Just looking for "advice"

Hi,

I just thought I'd chime in with my thoughts on this--although I am not a medical professional. I had both a c section and a vaginal birth, pre any prolapses. But I much preferred my vaginal birth. I had a severe infection after the c section and had a much longer recovery time. Also, keep in mind when they do a c section, I believe they have to separate your bladder from your uterus and this is what can often cause bladder infections. So, I would think this could perhaps exacerbate any prolapse. My midwife told me of a study on families with prolapse and said there was no correlation between c section or vaginal birth with prolapse. The study was done among sisters, one with no children, one with a c section and one with vaginal birth. However, I don't know if a vaginal birth would worsten an existing prolapse. When I was preparing for my vaginal birth, the teacher of my birthing class said we should try to do passive pushing---letting the body do the pushing and not forcefully push out the baby ourselves. If you do go the vaginal route, I wonder if this would help prevent any worsening of a prolapse. It is also important to know what the optimal birthing postions are--ie. not flat on your back. I don't know if this helps you, but always wished I had had more information before I had my first c section. I'm sure Christine will have more specific information for you.

Pam

Dear Jennifer,

Read the Apr 27 post by Jon108 for the link to an article about c-section vs vag birth and prolapse. The studies are just beginning to be carried out on this.

In order for you to have a successful vaginal birth you must have a deep understanding of the issues and real confidence that you will prevail. You must also have the support of excellent birth attendants. All of what you describe with your previous vaginal birth sounds like the classic obstetric setting and it is no wonder that you prolapsed.

I guess the most important points in considering your present dilemma would be (1) That you would read enough and have support enough to go for a really successful VBAC. (2) That you would understand that your prolapse might indeed worsen, but that you would accept that and be open to working with it afterwards. (3) That your back specialist has told you that you can create a natural lumbar curve and all other elements of the posture even with the spinal rod. (4) That the rod would not interfere with the squatting and other intense pressures associated with natural childbirth.

I wish I had a solid yes or no for you, Jennifer. My best judgement is that if you do not have real and deep confidence in this as well as great support, you might instead be fearful and it might not be the experience you are hoping for. In that case, a c-section might be the best option.

I so hope Jane will join us here.

As always, wishing you well,

Christine

Jennifer,

Sorry I didn't know your whole background before I replied! You sound like you have done a lot of research on this already. I, too, think I pushed too hard during my labor and wish I had heeded my teacher's advice on the passive pushing... But I always wondered if my c section had anything to do with weakening any bonds since I didn't know they had to pull out the bladder to get to the uterus during the surgery. Anyway, I certainly wish you the best of luck no matter what you decide and a healthy baby too!

Pam

Thanks for your softer voice, Pam. Sometimes I sound like a Gestapo!

I haven't been able to get to the computer much lately, so I'm little late catching this post.

Jennifer,
I had a c/s in 2000 with my first child-- really for no reason. Neither baby or I was in danger, but my dr. was scheduled to be off at 7:00 pm and it was a quarter till 6:00 pm... hmmmm...

Anyway, afterward I did a ton research on vbac, interviewing caregivers, and ended up doing a homebirth with midwives (not CNM, real midwives) in 2002 because my local hosptial went to a NO vbac policy and I just knew that I could have a natural vaginal birth if I were given the right support. I birthed in a squatting postion and only a slight "skid mark" kind of a like a rug burn on a small part of the inside of my vagina (sorry if too much info)...anyway I had no damage to my perinum (no tear, no episiotomy) and I only pushed a little over an hour. However, it was after this that I noticed that I had prolapsed universally-- bladder, uterus, and rectum. I have not been diagnosed with a grade and I would say that all 3 are relatively mild and if I stayed like this rest of my life, I'd be happy.

