Last year, at 37 1/2 weeks pregnant, I had what would be my second-to-last prenatal appointment. I didn’t know it then, but I would later revisit this day and the subsequent decision I made with much regret.
A little back story: When we were interviewing midwives, I expressed my desire to have as little medical intervention during the pregnancy as possible, which included my wish to avoid unnecessary ultrasounds. My midwives (M & C) agreed, noting that they may recommend one toward the end of the pregnancy to determine fetal position if the external manual examination was uncertain.* They noted that this was rare, although throughout the course of the pregnancy, they commented that my [apparently] uber-tight abdominal muscles made it difficult to determine what was where, baby-part-wise.
Anyhow, somewhere around the beginning of the third trimester, M, the midwife I saw for most of my prenatal appointments indicated that baby was head down, just like he/she should be.
And then came the visit at 37 1/2 weeks, and M said that she was uncertain of baby’s position. She went as far as doing a vaginal exam, trying to feel for some prominent part of the skull. When that was also inconclusive, we talked about the possibility of an ultrasound.
Since I wasn’t seeing an OB or working within the traditional medical system, it wasn’t as simple as having the doctor order one, and it wouldn’t be covered by insurance. M gave me a brochure of an independent company that works with midwifery clients who want ultrasounds (I believe this is the place).
As was the case with most of my prenatal care (and as was my wish), M left the decision on the ultrasound up to me, saying I could take a wait-and-see approach, continuing the basic “optimal fetal positioning” exercises and assuming that the baby was already head-down.
I left the appointment feeling disoriented and uncertain. It was one of the few appointments that Matthew didn’t attend with me, and getting and processing the news on my own didn’t help (though I called him immediately after). Two-and-a-half weeks until my due date, and we think the baby is head-down? I wanted to believe that all was right, but . . .
Later that day, I contacted the ultrasound place. They were very accommodating and informed me that I could get a quick, basic 2D ultrasound (plenty of information for determining fetal position) for sixty dollars, and for just a quick peek (and understanding that I was near the end of the pregnancy), they could work me in almost any time.
I said I was still deciding and I would call back if I wanted to make an appointment. I didn’t call back.
A week-and-a -half later, my water broke. Twenty-four hours after that, after transferring to the hospital due to an irregular fetal heart beat, I had that ultrasound. It showed that baby was breech, and over the following twelve hours, I watched my careful plans and preparations for a natural home birth turn into my worst fear: a Cesarean section.
So here’s the thing: if I’d known the baby was breech before I was actually IN labor, we could have tried a variety of methods to turn him. And I could have had that information.
A relatively small step (sixty dollars and less than two hours of my time), could have resulted in a dramatically different outcome and a birth experience that was inline with my hopes. Nearly a year later, I can’t stop ruminating on the what-ifs, even though I know it’s not healthy.
Looking back, I wondered what I was thinking, not scheduling the ultrasound immediately after the uncertain prenatal visit. Was I being excessively frugal? Just lazy?
After more time to reflect, I believe it was a combination of factors. One, I trusted M & C; I guess I thought that if they were REALLY worried that the baby was breech, they would strongly advise the ultrasound, rather than handing me a brochure and leaving it up to me. Two, I wanted to believe that all was well — overall, I’d had a very easy pregnancy and I’d stayed relatively active and done all the things that should have allowed the baby to assume a head-down position (less than 4% of health, full-term babies are breech). Three, I was tired — between work, last-minute baby preparations, and just living life, we were pretty busy in those last few weeks, and I wasn’t feeling the greatest.
Legitimate reasons or no, at the end of the day, I have to live with the consequences and the what-ifs of my decision, and for the past eleven months, that has been a hard place to be.
*Not their real initials