So I have some news....I'm pregnant!
Even with the prospect of a c-section looming in my future, I decided not to stress. "This is a really uncommon birth scenario," I told myself, and considering my daughter came at 41.5 weeks, I figured my uterus still had plenty of growing to do in the following weeks and that my placenta would likely grow to be free and clear from the cervical opening in the next month or two. So I refocused my hopes on a homebirth or at least an unmedicated, natural birth at the birth center in Seoul.
At 31.5 weeks, however, I woke up with heavy spotting. Knowing the risk of placenta abruption, I knew I needed to be seen as soon as possible. The scary part is we didn't really have a plan or a 'go bag' packed. After a bit of head scratching and scrambling around, I assured Jonathan I could drive myself to Seoul (1-2 hrs away) and that he should go on to work and that everything was fine. I had Jonathan take a quick (potentially final) pregnancy pic, packed a overnight bag for Lucy, and dropped her off at a friend's house on my way to Seoul.
"Quick take my picture, even though I might be hemorrhaging internally." Brilliant.
About halfway to the birth center I realized how dumb I was to drive myself. What if it really was an abruption!?! Praise God the ultrasound showed it wasn't and that everything was fine with baby. It also showed that I still had complete previa; in fact, the placenta was a good 2cms past the cervical opening and would have to do a substantial amount of growing to avoid a c-section. My OB still said we would wait until 35 weeks to make any decisions and I was sent home.
That night I began working on our contingency plans if something happened again before 35 weeks. My head was spinning with possible scenarios and the reality of how limited my birthing options are here in Korea. The closest Korean hospital (covered by insurance) that an ambulance would take me to is still 45 mins away, the Army hospital and my birth center are 1-2 hours away up in Seoul, etc. And then there was the reality of possible complications from abruption or even planned c-section--blood transfusion, hysterectomy, death. I was mentally and emotionally exhausted by the 'coordinating' aka scenario building.
The next day, I still had spotting but it was old blood, nothing fresh, so I wasn't alarmed. That afternoon, however, I started having regular contractions, lower back ache and cramping. I decided this was a good time to go up to the Army hospital in Seoul and get a second opinion and ask detailed questions to the English-speaking staff. Again, the ultrasound showed everything was fine and I was sent home. (As a side note, the Army hospital ultrasound measurements showed a "MEGA baby--97th percentile in size--we should move your due date by 2 weeks--5lbs 4 ozs--blah blah blah," which means either the baby had an AMAZING growth spurt from the day before when he/she was measuring at 4lbs 12 ozs at the birth center OR ultrasound measurements may not be completely reliable...hmmm)
So after A LOT of back and forth and strategizing, Jonathan and I have settled on a planned cesarean at the Army Hospital, most likely at 37 weeks and 2 days on May6th (could still change). The biggest factors being that it will be free, the staff is experienced with c-sections, they speak English, and the hospital seems more supportive of breastfeeding and do not have the mandatory separation time for 'observation' that many of the Korean hospitals maintain, and the doctor was very supportive of my birth plan.
I met last week as a normal, non-emergent OB appointment with a doctor at the Army hospital, and it couldn't have gone better. My doctor took a very long time to sit down and discuss in detail all of my options, my birth plan, the dangers, and even the possibility of placental movement in next few weeks--yes, she entertained my hope that a natural birth might still be possible if the placenta miraculously moved. We will see next Friday, when I have my 35 week ultrasound. That's when the final decision to schedule a c-section will be made. I still have a final consult at the birth center as well (where we pay out of pocket due to insurance) the same day...just in case things have changed. I will keep you posted.
In the mean time, I covet everyone's prayers. I've already felt a great sense of comfort during this trying time and I'm confident it is a direct answer to prayer. The biggest thing to pray for right now is for no new bleeding between now and the pending surgery. If new bleeding occurs, I will be calling for an ambulance and going to Dankook, which is the local Korean hospital with a NICU. Also, the dangers of abruption are still present. A planned c-section is dangerous for me, but mostly safe for baby. An emergency c-section due to abruption, however, is dangerous for both of us, and both baby and I could lose a catastrophic amount of blood between here and the hospital 45 minutes away. Pray for a safe SCHEDULED surgery and limited blood loss for me and safety for baby. Since I have an anterior placenta, the surgeons will actually have to cut THROUGH my placenta. That's not good, nor is it routine and the risk of blood loss is much higher for me. Baby again, should be fine and will be removed quickly, but the docs will have to work quickly afterwards to manage my blood loss. You can also pray that the placenta moves--doctor said it is more likely for placenta to move enough to attempt a vaginal birth than it is for placenta to move out of way of incision site. Honestly, I'm not sure I want the placenta to move enough to allow the option of natural birth any more. Even then the placenta will be close enough to cervical opening that abruption could occur and same dangers are present, except I wouldn't already be prepped for OR. I'd prefer a planned c/s over an emergency c/s any day, and I really hate the idea that I might have to make a decision that would endanger my baby over a 'safer' option of c-section. In that sense, I'm okay with having my cards dealt to me and moving on with the current plan. Also, just pray for comfort for me and Jonathan. We've had a lot to process and still have a lot to process and it's honestly a little scary when I actually stop to think about it. And just as a request, please don't ask me how I'm doing. That's really a hard question right now. I'm fine. If I wasn't I'd be in an emergency room or OR at the moment, but feeling fine right now doesn't really have any relevance to how dangerous my pregnancy or current condition really are, so I don't have a simple answer for that question, especially since this is my attempt to 'summarize' what's going on. Soooo....a week and a half until my next appointment. No news is good news until then.