United Brachial Plexus Network, Inc.

Hey all! We my hubby and I started discussing about having another child I knew this was the place to go with my concerns. We have talked it over and over. On the what ifs?? We haven't made out set decision on to or not to have another. My biggest concern is a C-section. The doctors said it was going to be mandatory the next time. And so does my hubby. He has seen me get so upset with this injury he doesn't want to see it happen again. And neither do I. But I am so terrified of a section. The needles, the staples, the pain, needing everyone's help, the pain meds, etc. It is a bit overwhelming for me. I had both my sons natural and it is hard for me to grasp the idea of a section. That is major surgery and lots of pain. Am I right? With natural once the baby is born the pain is gone but with a section I imagine it hurts quite a bit. I am not a big fan of needles epically near my back, or taking any kind of meds. And codeine makes me crazy. I guess what I am looking for is personal experience. I have already had one bad experience and I don't want to have another. Please help. Thanks in advance for your help.

Ash mom to Brayden 5yrs GA

This is what I typically say to women. First off...you have to get informed which is what you are starting to do. Good for you.

Secondly...you need to have many conversations and ask lots of questions to your provider (and anesthesia department) if you are going to go ahead with a cesarean or while you are trying to make that decision.

Thirdly...if you do go ahead with a cesarean...ask anesthesia to give you a medication called Duramorph in your spinal for pain during and after your surgery. It works well for the majority of women. I am an RN who does L&D/mother/baby care and I take care of women who have c/s all the time. Those who have had Duramorph versus those who just had Fentanyl...well there is no comparison! Those with Duramorph are up walking around with much more ease that afternoon, are less groggy (because they are not requiring a morphine PCA for pain control), are less nauseas if nauseas at all, and are all around happier with the experience! Itching is something I see frequently, but itching versus pain...which would you rather have? And the itching can be dealt with.

Every person has different experiences with c/s. Some women jump right out of bed the first time as if they didn't just have surgery and others don't. What is your normal pain tolerance level? If it is high, then you'll probably tolerate pain afterwards well. You won't be left high and dry after surgery. This is what we do at my hospital for pain after a c/s. If you've had Duramorph, then you will get Ibuprofen (Motrin) every 6 hours on a regular basis for added pain relief. It helps with pain and inflammation. The Duramorph will be in your system for 16-24 hours giving you pain relief. If it wears off sooner, then we ask the doctor for something stronger (Norco). If you didn't have Duramorph, then you get a Morphine PCA (you push a button and get morhpine in an IV, but you can't get more than a certain amount as the machine is programmed to lock for a certain number of minutes after each dose...this way you cannot overdose) and Ibuprofen, then the next day you start on Ibuprofen and Norco for both situations (Norco is the same as Lortab or Vicodin but with less Tylenol in it, but it still has Hydrocodone in it which is not tylenol #3). This chain of events works very well for 99.9% of the patients I work with.

Not all doctors use staples. We only have one doctor that uses staples. The rest use stitches from inside out, including on the skin with steri-strips on the skin to reinforce the stitches on the skin. The stitches all dissolve. Nobody has had any problems and I've been doing this for YEARS! It's called subcuticular stitches. Ask about that because it pulls less and you won't have to have staples removed.

Needing help is normal. I suggest to all moms while preparing them for discharge to have family and friends wait on them at home. "Nobody can come through your front door unless they buy their way into your home" I tell them. Visitors must bring a casserole, do a load of laundry babysit the newborn at your own home for an hour so you can nap, etc. Needing extra help is ok. You won't need it for 6-8 weeks.

It can be a bit challenging in the first week or so, but you're in the hospital for the first 2-4 days depending on what you choose to stay for. Many of my patients ask to go home at 48 hours after a scheduled c/s where they didn't labor first. Especially if this isn't their first baby and they've breastfed before. Even if it is their first c/s for whatever reason (breech, previa).

Your fears are real, and you need to voice them. Relay them to your husband, doctor, and family. Get them validated, discussed, and find out if you can throw them in the trash or need them discussed further. I hope I've helped.

Best wishes in your decision to have another baby or not, and the manner in which to give birth.

Tanya in NY
Amber's Mom, ROBPI, 5 years old

Great advice from Tanya.

I would only add to make sure to ask/request your doctor to use a generously sized incision to get the baby out. There have been BPIs with c-sections and I think it can usually be traced to an incision that was really too small and still required a lot of manhandling of the baby to get it out. Doctors like to leave (and women like to have) a small-as-possible scar but in your case I would err on the side of larger just to be safe.

Kate

Thanks for your concern everyone. ME and my hubby have greatly discussed it. He is dead set on a c-section. But I do know that it is my decision and I will be asking all of those questions. You all brought up things that I hadn't even thought of. Now that I am a little better informed I can ask lots of questions. Thank you so much and anyone else feel free to give me more advice. All is welcome. It is a big decision and if you don't feel comfortable feel free to email me. I can use all the help I can get. I just knew there were some moms out there that have had a baby after the BPI baby.

