the risks associated with VBAC and the complications that could or could not occur.  There is no guarantee that I will go into labour & I might very well end up with a repeat emergency cesarean which I fear will be even more traumatic.  There are too many 'if's' and 'but's' and variables for my analytic nature.

I am very fond of my gynea and I trust him completely.  Netcare Sunninghill Hospital where I birthed my first little one at is a fantastic and a very well equipped and staffed hospital.  I like the comforting feeling that that familiarity gives me.  Another reason is I know that this is what Dad feels the most comfortable with as well.  This is not only my child but his as well and therefore not only my decision.  I always joke and say that I only have 50% shares in what is growing in my uterus.  I love him dearly and I would hate to put him through any kind of trauma.

I am still so early in my pregnancy - 10 weeks this week - and a lot can happen still, but in my heart I know that this is the right decision for me and for everyone in my family, not for anyone else who might read this, or might feel they are is a similar situation or have similar circumstances.

The Doula That Gave Birth

I was having a look around on other Forums on moomies.co.za and came across 'Birth Stories in the Making' with a thread 'Anina is in Labour!'  I figured out that Anina is the doula who answered my last question on the VBAC support forum.  This is a Forum on which you can tell your birth stories.  You can post from when you go into labour to when the baby is out and after & post pictures and everything.  I read Anina's thread with interest.

Somewhere in the middle of the thread they posted to say that they broke her waters & there was meconium in the amniotic fluid & that baby was in distress.  I always thought this was a real worry because if the baby swallowed this there is big problems & it means that baby is stressing so much that it's tummy started going!  They just later posted baby is no longer in distress.  Huh?  I don't know enough about how and when the call for an emergency is made.

This is the last bit that she posted after giving birth & while telling her birth story:

This is where things started going a bit pear shaped, I dilated fully and docter came to deliver baby. He is great and all for natural, don't get me wrong, but he believes in purple pushing.

So my way was not working to great and I was starting to feel nervous as I could see he wasn't to pleased with my breathing thing. The next thing I knew, I decided to push and with 3 or 4 pushes, baby was out. But giving up my hypnobirthing breathing made me unsure of myself and that made it impossible to not feel pain, so yes, the last 10 mins did hurt. I tore a bit, but its not as bad as with my first son. 

So at 10:40 am my little girl was born the way (almost) that nature intended it to be. I was a bit disappointed about the pushing at the end, but all in all, it was a great experience. 

Interesting that even though she had a labour and birth as natural as they come she still uses the word disappointed.  I don't know what "born the way (almost) that nature intended it to be" even means.
Seems that perhaps some women will always find fault no matter what birth experience they have & will always have wanted it different somehow.  Perhaps it is more about feeling in control and having a sense of empowerment more than it is about the actual birth.  This is just a theory.

The Pediatrician

Took Bella for her one year check up today with Dr Nunes.  Not only was she the pediatrician on call the day Bella was born but she is also one of dad's very good friend's sister.

All is perfectly well with Bella, she is growing beautifully, above average tall like her dad :-) and her weight has caught up nicely now and is also in the 95th percentile.

I told her we are expecting our second now and wanted to know if, in her experience, does having natural or planned cesarean have any effect on the baby's health and development.  She told me that there are a lot of theories but none can be proven.  There is no proof that planned cesarean does has any negative effects long or short-term.  I asked her about ADD and told her my friend has this theory that ADD is linked to cesarean birth and she told me that is absolutely not true.  ADD is genetic, and if there is a family history of ADD the chances are baby may get it, but it has nothing to do with the way that baby is birthed.

Elective cesareans for personal reasons aside, cesareans are a life-saving intervention.

She did say that what does happen, that she has seen happen to about 6% of early elective cesareans,  is that dates are miscalculated & when an elective cesarean is done at 38 weeks, baby is actually not ready, and is born when their lungs are not mature enough.  She calls it 'wet lungs' and then baby has to stay in NICU for 5 days.  So if you can try and rather go closer to 39 weeks or see how long your Gynea/ OB will allow you to carry before having an elective cesarean, it will be more ideal.  

