Many are the plans in a mother's heart

It's been a long time since I blogged. As a matter of fact, I haven't written one this entire pregnancy. I think it has something to do with running after my 2 year old all day, and dealing with high blood pressure throughout this pregnancy that leaves me with very little physical or mental energy at the end of the day.

But today I am 37 weeks pregnant, with just 2 more weeks to go, so I thought I would get one pregnancy blog in before we bring home our new son or daughter. Be prepared, it's a long one, 9 months in the making!

It's amazing to me how much our children teach us, even before they are born. I have been learning so many lessons from this little one already. But I think the hardest, and most important one is that "many are the plans in a [mother's] heart, but it is the Lord's purpose that prevails" (Proverbs 19:21).

I have never shared Abby's birth story, but her story has a lot to do with how I wanted the birth of this little one to happen. I had a difficult pregnancy with Abby, including gestational diabetes and preeclampsia. I remember walking into the doctor's office when I was 37 weeks pregnant with Abby, and my blood pressure was so dangerously high that I had to be induced immediately.  I was blessed with a wonderful team of doctors who took excellent care of me, but there were many frightening moments during labor, including a time when Abby's heart rate was so low I was almost wheeled into an emergency c-section. At the last second Abby's heart rate came back into the normal range, and I was able to avoid surgery.  But my epidural caused me severe back pain for weeks following her birth, and I struggled with my blood pressure for 3 months. I am so blessed that she was born healthy, beautiful, and ready to take on the world. But I was scared about what the next pregnancy would bring.

This little one made his or her presence known to me right away. I remember the moment I knew I was pregnant. Ben and I had been working on a number of home projects, and one afternoon in August I was taping up our large bay window so that I could paint the trim. I was standing on the window seat working in the hot afternoon sun, and all of the sudden nausea hit me like a strong wave. And that's when I knew... I was only 3 weeks along! The doctor couldn't believe I had morning sickness so early on. But this baby has always had plans of its own.

I had much worse morning sickness those first 12 weeks than I ever did with Abby. Food was my enemy, and there was a period of about 3 weeks where all I could stand to eat were Ramen Noodles. But once those first 12 weeks passed, I started to get my energy back and feel much better. I knew my next hurdle would be taking the test for gestational diabetes. I had a big scare when I took the test while pregnant with Abby. It caused my sugar to go so high I had to be admitted to the hospital for a day until  I was stabilized. Needless to say, I was very nervous to take the glucose test again.

It was around the week that I had to take my glucose test that I started praying and asking the Lord to help redeem the experience I had with my first pregnancy. I desperately wanted things to be different this time. I remember the day I received the call from the nurse telling me I had passed the glucose test. I didn't have diabetes this time!! I literally shouted for joy on the phone. I felt like a weight had been lifted from me, and I was convinced that this meant the rest of the pregnancy would be "easy".  I knew that with no diabetes I was considered "low risk" for the first time! And so I began to think a lot about what I wanted in terms of my labor and delivery. Many are the plans in a mother's heart....

Part of what made my experience with Abby so difficult was the intense pain that my epidural caused for weeks after her birth. It made bonding with her and caring for her so much more difficult, and made my recovery much slower. Because of this and a few other reasons, I made the decision that I wanted to have a drug-free birth this time around. I knew it would be difficult and painful, but I hoped that it would also make my recovery faster and easier. Once I knew this is what I wanted, I began to look into the possibility of switching practices, as part of me just wanted to get as far away from the difficult memories of labor with Abby in the hospital and do something entirely different. I found a wonderful birth center, with very experienced midwives. I called and talked to them about my history and hopes for this birth, and they were extremely supportive and shared my vision entirely. They had a facility that felt like home. It was such a calm and soothing place! But they told me that they could only accept me into their practice if my blood pressure stayed low, and everything else remained 100% low risk.