Hello, My first child was born with LBPI. I have since had two other children via c-section (no injuries--thankfully). For me, there was no choice--I just did not want to experience any of the problems, anxiety and other issues associated with having another vaginal birth. There was no way I was going to put my future children at risk for a BPI knowing what had happened to my daughter. And my doctor was only going to feel comfortable with a c-section knowing what had happened during my first birthing experience ( I had a new doctor!) I realize that a c-section is MAJOR surgery--however, in my experience, it was completely different and way easier than natural childbirth. Now, I am not promoting c-secs over natural. But I was in more pain after my vaginal delivery (due to the extra stress, pulling, epesiotomy, etc.) than I ever felt during my c-sect. The sections are usually scheduled, less stressful, and an anestisiologist(sp.) is by your side the entire time during the surgery. I started feeling nauseaus at one point during the section and when I told him, it was taken care of immediately and within 2 minutes I was fine.
Also my doc used "glue" on the outside and dissolvable stitches on the inside to sew me up. The scar looks fine--and nobody but my husband would ever see it anyway! Post-op, I was in great shape--up and walking that evening. I had some gas pains, but rocking in a rocking chair or on the toilet really helped with that. I did not need any extra help afterwards--although I welcomed any! I actually needed more help after my vaginal birth.
I know not everyone feels the same about sections, but in my experience I would never have done it differently and it was a blessing for me and my two youngest children.

I just had my 2nd child almost 2 weeks ago by c/s. It wasn't nearly as bad as I thought. In fact, it wasn't that bad at all. It was a little scary going into it because you kind of feel out of control, but it was a much better experience than the 1st time around. Like Tanya mentioned, I had the duramorph in my spinal and I really felt no pain for the 1st 24 hours. I also had something in my IV that started with a T, I can't remember the name, but it was amazing too. It didn't really make me feel that tired or groggy even, just no pain! I was actually in more pain once I left the hospital, but that wasn't really that bad either.
You have to make the decision about whether or not having another child is right for you, but I wouldn't let the c/s scare you away. It wasn't that bad at all! And I'm only 2 weeks out, so I'm not even looking back on it and can't remember the pain. I was pleasantly surprised by how easy it was. If you want more details I'd be glad to share. Just email me your questions. shariwessels@sbcglobal.net Hope that helps.

Oh yeah...I have no staples either. Stitches inside that dissolve and glue on the outside. I agree w/ the others that it wasn't any more painful than vag. delivery b/c the vag delivery was so rough! I was sore for months actually after my 1st was born. The pain is just in a different place. There are also some things associated with the spinal that were kind of different. Like you have a catheter for a day or so and when they took mine out I had trouble being able to urinate on my own so I had to have another catheter put in the drain my bladder. But after a few hours I was fine. The nurse said sometimes it takes your bladder a little while to wake up from the anesthesia. Even that wasn't so bad. At the end of the day, having a healthy uninjured baby is worth a little extra pain anyway!

sorry...keep reading things and realizing I left things out. I did itch like Tanya mentioned, but they gave me some medicine for it that helped. My torso itched, but the worst was my nose. It itched like crazy!!! The medicine helped though.

Hi Ash,
I had two babies via vag birth. The second child has a BPI. I have gone on to have one other birth afterward and am currently expecting a fourth child.

My third birth ended up being a scheduled c-section. I initally cried for days over it (before hand that is) but in the end I would say it was a wonderful experience for me. It was way better than my other births. I even bonded faster to that baby than my first two.

The first two weeks of recovery were the hardest. But by 6 weeks things were back to normal in the recovery department.

My first bit of encouragement would be to consider a different doctor if you are still seeing the same one who delivered your child with BPI. A different doc might be more willing to let you attempt a vag birth but you really need to weigh the options. And I totally understand that because my doc wants me to consider a VBAC this time! Anywhoo!!!

I honestly don't recall a lot of pain unless I tried to do too much. And at first I was send home without a belly support wrap thing. That caused some issues to walk around without it since the hanging flesh didn't like the incision. In truth it felt a lot like I had a pubic hair caught in my zipper! LOL so funny to remember but painful at the time. So it hurt but not too bad. I torn really bad with my first and walking was painful for awhile. Actually I had the least pain issues with my child who has the BPI... he was more injured than I!

A c-section is major surgery which is something to consider. I know a lot of people on this board will tell you that you should just go straight to a c/s after a BPI birth but you really can consider a vag if that is what you perfer. But you need a confident doctor and a hubby that is willing to support you in that option.

So from my experience the c/s really was great. I was looking forward to it again this time around until my doc mentioned VBAC. And now I am considering it but I am not looking forward to it yet.

Oh yeah... I didn't have much more help after the c/s than I did my vag births. So that part was about the same I think.

Please let me know if I can help you further!

Blessings,
Kristie

my son Joseph has lbpi. I also suffered a severe pubic symphasis seperation injury. My husband and I thought we were done having children and were suprised to find out our third child was on his way. I have been in pain everyday for two years. We were very concerned about my injury as well as the potetial injury to our unborn baby. We opted for c section. Five weeks ago we welcomed our third son into the world via c section one week before my due date. He weighed in at 9lbs 7oz. We are glad we chose c section. I wonder how big he would have been if he was term. I was very nervous about having surgery. I had never had stitches before let alone surgery. All went well. I had 16 staples but that wasn't so bad. I was nervous about getting them out too but it was no big deal. The reccovery, though painful, was not nearly as bad as the recovery from the pubic separation.
Joseph's mama. 20 months lobpi