Musings of a Marfan Mom

June 7, 2010
by marfmom
15 Comments

To VBAC or Not to VBAC?

Let me start this post off by saying if you’re in any way related to me or in any way unreasonably freaked out about me having a baby, just skip this post please. I’m going to discuss my personal risks and benefits for having a VBAC (vaginal birth after a cesarean) vs a 2nd cesarean section.

Possible risks of a VBAC:
organ prolapse
spinal headache from the epidural
epidural not working –> causing blood pressure problems
aortic dissection (1-2% risk)
uterine rupture (aprox. 2% risk but no data on Marfan patients so may be a bit higher)

Possible risks of a c-section:
organ prolapse
spinal headache from the epidural (I do not want to be put under again)
epidural not working –> needing general anesthesia
blood pressure complications (like last time)
aortic dissection (1-2% risk)
uterine rupture
scarring problems, including intestinal adhesions (which I have a history of)

Benefits of a VBAC:
get to experience labor
be present for the entire birthing process
have the opportunity to watch my child being born (yes, I want the mirror)
hear the first cries
be able to hold my child right after s/he is born
be able to breastfeed immediately
won’t need narcotic pain medications for as long
be able to walk a lot earlier than with a c-section

Benefits of a c-section:
ummm…I won’t have to worry about tearing I suppose.

Again, this is MY personal risk/benefit list. Many of these risks are universal, Marfan or not, but if my aorta were 4 cm or larger than a c-section would be a safer route. As I’ve written before, the literature says that for women with Marfan and an aorta of less than 4 cm, vaginal births with an epidural are recommended. I make my list because according to Drs. Reed Pyeritz and David Liang, there are no research papers on VBACs in Marfan syndrome (VBACs are not recommended for women with Loeys-Dietz syndrome due to the increased risk of uterine rupture that the syndrome presents).

Although my risks are somewhat similar between procedures (it’s hard to assign percentages of risks to someone with Marfan because of the dearth of research, but the blood pressure risks should be less with the VBAC if the epidural works), the benefits of a VBAC blow a c-section out of the water. I made the best decision I could at the time when it came to Menininho’s birth, but I still feel sad that I missed out on so much of his first day on this earth. I’m going to do everything possible to make sure that doesn’t happen again. I never again want to tell my baby that I don’t know what happened to him in the hours after he was born; I want to be able to say that he was with me.

My decision is to VBAC.

Post edit: I should clarify that I recognize there are a whole lot of reasons why I may end up with a c-section: my aorta could grow, I could have a prolapse in pregnancy, I could develop pre-eclampsia (again?) that would necessitate an early and quick delivery, baby could be breech, etc. And if any of those happens and a c-section really is necessary, I am ok with that. It won’t be fun being cut again, but I know the circumstances will be out of my control and what matters most is a healthy baby. But if the choice really is up to me, and I can have either delivery option work out, then I choose VBAC and the above is why. 🙂

June 4, 2010
by marfmom
8 Comments

Friday Favorites

For those of you new to my blog, every Friday (ok, most) I post links to some posts that I’ve enjoyed reading over the week and encourage all of you to do the same and link up here.

I’ve read Mom 101 for quite awhile, but her post A rivederci, Gino really spoke to me. It’s a beautiful tribute to Gino’s Restaurant, an establishment that shaped her formative years, especially her relationship with her grandfather. It closed last month after 65 years. Check out the entry; it’ll tug your heartstrings.

I just came across Wood Turtle’s blog and will be reading much more frequently now! Wood Turtle writes about islam and feminism. I was introduced to her via her post MILFing it for all its worth. She discusses being sexually harassed by a teenage boy while running in a park and how the incident was kind of turned around on her and what that means about society as a whole. Really fascinating and I definitely agree with her! As the mother of a son, I feel it’s my responsibility to raise him to treat women (and men) with the respect they deserve and not allow him to think that actions like grabbing a woman’s rear end is in any way appropriate.

June 3, 2010
by marfmom
13 Comments

Losing My Writing

This week I’m writing on Mama Kat’s Writers’ Workshop Prompt #2: What did you once lose? Describe your search to find it again.

In my soul, I am a writer. I don’t profess to be excellent or even average, but I’ve always had a deep need to put pen to paper.

I started keeping journals in kindergarten and writing short stories soon after. My passion for the written word was something that others seemed to recognize about me. When I started at a small private school in 4th grade, I was told about a statewide writing competition called Power of the Pen, which was for 7th and 8th grade students. My teachers began to groom me for the time when I would be able to compete. I couldn’t practice with the team but I was given books of past winners’ essays and access to the current prompts so that I could practice on my own. I was thrilled when I was old enough to be an official member!

My school had a track record for producing medal winners, and the expectations for me were high. I was pleased to be a part of a team and have something I excelled at, especially as sports were not an option for me given my health. My first year I did alright but didn’t make it past the regional competition and never medaled. That was ok though; I had a year left.

I felt the pressure was on in 8th grade. I narrowly missed a medal in district competition (top 12 received medals and I placed 13th) and again at regionals (15th). Heartbroken I assumed that my days of Power of the Pen were over, but a few weeks later I received word that I had made it to the State competition! However, because I had performed so “poorly” in the past, my principal and coach decided that my coach would not be accompanying me to the tournament, even though it was being held less than a 5 minute drive from our school. My friend’s mother, another teacher at our school, ended up taking the day off to go with me. When I barely missed a spot in the finals I was disappointed but felt I had still done a good job.

My principal felt otherwise. She instructed that no mention of the competition be made to the rest of the school and that it otherwise not be acknowledged. I didn’t deserve any recognition because I had failed the school by never medaling (no one else on the team did either, or place as high as me). My friend’s mother bought me a beautiful commemorative mug and she, my mom (another teacher at the school) and a few students still found a way to mention it on the school radio station my mom helped run, but I was devastated. I felt I had truly let down my school and that I wasn’t a real writer.

I lost my ability to write after that. Whereas the words used to come easily, I lost all the stories in my head. A creative writing class I tried in high school left me in tears each night as I struggled to come up with pieces to write about and the self-doubt as to my abilities. Except for private journaling and research papers for school, I never wrote again, though I always ached to be able to.

Then, last summer, I was asked to speak at the National Marfan Foundation’s annual conference about my personal journey with Marfan syndrome. I was keeping a family blog at the time, just general life updates and pictures of my newborn son. I decided that I’d write a 4 part series about my story and post it in order to get the juices flowing and figure out what to use in my speech. To my shock, people responded to what I wrote! My brother, who already had a successful blog, encouraged me to revamp my site into a place to write about Marfan and my life as a mom, and Musings of a Marfan Mom was born.

It took about 10 years, but I was able to reclaim the part of me that was able to write. I relish the evenings after Menininho goes to bed, where I can turn on the TV, curl up on my bed with my laptop, and write the next day’s blog post. I’m flattered that anyone takes the time to read what I write, but now I know that even if my readership dwindles to 0 tomorrow I am and will always be a writer, and I won’t lose that knowledge again.