I asked her about VBAC & she said she is not a fan but it is a personal matter.  If something should go wrong both mom and baby are in big trouble.  She suggested not doing a VBAC at a place like Genesis clinic, that has no NICU or facilities or staff to deal with such emergencies.  You end up getting transferred to a close-by hospital.  If your Gynea/ OB is willing, you do it under his nose in a properly equipped hospital facility where, if something does look like it might go wrong, the doctor is right there and can intervene immediately.  She did also state that generally they do do more cesareans there days due to litigation but she did not elaborate, and I also didn't ask.

The Evil Gyneas

Only two people requested the research documents from me.  And they were guests to the forum, not people who post to the thread.  Interesting that neither the midwife nor the doula, excuse me, professional birth supporter, requested to see these...I suppose they must know all about it then.

One girl who asked me for the research document in a private message told me that she is only 5 weeks but looking at her options.  She told me a good friend of hers refused medical intervention whilst in labour and the baby was very distressed when she finally came out and had also swallowed amniotic fluid.  She was admitted to NICU with pneumonia and had to stay in hospital for I'm not sure how long.  

No one has posted on the thread since.  This thread is 5 pages long and just all of a sudden it stopped.  I'm not saying I have anything to do with it but it just makes me think.  When people were telling how terribly evil their gyneas were and how unhappy they feel about their birth and the fact that they couldn't have this 'beautiful Hollywood birth' they imagined having, everyone was pitching in.  Why is everyone so suspicious of their care givers - all gynecologists are being accused of looking for excuses to cut and wanting to book you for convenience.  Everyone feels that they are being fed untruths by their gyneas and that somehow the gynea decided for them how their birth will happen.  Perhaps women feel robbed somehow and are looking to find blame. Are they happy that their baby's are born healthy & happy?

Now that there is a question about whether or not they are considering anybody other than themselves here, no one has anything to say.

I've got a lot to think about.  This is not just me or my baby, this affects Isabella & Dad as well as the rest of the family too...

The Forummmm....

I picked up quickly that this discussion board was driven by a midwife and a doula who think there is absolutely nothing positive about cesarean, its much better to risk VBAC and that you are not woman if you do not at least try to push out your baby through your vagina.  Anyway, so that got me thinking about how objective this support really is...anyway, I am still following the tread.

I posted the following question on the forum:

I've been having a bad day today  &  

Has anyone here ever felt, even just fleetingly, that their putting their unborn child at an unnecessary risk by attempting VBAC? Repeat c-sections also have risks as do first natural births and c-sections (elective & emergency), but less so than VBAC. 

My midwife sent me a 23 page document on VBAC research just showing the facts. It is in no way disturbing or discouraging. Send me a private message with your e-mail and I will forward it to anyone who is interested.

This is the answer I got from the doula (she calls herself a professional birth supporter):

Widget, there are more risks to repeat c-sec than to VBAC. So you are making the best move. Here is a quick pic that shows some of the risks. Bring on the fears you have and lets discuss them on here, it might help a lot of people.

The E-mail to Dad

E-mail I sent to Dad after we had a lengthy discussion:

I just thought I would send you a few facts that stood out most to me.  I suppose it’s all relevant & you can compare it to first natural births etc, but let’s just look at these facts as is.  I’m sure we will both agree about what is the best decision for all four of us. Are we happy with this?

1.      The records indicated that one hundred and eighteen out of two hundred and one (118; 58.7%) women were successful in their attempt to have a VBAC. The study results show that 83 records (41.3%) of women reflected an unsuccessful attempt to have a VBAC and thus their neonates were birthed by repeat caesarean section.

2.      Risks for a TOLAC (trial of labour after ceasar), compared to an elective caesarean include an urgent repeat caesarean section and a risk of uterine rupture of 22 to 74 per 10 000 births. Uterine rupture is a very rare complication, but can result in an increased incidence of blood transfusion, hysterectomy, admission to intensive care unit (ICU) and death of the mother.

