Having a Bicornuate Uterus

I have a Bicornuate Uterus. What the heck does that mean? Well I will tell you. Where a “normal” uterus is sort of shaped like an upside down pear, a bicornuate uterus is more heart shaped, in that it has two sides of it. Heartshaped is a very nice way of putting it, as if you look at the image on the Wikipedia page it is not quite as romantic looking as “heart shaped” sounds!

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VBAC or Elective C?

I had my first midwife appointment today and she asked how I felt about this question, and I can’t say I haven’t thought about it a lot, but I am nowhere near reaching a decision!

VBAC (Vaginal Birth After Caesarean) or an Elective C-Section?

During my previous pregnancy I had high hopes of a natural delivery, hopefully including a water birth. Because of my SPD I felt this would be the best route as the water should help support my pelvis and limit at least some of the pain! I was quite open regarding pain relief and figured that as I had no idea how labour felt, or how I would react to that pain that the best approach was to see how it went and make decisions at the time.

Then, Monkey was Breech. After lots of attempts to turn him, ranging from being advised to ‘visualise the baby turning’ which hubby helped with by turning himself around in bed (lol, which was hilarious, and ridiculous, but sadly DIDN’T help!) to having a consultant attempt to forcibly turn him in the womb via an ECV. That was seriously painful and not an experience I’d care to repeat! It obviously comes with some risks too.

So as he refused point blank to turn around it was recommended that we have a C Section. I hate the word elective as it feels like somehow you are choosing that option, for no other reason than you want one. What they mean is ‘planned’ rather than ‘emergency’ so I wish they’d just use the word planned! Anyway, digressing, I know it is possible to deliver a breech baby naturally however I did do a lot of research and found evidence to suggest that since C-Sections have become the more popular option in breech cases, that the skill level required to deliver a breech baby naturally isn’t found as commonly in hospitals anymore. While you may be lucky and have a midwife who has delivered breech babies, and knows exactly how best to do it, you may also have a midwife who has never delivered a breech baby before, as they are more commonly born via C-section. This means that the risks of a natural breech birth are now actually higher than the risks of having a C Section. (That is how I interpreted the research and advice I received at the time – I am not a midwife, doctor or scientist and it may not be correct, all I can do is say how we made our decision.)

So we opted for a C-section. Now, it turns out that I have a Bicornuate Uterus (sort of heart shaped rather than round) and Monkey had no chance in turning round, because he was stuck in one side and could not turn. The consultant advised that there is basically a 50/50 chance that any future pregnancy would also be breech, which would mean there isn’t much of a decision to make and we would go for a C-Section again without question.

But the question is, what would I do if the baby is not breech. Would I go down the road I know and have a C-Section regardless? Plan it in and eliminate all doubt? Or do I think back to my original hopes for my previous pregnancy and aim for a natural water birth?

Now, don’t get me wrong, I don’t relish the thought of going under the knife again. I would much rather not have the post surgery recovery time, the agony of life that is post C-Section, when you realise more than ever before how important your stomach muscles are and how debilitating it is when moving them causes you agony! I don’t want to be in hospital for days post birth again, being kept awake by all of the other babies on the ward, in addition to my own, struggling to care for baby in those hours overnight when hubby has to go home and I can barely move. That I am NOT looking forward to should I choose that route.

BUT, and it is a big but, the birth itself was calm and relatively stress free.We knew the day, I went to a wedding the day before, knowing the next day I would have my baby. We checked in and were second on the list so Monkey was born by 10am. there was no pain pre-birth, it all ran very smoothly and was just lovely and calm.

I am a planner so for me the unknown elements of giving birth have always terrified me somewhat. When will it happen? Will I go to hospital too early and be sent home? Will I leave it too late and not get there in time? How bad will the pain be? How will I cope? (I’ve watched one born and I know some women cope better with the pain than others – not criticising, we are all built differently and can’t compare, it’s just hard not knowing how it will be for me.) Will I need an epidural? What if something goes wrong? What if I need an assisted delivery? What if I need an emergency C-Section anyway and still have all the negatives of a C-Section, without the benefits of the calm build up?

Add to this the SPD, I know women with SPD give birth naturally all the time but there are added complications and there are fewer recommended positions, for example being on your knees is recommended far and away above lying on a bed with your legs in stirrups.

Am I just nervous? Is that why I am hesitating? Am I a coward for wanting to go down the ‘known’ route of a planned C-Section? Am I less of a woman if I never go through the experience of a natural birth? Am I missing out? But then should I take the option of a natural birth (which comes with it’s own risks as well after a C-Section, including tearing the uterus scar) purely to avoid these opinions? Should I be swayed by such negative thoughts?

I am not going to rush the decision as I am well and truly divided over which I would prefer. I may end up having very little choice anyway if this baby is breech too, so in some ways I don’t want to get my hopes up for a natural birth. I am being referred to the VBaC Clinic, where they will hopefully be able to give me some further advice and help me to make an informed decision.

have you had any experience of this decision? Which way did you go?

