Why I chose c-sections

I came across a blog called Bubble Wrapped Birth and it got me thinking that I should explain why I made the birth choices I did. I realize most people reading this will be friends and family and will already know why I made my choices. But if you've found my blog while researching the best ways to birth a hemophiliac baby, I have to make a disclaimer here. The following is based on my personal experiences and gut feelings only. I'm not at all suggesting that anyone should make the same choice I did. If you are trying to make that decision, listen to what your doctor says, do your own research, and do what you're most comfortable with. I don't think there's any right answer. With both of my pregnancies I felt that my doctor gave me a lot of flexibility in making the decision I felt best about and I think that was because he didn't have the right answer either.

When I was pregnant with my older son the recommendation for carriers of hemophilia with a male baby of unknown status was to attempt a vaginal delivery, just like anyone else. Internal fetal monitoring (a clip attached to the skin on baby's head to monitor the heartrate), vacuum delivery, and forceps were to be avoided. If, in an emergency, an assisted vaginal delivery became necessary, forceps were considered preferable to a vacuum.

I went through much of my first pregnancy knowing these recommendations and accepting that was my plan. No one had told me it could be any different. I know exactly when I started doubting that plan. I had been a labor and delivery nurse for two years at that point. One day I had a completely normal patient who had a normal vaginal delivery and the baby came out with one arm covered in bruises. Now that I think about it, that baby may have had some kind of undiagnosed bleeding disorder but at the time, all I could think was "what if that was my baby?". There was nothing unusual about her delivery. She had the kind of vaginal delivery that would have been ideal for me but still her baby was all bruised.

I spoke to my obstetrician after that and he felt it was perfectly reasonable if I wanted to opt for a cesarean section. I might not have done it if I wanted more than two or three kids but it was right for me. My doctor and I discussed the delivery and I made it clear that if he struggled to get the baby out I was more than comfortable with him making a vertical incision on my uterus. I wanted my uterus damaged before the baby was damaged.

I had a good experience with my first c-section. Obviously, it's no treat for the first couple of weeks but I had no complications and by the end of six weeks I felt pretty normal. When it came time for my second delivery, I had no interest in trying for a vaginal birth after cesarean (VBAC). We still had an ultrasound to determine gender for planning purposes but it had nothing to do with my decision for delivery. My recovery this time was similar, no complications.

If you really want a "natural" delivery, don't listen to a jaded labor and delivery nurse like myself. I work in a centre where a very high proportion of patients are legitimately high risk. I will admit that it can get you in a mindset where you can see risk in every delivery. I've seen patients go from normal to an emergency in a second. The scenario I would worry about most for myself would be the one in which the head is crowning, the heartrate is down, and the baby has to come out. It's too late for a c-section in that case and that's when a vacuum or forceps might be necessary. Or what if I had a shoulder dystocia? That's a true obstetrical emergency that you can't always predict. I've seen moms and babies both get injured in that scenario, just to save the baby's life. That sounds dramatic and I'm aware that the chances of those things happening in any given delivery are low. But it's for reasons like that why a scheduled c-section is my comfort zone.