3.      For baby, the risks associated with a TOLAC include the death of the baby. The incidence of this loss is rare (about 10 per 10 000 which is the same as the risk for women in their first pregnancy), but this risk is increased compared with a planned repeat caesarean (about 1 per 10 000). When uterine rupture occurs the death rate of baby is approximately 50%.

4.      Risk factors that increase the risk of an unsuccessful VBAC are: no previous vaginal birth; body mass index greater than 30; previous caesarean section for abnormal progress of labour; previous preterm caesarean birth; less than 24 months from previous caesarean birth; maternal age of 35 years and older; non-white ethnicity; short stature; birth at or after 41 weeks of gestation; baby’s birthweight greater than 4.0kg; induced labour; dilatation of cervix on admission less than 4 cm; and a male baby.

5.      An elective caesarean has the lowest rate of poor short-term outcomes for mother and baby; a VBAC has the best long-term outcomes; and a failed trial of labour has the highest incidence of negative short- and long-term consequences.

6.      The risk for uterine rupture in an elective caesarean section is about 1 per 10 000 caesareans. Admission to the neonatal ICU for short-term care is increased in caesarean sections. 

The Fight about the little bit of obsessiveness

Dad told me that one of his client's wife 'did the whole Genesis thing' and ended up with an emergency c-section after 13 hours of labour.  I immediately got very defensive and said what is that suppose to mean & why is he telling me this.  He said that he just feels that all of a sudden this place is now the next best thing & he doesn't know if it really is the best and safest thing to do.

I got very angry & told him that this will absolutely go my way & I was very upset & said I felt that he doesn't support my feelings and decision (which I know is not true), yada yada yada.  I was carrying on a bit like only I can.

After a moment on my own and cooling down I realised that this was my red flag.  After all the facts I had read and the feeling in my gut I knew that this probably wasn't the safest thing to do but I just didn't want to see it.  I normally get defensive like this when I am making and impulsive & emotional decision.  It never turns out to be the right decision.

The Little bit of Obessesiveness

I read through all the information that the midwife sent me word for word.

It is all I can think about.  Having a VBAC & how am I going to get my body to obediently go into labour and let me have this baby 'naturally'.

I've made a summary of what visits I will see the midwife, what visits I will see my current gynea and what visit I will go and see the back up gynea at Genesis in case I do need a emergency cesarean again.

I wrote a little page on My Personal Motivation for TOLAC in case the midwife questions my motives.  I came up with three things:

The healing is quicker, I can go home sooner & I can pick up my little girl without being in pain.

I made a list of questions for the midwife:

Will you do a stretch and sweep?
Will you allow me to go beyond 40 weeks & can I then go for reflexology & acupuncture to try and induce labour naturally?
What if my body really is too small to deliver vaginally & my body just will not go into labour?
In your experience, do the babies generally come out okay or is the risk increased for them to have to be admitted to NICU?
Do you monitor the fetal heart rate all the time & will you pick up very quickly when something is wrong?
What do I need to put in my birth plan?

The VBAC Band Wagon

One of my posts: 

Kiewiet, wow well done! It is so inspiring to see all of you so motivated for your vbac. 

I didn't realise having a natural birth takes so much planning! I also got loads of information sent to me from my midwive RE VBAC & natural birth in the mean time before I meet with her. I honestly thought that because my two pregnancies are so close together that I will not be allowed vbac but as it turns out it may just lower my chances of a successful vbac. 

About the Raspberry leaf Tablets or tea, she says it is advisable to start it from 37 weeks. It makes your uterus more responsive to oxytocin, thus should speed up your labour. Drinks 2 tablets three times a day or 3 cups of tea a day. 

She also suggested using Evening Primrose Oil from the start of the 37th week. It softens the cervix in preparation of labour. 

Did anyone try reflexology to naturally induce labour?

I am stressing about going into labour spontaneously.  If my body didn't do it the first time, is it going to be able to this time round?

I got all very positive feedback from other members in the forum.  I feel great that others can share my worries and feelings.