I was petrified when I found I was pregnant this time around because I had finally begun to feel normal (a new normal). I am now 20 weeks along and I am more convinced than ever that vaginal birth is the way to go barring any emergency. I did not realize until I read my lab report that they peel the bladder back from the uterus-- moving it out of its natural position and then after the baby is delivered they "deliver" uterus out of the body to "examine" it abnormalitie-- moving it out its position. Adhesions can then form between the bladder and the uterus-- which I would think would make it more likely if one organ slipped out of the place, the other organ is essentially "glued" to it by scar and so it would pulled along. Just imagine all the fascia that has now lost its ability to move and flex. I really "blame" my c/s for setting for prolapse. And I know that women who have had only c/s births also can prolapse and I know women who have never even been pregnant prolapse. So...

I am planning another homebirth (this is soooo out of character for me--I thought homebirth only for irresponsible or uneducated, until I became really educated about birth). We will try to do a more passive second stage (baby's well-being will always be priority #1) and let the uterus do most of the work. I may also do hands and knees positioning this time. I'm thinking my organs will be over the pelvic bone and therefore protected from being "pushed out". I'm going to pray and research more. Christine your opinion is appreciated. I've not been able to get hands on the labor progress handbook yet.

I also feel that my body has already stretched once this way to birth so I am optimistic that the tissue will remember and stretch the same way this time and therefore I will not be any worse off after this time.

I also have plans in place to have lots of help after this birth. I didn't allow myself any recovery time after #2. I really feel it is imperative to take great care of the body after birth. RESTING RESTING RESTING. While the uterus returns to its normal size and position. Listening very carefully to my body. I am not planning on slinging laundry baskets up and down the steps until 6 weeks after birth or even using the vaccum (which was my orders after my c/s, anyway, but I thought a vaginal birth meant I could be super woman.) I am going to nurse my baby in bed during the first few days, lying on my stomach as much as possible as my pelvic floor heals and my uterus shinks. I'm looking carefully at Christine's exercises too for things to do religiously doing recovery. Then I'm going to practice the posture when I'm up walking, sitting or standing, contracting my pelivic floor as I change position.

After pregnancy the body has been through tremendous shape changes and it needs to be carefully nutured back to its prepregancy shape. Again, I'm going to praying, searching, and researching how best to care for my body-- as I am doing now for how to care for it during pregnancy.

Sorry I wrote a book. :)

Dear Jane,

Your response is like a beam of light. You just get it and I'm so happy that Jennifer, I and the others can benefit from your wisdom. The whole of this work truly does take us into the realm of life and death and calls on us to become more of ourselves than we ever knew possible. Thank you, Jane.

I believe your body, with the help of your midwives, will just know what is best at that moment. I will send you my copy of the labor progress handbook if you can't get ahold of one, as the information there is rich and important.

I now understand Kermit the Frog's lament..."It's not easy being green..." Sometimes I feel like I'm pushing a very large boulder uphill by myself and the help from you, Sybille, Chris and all the others is a blessed lifting of that weight.

Blessings, Jane

Christine

Tsk, tsk - pushing a boulder up hill? Haven't I taught you anything, Christine?

Bottomline - listen to your body and simply work with it. The Mayan massage seems to be the keynote help with this woman's body. On a nightly basis, that is part of my exercise routine. It seems to have helped more than I will probably ever know. At least I have become familiar with all the "valleys and hills" of my innards.

Sybille

I'm learning, Sybille!

I was thinking the massage might be theraputic for fibroids too...did you read or hear about that in any of their literature or from your therapist?

:-) Christine

Fibroids...those estrogen fed boogers can be a nuisance. Whether the massage therapy can be of any benefit, I honestly don't know. As of last year, my uterus was "small."

Here is my take on fibroids. They are estrogen fed and if growing, would indicate to me that the progesterone in a woman's body is not doing it's job and is being out run by the estrogen. That is why a woman, approaching menopause will actually feel her fibroids shrink as the estrogen declines. They just simply are not being fed.

One can purchase progesterone cream at a health food store, follow directions and see if that does not help in shrinking the fibroids. (Probably would help to get a blood workup to see what is going on with the estrogen vs. progesterone.) I work with a pharmacist(consultph.aol.com), who will listen and recommend an avenue tailored made for whoever he is consulting.