I had my first "official" appointment with them at 30 weeks. I walked into their office excited about my new birth plan, and so excited to have the hope of a completely different experience this time. I sat down and in the exam room, and started my appointment. And that's when all of my plans started to unravel.  When the midwife took my blood pressure that day it was 155/110. Dangerous to me and the baby. I laid there being monitored for 2 hours while the midwives discussed what would need to happen next. They told me that unfortunately, with my history, and my current blood pressure, that I could not be their patient and could not deliver my baby with them. They called my original doctor, who asked that I be sent to his office immediately. When I arrived at his office, with Abby in tow, he made it very clear that he was angry I had switched practices, and that he felt that it was a very poor choice on my part. I was crushed. Not only did I have to give up my plans for birth at the birth center, I now had an OB who was frustrated with me and felt that I had made a choice that could have compromised my health. After another few hours of monitoring, my blood pressure came down enough that I was allowed to go home. I had to start blood pressure medication immediately. And I was now high risk. Again.

It took many weeks to feel "normal" again after that. Blood pressure medication works by slowing everything down in your body. If I thought I was tired before I started that medication, fatigue had a whole new meaning after I began the medication. It was frustrating, as it made it very hard to care for Abby, and I had to rely on the help of family and friends to get through those first few weeks adjusting to the medicine.

But by about 33 weeks, I started to feel much better, and my body began to get used to the effects of the medicine. One of the side effects of the medicine and blood pressure problems is that it can cause growth restriction of the baby. In other words, it can affect how much blood the baby gets and cause it to be born underweight. In order to make sure that this did not happen, I was scheduled for weekly ultrasounds and monthly visits with a high risk specialist. Each week I went in, my baby looked great! As a matter of fact, it was growing a week or two ahead of schedule. In other words, perfectly healthy. I was so thankful! And although I was told I had a 50/50 chance of developing preeclampsia, each week that passed my blood pressure looked better and better. Other than needing medication, there was no other intervention needed. My doctor was very happy with my progress, and said that this was the best case scenario for someone with high blood pressure. He said that he would induce me at 39 weeks to avoid the possible complications that can occur in the last few weeks of pregnancy for someone with high blood pressure, but other than that no other intervention was necessary.  And so other than having to give up my plans of birthing at the birth center, I was again looking forward to the drug-free birth that I had wanted so badly this time. I started researching ways to manage pain in the hospital, and how to work with the hospital facility and staff to create a supportive environment for my experience. Many are the plans in a mother's heart...

One of the "upsides" to being high risk meant that I had the opportunity to see my little one every week on an ultrasound. I got to see him or her kicking, and making faces, and playing with it's little fingers every week! My ultrasounds started at 30 weeks, and each week my baby's head was way high up in my ribs and it's precious feet were kicking me for all it's worth down in my bladder. As the weeks crept by, I kept waiting for the baby to flip head down. About 85% are head down by about 32 weeks, and by 36 weeks 97% of babies are head down. Less than 3% are still in the head-up, or breech, position by full term (37 weeks).  And so the ultrasound technician assured me at 33 weeks I had nothing to worry about, that the baby would turn. And then she said it again at 34 weeks..... and 35 weeks...  And every week the baby was still head up. I started researching methods to make my baby turn. There are a lot of "exercises" out there guaranteed to help your baby flip. Head stands off your couch, laying upside down on an ironing board at 45 degrees, crawling around on all fours multiple times a day. I tried them all. At my 36 week appointment, I waited for the news I already knew was coming. My baby was still breech, of that I was sure. I can feel the head sticking in my ribs like the horn of a saddle if I lean over too much. The doctor told me that I had two options. Either I could let him try to manually turn my baby from the outside. Or I could schedule a c-section for 39 weeks in the hope that the baby would turn on its own before then.  I had already done my research, and knew that manually turning the baby was my last hope at achieving the birth I so wanted for me and my baby.