The Googling

I have been googling story after story of successful as well as unsuccessful VBAC attempts..some beautiful and inspiring, others horrifying.  One woman stated she had a successful VBAC but her baby went without oxygen for some time during the birth that it is now brain damaged.  Successful??!!  More women commented on the thread telling their stories of uterine rupture with disastrous outcomes.  I really feel for these woman and the babies.

I get the idea the success of VBAC has a lot to do with the reason for your first cesarean section.

The Midwifery

I started doing some research regarding birth options after emergency cesarean - VBAC.

I contacted a Midwife from Growth Spurts Midwifery and made an appointment with her for the 9th of October when I am 16 weeks pregnant.  Her admin lady sent me a whole lot of information regarding TOLAC (trial of labour after cesarean) & VBAC (vaginal birth after cesarean) as well as all other midwife care related stuff.  It is a lot of information but worth the read, I want to gather as much information as possible so I can make an informed decision.

I joined a Forum on Moomies.co.za lending support to those who wish to attempt VBAC.  I jumped right on the band wagon feeling inspired by all these women who also had their first babies delivered by emergency c-section and was left feeling disappointed.  I just know this is the right thing for me!  I have to do this for me!

The Birth Of Lo

I was due on Monday 15 August 2012, but our little girl was just to comfortable in mommy's tummy... I bounced around on my birthing ball, went for a walk with the dog every day, went out for a curry, had sex a good couple of times, but no signs of labour.

My induction was to be booked on the following Monday, the 22nd of August but since that was my birthday doctor said that we could do the induction on Friday the 19th instead at 4am.  I was glad that I knew for certain now that by Friday I would be holding my little baby in my arms.

We checked into the hospital at 10pm the Thursday night, filled in all the paperwork & I was booked into a normal room.  We had requested a private room but there were none available at the time.  The nurse hooked me up onto a Doppler monitor and took my blood pressure.  She asked me if I had always had high blood pressure during my pregnancy.  This was very strange because my blood pressure had always been perfect from day one.  She listened to baby's heartbeat and picked up a strange beat on it, almost as if the baby's heart was skipping a beat or faltering a bit every now and then.  Dad & I could also hear it clearly.  Nurse wasn't happy and said she was just going to phone Dr H to see if he still wanted them to go ahead with the induction.  She came back and said Dr confirmed that it was okay.  Dad kissed me goodbye & promised to be back first thing in the morning.  They gave me sleeping pill as I was stressed and excited & they said I needed to be well rested for the next day.

At 4am I felt very groggy when they came in to do the induction, the nurse did an internal ( I later heard her say my cervix is soft but posterior), and proceeded to insert he gel.  Almost immediately I could feel contractions starting.  Dad was there at 5am.  One of the other gynecologists that checked in on the patient I was sharing a room with came and checked on me and commented on how great my contractions were.  Baby's heart rate was happy and healthy.  Shortly after a nurse came and administered and enema which was not half as bad as I was expecting.  They brought me breakfast around 6am I think, I don't even remember what I ate but after 30 minutes I threw everything up anyway.

We managed to get a private room then and I moved to my relief.  I was allowed to walk around freely and hop around on my birthing ball.  After several hours, probably just before 11AM I was taken through to the labour ward.  A nurse did an internal again and said my cervix was moving forward but I was not dilating.  They did a second lot of gel and I could feel my contractions were very strong now.  I was in a lot of pain & when asked if I would consider having an epidural I said yes, I think they just wanted to give the anesthetist a heads-up so long as it was way too early progress wise.  After about an 45 minutes the nurse noticed that there were deceleration showing on the baby monitor...and went to call the doctor.  He came in and did an internal and showed me how much I was dilated - the width of his ring finger.  He said he was sorry but that we would need to do an emergency cesarean.  I was very disappointed and asked him if there was nothing we could do?  He said if I had dilated he could have at least tried to pull baby out but unfortunately this was the only option or we could carry on this way and very well lose baby.  Nope, I definitely didn't want that.  I consented to having a cesarean.  Immediately I was put on a drip to stop the contractions and I was given oxygen.  All this time Dad was holding my hand and I was crying.  This was all too much for me now & I couldn't hold it together.