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Remembering my first pregnancy and struggling with SPD

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Approx. 8 months pregnant

As I mentioned in my previous blog post, we are starting to think about having another baby. This has got me thinking about pregnancy and taken me on a little trip down memory lane to what my first pregnancy was like. Before I got pregnant I have to admit that I was a bit judgemental about women who had difficult pregnancies and thought seriously how hard can it be? One of my best friends had such a smooth pregnancy and I naively thought that every pregnancy was the same and that it was a lovely happy healthy time where women bloom.

Then I got pregnant, and oh how wrong I was and how I regretted being so judgemental in the past!

It was difficult from the off as I had really terrible morning sickness (more like all day, every day sickness) and just crippling exhaustion that made me feel like the living dead. I was useless at work (not great when you have just been promoted) and had so much time off sick. I also had to stop driving after a while as  this zombie-ness really made me feel unsafe on the roads, and after a few too-near misses I eventually stopped driving (and I love driving so I just wasn’t myself at all). This led to me feeling very depressed and in the end I was signed off work until my maternity leave began. I was already planning to leave at the very earliest point you can take maternity leave, but I finished a few weeks before that in the end as I was seriously struggling to cope.

As I started to feel a little less exhausted and sick, the slight nagging pain in my pelvis that I had ignored started to get steadily worse. I was diagnosed with SPD (Symphysis Pubis Dysfunction), which is due to the pregnancy hormone Relaxin. This is supposed to help your bones and ligaments make room for the baby, but unfortunately in some of us, this hormone causes our pelvis to relax too much, causing a lot of pain as the join at the front of your pelvis (the symphysis pubis) pulls too far apart. I saw a physio who told me to keep my knees together at all times during my pregnancy, and she even suggested I tie my knees together overnight so they didn’t come apart while I slept. Climbing stairs was a nightmare and soon just walking was agony, even at snail speed so I ended up on crutches. I wasn’t even allowed to go swimming as my pelvis was too unstable.

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Monkey trying to get out the wrong way! Two days before birth

The other issue we had is that apparently I have a bicornuate uterus, which basically means I have a sort of heart shaped uterus and makes a breech birth much more likely. We didn’t know this at the time and did all sorts to try and turn Monkey (including the doctors trying to forcibly turn him, which we couldn’t possibly know would never work as he was stuck in one side of my uterus). So all plans of a nice water birth went out the window and we had a caesarean, which is how they saw that I have a bicornuate uterus.

Of course I know that in many ways we were very lucky, Monkey had no problems at all, and there was no scary risk factors in terms of either his life or mine and of course I would rather feel some discomfort than have any more serious problems. But from start to finish, it wasn’t great. I can truly say I never got the pregnancy glow that people talk about and I’m not looking forward to going through it again. Hopefully the nausea and exhaustion won’t be as bad next time. I won’t be working silly hours in a stressful job so I definitely have an advantage there. Plus that kind of thing can vary a lot from pregnancy to pregnancy so fingers crossed I won’t feel so bad second time round. Because of my strange uterus I have a 50/50 chance of another breech baby, which would definitely mean another caesarean, so we will just have to wait and see with that one and I guess what will be will be.

On crutches at a wedding - look at the size of me!

On crutches at a wedding – look at the size of me – approx 8 months pregnant.

But the SPD, by all accounts is likely to reappear. I have heard that not everyone gets it again, but in most cases if you have had it once you are apparently likely to get it again, with the symptoms appearing sooner and progressing faster, so I have that to look forward to! I still get the odd twinge every month before my period so I have to prepare myself for the worst I think (then I may get pleasantly surprised, who knows?), but  I am doing everything I can to try and prepare for it though. I was a bit overweight before I even got pregnant last time, which can’t have helped, so I have been steadily trying to get healthy before we start trying again. I am quite a bit lighter than I was last time so hopefully that will help by putting less pressure on my pelvis.

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My exercises, stuck on the wardrobe to make sure I do them!

I also know the exercises I need to do to strengthen the muscles supporting my pelvis (the transverse abdominus and pelvic floor) and my new year’s resolution is to start doing these exercises every day so that I am in the best shape possible before I even get pregnant to at least try and limit the damage! I will also know what it is next time, so unlike last time where I ignored it for a while, and then tried to push through the pain and carry on as normal (apparently completely the wrong thing to do!) I will listen to my body and take it easy when I need to. Even though I will hate to do it!

I am worried about what all this will mean for Monkey, as he is such an active child and loves going for walks or running about, and I love doing those things with him. My best Christmas present is a nice pair of winter boots to keep my feet warm as we spend so much time outdoors! How is that going to work if I end up on crutches again? How will I keep him safe if I can’t run after him should he make a dash near a road? He is pretty good but you can never be too careful. If I have to stop driving again because I don’t feel safe how will we get to baby groups and go on play-dates?

Both sets of grandparents have already offered their assistance and I know will help out as much as they can. Hubby has also said that he will work from home more if he needs to so that he can help out. But I know that no matter how much help I get, I will struggle with the fact that I am not able to be the mummy I want to be, even if only for a few short months.

But needs must, and it was worth all of the hardships last time to have such a gorgeous little man at the end of it, and I’m sure it will be worth it to have another gorgeous little baba in my arms one day. Fingers crossed that all goes as well as can be hoped for!

 

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