I knew I was estrogen dominant as I had all the classic symptoms, i.e., anxiety to the max, sore breasts, water retention on a monthly basis. Approaching menopause, I was in too much of a hurry to lower the estrogen or at least counterbalance it with progesterone, so for five years I applied progesterone cream. My mood stabilized and I no longer had sore breasts. Whether I had fibroids, I couldn't tell you. All I know is that I felt better all around and eventually my periods ceased when I was 55. I will, at times, even now, apply progesterone on my face; it feels so soft afterwards. I am not saying this is for everyone; I just attempted to reason on women, who still have their monthly periods, are prone to fibroids, really shouldn't be in a rush to get rid of them - especially if close to menopause. Progesterone also helped with the excessive bleeding that some women seem to go through.

The progesterone at the health food store is a bit benign. Even now, I do take biest, a combination of estrogen and progesterone from a compounding pharmacy, sublinqually, about three times a week. I just feel better and at age 58, I need all the help I can get. I refuse to take any laboratory created HRT (Premarin, etc).

That is my take on all of this and seems to work for me.

Sybille

Hi Sybille,

Yes, I too think women should leave their fibroids alone, however, a diet rich in estrogenic foods should help to displace some of the stronger estrogens from receptors. Here's how one of my favorite women's health writers, Nancy Lonsdorf, MD, responded when asked, is "natural" progesterone safe?

"Proponents of bioidentical progesterone downplay its risks, and I have yet to meet a woman taking it who did not assume that it was completely risk-free or even anti-carcinogenic. However, while bioidentical progesterone has been shown to protect against the uterine cancer-causing effects of estrogen when taken orally (as does Provera), it has NOT been shown to protect against the cancer-promoting effects of estrogen on the breast. Given recent findings that taking synthetic progestogens with estrogen for ten years doubles the risk of breast cancer over taking estrogen alone, we must assume until we see proof to the contrary that bioidentical progesterone carries a similar risk, whether taken as a capsule or as a cream rubbed into the skin."

Perhaps women with fibroids who are approaching menopause might try experimenting with pelvic massage, as it seems it could only help in dismantling the fibrotic tissue.

Christine

Hi Christine~

Just tossing ideas here. As far as I am concerned, all hormones are unsafe. I personally think, though, the timing of the use of these hormones may lessen their ability to promote life threatening illnesses.

Remember the wife of a Beatle (can't remember her name?) She succumbed to breast cancer and was an enthusiastic proponent of soy. (Most breast cancers are estrogen receptive) My personal opinion (not knowing the facts or her medical history)suggests to me that she overdosed on estrogen from the soy and other "natural" estrogen through food products and even tea. Did she have an intact uterus? Was she still having her periods? I don't know those answers.

When I had my periods I stayed away from anything that remotely suggested I would be putting extra estrogen into my body - safe or not safe. When my periods became irregular, that is when I took the progerstone for the next five years. (and largely due for the other symptoms) Irregular periods, to me, with all the other side effects, indicated more estrogen then progesterone. Why would I want to add insult to injury by consuming "safe" estrogen through food products? I couldn't see doing that. As far as my mind set went, I had to "neutralize" the estrogen that seemed to be the dominant hormone in my body. To me, it makes perfect sense. To a professional in the medical field, it may come across as playing Russian Roulette with hormones.

Again - I am not advocating any medication (hormones) to help women get over the hump of coming into the most exciting part of their life, which I liken to the Spring of one's Autumn years. It is Spring in that it is a rebirth on a well seasoned artist's canvas (life), whose Autumn colors are young and vibrant in brilliance.

Sybille

Hi Sybille,

There's a fair amount of research that suggests, rather than adding to the total amount of estrogen in the body, phytoestrogens (like parsley, garlic, carrots, alfalfa sprouts and beans) compete with the stronger forms for placement on estrogen receptors. I'm not a big consumer of soy and I don't think soy played a big part in Linda McCartney's cookbooks either. Rather, she included a ton of dairy and also lived in a part of the world that was heavily contaminated by Chernobyl. ???

:-) Christine