They pushed me into the theater and asked Dad to go and 'scrub up'. In the meantime the anesthetist started inserting the spinal block - which I remember was incredibly sore! Dad came in just as he was finishing up, I looked up at him with his silly blue scrubs and silly blue net on his head and told him he looked ridiculous.  I was quite upset.  I was told to lie down quickly on the operating table.  The staff - nurses, anethetist, my gynea, were incredible and supportive, checking that I was okay all the time.

I felt a lot of tugging and pushing at my tummy but I felt no pain. The one assistant doctor (I think?) asked if I would like to see when baby came out.  I was very reluctant, I really didn't want to look up and see myself cut open.  She said it was nothing to worry about, she would tell me when baby came out.  One nurse pushed down very hard on my abdomen and doctor pulled baby's head out.  They told me to look and the anesthetist helped my head up so I could see her come out and it was so surreal!  Now I was crying with joy and not fear and disappointment anymore.  Doctor showed her to  me and I asked "Why isn't she crying?" and someone said, either the doctor or anesthetist, that she doesn't have to cry.  It was 12:10PM. They took her probably about 5 steps away and I kept looking to try and see her and she started screaming!  :-) What a healthy set of lungs.  Dad was standing with her all the time & cut the umbilical cord.  The pediatrician checked her, weighed her, and then immediately came and put her on my chest.  She was not away from me for more than I would guess 2 - 5 minutes.  I stared at her in awe.  They stitched me up - I still remember on of the girls saying "Look at how flat your tummy is!" - and transferred me to another bed so they could wheel me out.

One of the nurses took a family picture of the three of us there in the theater.  They opened up my gown and unwrapped her and put her naked on my chest and she immediately latched and started breastfeeding.  As we were wheeled out of the labour ward the first person to see us was Dad's Mom.  No one else was there yet.  She teared up and I teared up and it was just amazing...but they were trying to get me to the maternity ward quite quickly and before we disappeared through the doors she aksed "What is her name?"  Dad looked at her and it was such a special moment and said "Isabella".  The doors closed.  I don't think I had ever ever seen Dad glowing like he did that day.

The Thought of Giving Birth

Okay so now everything is confirmed & definite.  Now I start thinking about actually having the baby - as in the actual act of giving birth and I feel almost this compulsive need to pursue my dream of birthing this baby naturally.    

I discuss this with Dad while we are driving and he is supportive although a little apprehensive, especially because the gynea said from the very beginning I will have to have a cesarean with our next child now also & that natural birth will be too dangerous.  The nurse that did our antenatal classes before we had Lo was also very adamant about 'not even going there'.

So I decide to make an appointment with a midwife at Genesis - an active birthing clinic - to discuss this option.  All I want to do is make an informed decision.

The peanut

Dr H showed me our peanut today!

It was a little blob measuring 0.5mm with a heartbeat of average 129 bmp. It was surreal!

I am ecstatic & already in love :-)

My due date is 26 March 2013.

Another One Just In Case

The day before my doctors appointment I decided to take yet another test...just in case.

I don't know why, but I just felt like it still wasn't quite sinking in.  Even though I was getting quite bad morning sickness (more like morning & afternoon sickness) & felt very tired, I still worried that I was going to go the doctor and he would put the sonar on my tummy...and it will be empty.  I wonder if other people feel the same way I do before going for their first scan.

I had decided not to waste time and money going for blood tests with my doctor when I could just go straight to my gynea/ OB even though it would only by 2 weeks later.   I would rather waste R79 on a digital test this time.  This one I had to read the instruction leaflet first because I had never done a digital test before.  Also, I thought this will probably be my last pregnancy test ever.  I felt a little sad.