I agreed to the procedure. It's called an external cephalic version (ECV). So on this past Friday, I was admitted to the hospital at 11:45am for my ECV. I was terrified. I knew a few people who had had the procedure done, and it sounded like one of the scariest things I had ever heard of. The doctor actually pushes on your belly as hard as he can from the outside, pushing and pulling the baby into the correct position. The baby is monitored the entire time to make sure that the pushing and pulling does not cause any distress. And it is done in a room on the c-section floor in case an emergency occurs. Thankfully, my doctor suggested that I have an epidural for the procedure as it helps to relax the muscles and make the turning easier. And although I was terrified of the back pain that resulted from my last epidural, I knew that I would not be able to withstand the procedure without it.

The anesthesia team came in and administered my epidural around 2pm. Within a few minutes of inserting it, I knew something was wrong. My ears had a strange pressure in them, I was unable to hear, and I felt like I would pass out. The team checked my epidural, and found that it had migrated into my blood vessel. My entire left side was numb, and my right side still had full feeling. I had to be lifted up, the epidural completely removed, and a new one inserted. The doctors and nurses were whispering frantically to each other behind me, no one telling me what was happening. They just kept saying "I can't believe it migrated to her blood vessel, this is so rare, this is so rare." I remember asking them "Am I going to be ok??" Thankfully they were able to fix the problem, and it took a few more minutes, but I was stabilized and they were able to numb my right side.  At this point I just kept praying "Lord, after all of this PLEASE let this work. PLEASE turn my baby."

My OB came in, and with help from another doctor the procedure began. For about 15 minutes I laid there, eyes closed, holding the hand of a nurse but in my mind it was the hand of Jesus. I can't really describe the procedure adequately. They literally lifted the baby up in my stomach and began to turn it around, in a forward roll kind of motion. I just kept my eyes closed, breathing deeply, and praying. It hurt at first, but as I prayed, the pain went away and I was able to focus on staying relaxed. They got the baby turned about 3/4 of the way, but it stopped there. They tried for about 15 minutes, and each time they turned it a little, it would turn back. As the minutes passed by, I began to realize that it wasn't going to work. That my baby wasn't going to turn. The doctor let go of my stomach and looked at me. I could tell how sorry he was. He said one of the baby's feet was positioned so low that it would not budge, and was the reason the baby can't turn around. It has one leg fully extended, anchoring it in the breech position. I thanked the doctor for trying.

Then the room began to empty out, and after a few minutes it was just me and Ben in there, alone. And I was left with the reality that I will have to schedule a c-section in 2 weeks. And there went the rest of my plans. And so here we are, two days later. I am still working through my feelings.  Some people have said to me "Remember, the only thing that matters is a healthy baby." I get frustrated by this. I am this baby's mother... OF COURSE the most important thing to me is the health of my baby. But this baby is coming out of my body, and so my experience is inextricably linked to the way in which my baby is birthed. I have a vested interest in how this goes, and I deserve some time to grieve the loss of the experience that I hoped for. A c-section is not the end of the world, but it is also not a cut and dry experience. It is major abdominal surgery, and it is often a much more difficult recovery. And it means giving up certain things, like immediate skin to skin contact, and the ability to get up and move around after delivery. I don't need advice on the c-section, I just need some space to process my disappointment and the freedom to move forward at my own pace.

I am adjusting to the idea of it all. I am working on accepting it. I am learning that, despite how "ruined" my plans get I can trust that the Lord is good. He was with me during my diabetes test, calming my fears. He was with me that day my blood pressured soared. I felt his presence as I waited in fear of what would happen to my baby, and rejoiced that He protected us both. And He was with me on Friday, holding my hand and telling me I could withstand the ECV procedure. And He is with me right now as I write this, working out my feelings and comforting me in the loss of my dreams.

I can't wait to meet my baby. The one who has caused me all this trouble, but whom I love with my whole heart already! The one who daily reminds me, "Many are the plans in a [mother's] heart, but it is the Lord's purpose that prevails."