A Prayer Request for Our Little Guy's Heart and Birth

This picture captures the moment that most stands out in my mind when I think about Makayla’s birth.  It was so awesome.  She was born gently in a birthing tub, in our home, with Eric and the big girls there with me (along with my midwife, assistant, doula, and two dear friends helping to look after the girls and take photographs.)  I have never felt so surrounded by love and have never experienced so much love for all the people around me, as I did in that moment.  Being in labor and giving birth is, by far, my favorite thing to do.  I often tell people, in complete honesty, that if I could wake up and birth every single day, I would.  Really, seriously, I would.  I have no idea what I’d do with all those babies…but I love bringing new life from my body just that much.

While all three births have been great experiences and completely unmedicated and intervention-free, Makayla’s was definitely my favorite birth.  Being at home where I could curl up in my own bed with my baby and no one coming in every time I doze off to take my vitals or ask to mess with my baby was fabulous!  And I have SO been looking forward to that calm, safe beginning again for my baby, myself, and my family.  (Both Gabriela and Lilian have such good thoughts and memories from the day Makayla was born! And I think Eric liked leaving all the running around and getting somewhere to everyone else this time.)

When I had some bleeding at 19 weeks with this pregnancy and we discovered, through ultrasound, that my placenta was positioned over the cervix, I wasn't overly concerned.  Somewhere around 15% of pregnancies have some degree of placenta previa at 20 weeks.  That drops to less than 1% by full term.  The placenta pretty much always migrates up as the uterus expands.  I've taken several steps as prescribed by my Traditional Chinese Medicine Practitioner (Western medicine says there is nothing to be done but wait and see) to help ensure it moves (herbs, acupuncture, diet changes, plenty of rest, and yoga), and I've been sure it would do just that.

So at 34 weeks when we went back in to check on the position of the placenta, I was both shocked and disappointed that it was still just barely covering the entire cervix.  You can’t too very well have the placenta (baby’s life-line) come out before baby.  And so the safest way for baby to be born with a complete previa is via Cesarean birth before you go into labor on your own.  The placenta still could move, and we would certainly look at it again before anyone starts slicing me open, but the likelihood of that happening is declining.

The other piece of news we received last Thursday, at that 34 week appointment, was that our little guy has Tetrology of Fallot.  It is a congenital heart defect consisting of 1. ventricular septal defect (for him, a  large hole in his heart between the ventricles), 2. overriding aorta (the main artery in a less than optimal position), and 3. pulmonary stenosis (in his case, this seems to be very a very mild narrowing of the right ventricle outflow tract.)  It will basically cause some blood to bypass the lungs and mix with the oxygenated blood being transported through his body, reducing his oxygen levels.  While this doesn't generally pose a risk to newborns, which have relatively low oxygen needs, as he grows and becomes more active, it is a serious problem.  The expectation is that he will require open heart surgery around 4-6 months to correct the malformations and afterwards he would be expected to lead a normal life with little-no restrictions.

That second piece of news complicates the first though.  OBs recommend a c-section at 36 weeks with complete placenta previa to minimize the risk of the cervix opening underneath the placenta and causing a major hemorrhage.  (Side note: Given that none of our babies have come before 40 weeks, we aren't comfortable with and would not consent to extracting this kid 1+ month early, regardless of the recommendation.)  Meanwhile, under normal pregnancy conditions, the pediatric cardiologist would prefer a spontaneous vaginal birth so that baby gets the strongest, largest start and doesn't have the breathing difficulties that so much more often accompany a non-labor Cesearean and/or pre-term babies.  Ultimately, since we’re the ones with the most at stake here, Eric and I have to look at all the evidence and decide where our comfort level is and at what point we feel the risks/benefits are most balanced. 

The big picture: the prognosis of placenta previa and Tetralogy of Fallot are both good in this day and age.  While both would have most likely lead to death of baby (the heart condition not right away, but eventually) and quite possibly mother 200 years ago, current medical technology has lessened the risks considerably.  

But the thought of my baby coming to me through major abdominal surgery (not to mention recovering from said surgery with four children 5 and under) is hard to wrap my mind around.  And then throw in open heart surgery with a 7-14 day hospital stay for my infant son and it all seems a little overwhelming. 

The reality check: I know other people suffer with much more.  I have friends dealing with infertility who would LOVE to be told, “you will have a baby, but he will need to be born via c-section.”  I have friends and family who have received terminal diagnoses and lost babies and others with children who will have life-long challenges and limitations, and “we’ll do a surgery at 4-6 months and after that all should be fine” would be the best news of their life.  And I do feel selfish and ungrateful at times to sit with the feelings that I have surrounding my situation.  But I also accept my emotions while praying for strength and serenity in all things.

I am incredibly thankful for the life I have, for the children God has entrusted in my care, for easy and uneventful previous births, and for this sweet little boy who will soon join our crazy family on the outside world.  We will handle whatever comes our way.  But I would be ecstatic if this placenta would slide a few inches up and over to open the path for baby.  And if God would see fit to stitch up our little one’s heart on His own, I can think of no greater miracle in my life.  I know He is in control.  He will give me, Eric, and the girls the strength to do what needs to be done.  And I know He answers prayers.  So if you would like to join me and my family in praying for this little guy and his birth, we would be most appreciative.

We have an appointment tomorrow afternoon with an obstetrician to start talking about the birth plans.  I'll update soon with more information.