The instructions said it would show results within 5 minutes - sometimes as quick as 30 seconds....so I waited and stared at the little hour glass for what felt like 30 minutes.  Dammit!  Why is it taking so long?? It is either going to read 'Error' or 'Not Pregnant' I just know it.  Nope.  It flashed.  Pregnant 3+.  Cool, I don't have to cancel my appointment for tomorrow.

The + sign

I went and bought a second pregnancy test just to be sure sure, before I make a doctors appointment.

I got so busy after coming home from the shops - and I made sure that I had not gone to the toilet since going to the shops, so that I could take the test as soon as I get home.  Anyway, with a little 11 moth old crawling around, unpacking my shopping bags & going after the cat with a sachet of creamy mac & cheese in hand I did not get around to it.

Later Dad got home, Lo crawled to the door ecstatic that "da-da da-da" was home, and I had a chance to 'go make a wee'.  This time it was a purple one that doesn't show two lines but a + sign.  Dipped it in the cup, put it flat on top of the toilet, washed my hands, opened the door, continued talking to Dad who was hanging around outside the door with Lo...and glanced at the test.  Yep, that is as positive as these tests can show.  The test line was darker and thicker than the control line.  Dad kissed me and said congratulations Mom.  Lo laughed, even though she has no clue what we are happy about.  Such a cutie-pie.

The first two lines...

I was playing with my little one when I got up and all of a sudden felt dizzy and a wave of nausea overcame me.  A familiar nausea... I had a pregnancy test stashed in my 'red-days box' for times like these.  My period was already a week late but I hadn't even considered the possibility of...

I popped my little one in the bath to wash of all the paint she had managed to eat & smear in her hair.  Peed in a cup, took the test out of it's plastic wrapper.  I don't even look at the instructions anymore, I know how these test work.  Their all the same.  Pulled off off the pink cap and submerged the absorbent tip in the cup for about 10 seconds.  Took it out, put the cap back on and put it flat on the back of the toilet.  I glanced at it briefly while it was soaking up what it needed and I saw only one line appear - the control line.  Cool, no worries then, I knew I wasn't pregnant.

I carried on washing Lo and after the water had turned blue from the paint and I was sure 5 minutes had past I looked at the test again, and did a double take.  There it was.  Two lines.  No mistaking it.  How on earth?...oh dear!

I probably picked up my cellphone 10 times considering either phoning or sms'ing the father of my first and now probably second child.  Why am I so nervous?  I think I'm still just in shock!  Maybe I should just ask what time he'll be coming home...no, no...he'll suspect something.  I want to tell him in person without him thinking anything before I see him, so I leave him to his day & hope something doesn't hold him up at the office so he won't come home later than normal.

When he walks in through the door at his normal time, he scoops up Lo in his arms as she comes crawling towards him with a big smile on her cute round face "da-da da-da" & kisses me 'hallo'.  My tummy does a flip & I almost just burst out saying 'I'm pregnant!' but I don't and the evening carries on by it's normal routine.  Once he's put Lo to bed & we can have dinner & some quiet time together he walks into the living room and says 'what's wrong?'  dammit, he knows me so well.  "I'll talk to you now when you come and sit down."
Him "You haven't started your period?"
I shake my head
Him "Did you take a test?"
I nod my head
"Are you pregnant?"
I nod my head
"Really now?"
Me: "Yes!"
He comes and sits down next to me on the couch.  "I'm sorry" was the first thing I can think to say.  It's just such an unexpected surprise.

I felt a bit bad about the first thing I said to him & how I felt when I found out at first, but during the day I had already started getting excited about the new addition to our family that was on it's way!  Dad felt the same!  He was like "why are you apologising?! No, this is exciting and happy news!"  Then his next thought was, same as mine, how on earth?  But really!  The only conclusion was that our contraceptive must have failed or at some point something must have just slipped through, because we really weren't trying to conceive again just yet.  Anyway, we'll never know, but we did decide to tell people that we weren't not trying because we always said we wanted our two to be close together.  Wow we have got so much to plan & think about now.  Growing from 3 to 4 is going to take some adjustments and big decisions for all of us.