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Delivering A Baby (c-sections, Water Births, Etc.)


katherinel

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Hi All!

I am pretty new to the DINET Forums. But one of the reasons I joined is because I have fears about having children someday, and I would like to talk to other people who have POTS about it.

One of the things I have really thought about is delivering a baby by having a water birth. Dr. Grubb told me that swimming is one of the best exercises for people with POTS because of the effects of the water pressure on your body. It seems from what I have heard that water births are a lot less strenuous on the body than a regular birth.

I have also heard a number of people with POTS have had C-Sections. This would be preferable for me over a natural birth. I know my blood pressure really plummets when I am in pain, and I worry that I would start passing out with the contractions. But from what I understand you can't just ask for a C-Section...

Does anybody have any thoughts on this particular topic? I would love to hear it if you do.

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A c-section can be asked for actually--in that, this would be something to discuss with your dr. Women with certain health problems, previous c-sections, etc. are actually scheduled for c-sections rather than even go into labor. But it has it's own risks for the mother and child. So, you would need to discuss with your doctor(s) about the best approach for you.

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I think with the right wording, a doctor can make the insurance believe that a C-section is necessary. Pushing is very similar to the valsalva maneuver - which can make some POTS patients pass out. I can't imagine fainting during labor is good.

Personally, I have been told by my orthopedist that I have to have a C-section, as my hips dislocate randomly. I can't imagine trying to push out a baby, passing out randomly (with massive tachycardia) and a dislocated hip. ;)

Sara

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I had a baby 4 years ago and went through labor and delivery as naturally as possible. Just a few days ago I had a baby, but had to have a c-section (for reasons other than POTS). I'd be happy to share about my experiences with both. I can't do so at the moment, though. I'm still very tired and recovering, but I'll be back. If I forget to come back to this topic, please feel free to send me a personal message and remind me to do so.

Rachel

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During my last pregnancy, I know that I had undiagnosed POTS. I was actually diagnosed a couple months after delivery.

I always had very easy labors. The last, however...not so much. Big baby with her head not positioned quite right and therefore causing difficulty with engagement. Simply put, her head would seem to go down, then pop right back up into the pelvis again. I did this at home for at least 24 hours. Only time I ever had back labor. Anyway, at some point, I decided to try getting into the bathtub as other people raved about the soothing effects of warm water during labor. DID NOT WORK. In fact, it felt far worse for me. I suppose the warm water contributed to vaso-dilation? Out of the water, during contractions, I think my blood pressure probably went up and then would plummet after each and every one. After awhile, I was in effect passing out between them due to this. Being in the warm water seemed to contribute to this. Ofcourse, I was also on my back in the bathtub....the worst position to labor in. Any other position feels better than laying down.

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I've not had any children but I have been advised by my gynaecologist that if/when I do have a baby that I should have a planned c-section due to various health problems. It is something that you could discuss with an obgyn even before getting pregnant - the decision will be based on a number of things including your health, the babies health and your preferances. I would advise that when you do decide to start a family that you have a pre-conception consultation with a good obgyn to start discussions on this sort of issue and also to make sure that your meds etc are the best combo for pregnancy.

Flop

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I will be having a scheduled c-section in January. You CAN just ask to have one but your doctor will probably fully educate you on the recovery process. I have no idea about insurance and that hasn't even come up. I would assume having a condition like POTS can make it easy for the doctor to write it as a medical necessity. My OB and cardiologist kept going back and forth on what would be better for me. I have had a pretty smooth pregnancy. We all did our homework and put a lot of thought into the delivery. My OB told me he was going to leave it up to me. I could have a c-section or I could try labor and if it was too much then I could have a c-section. He did warn me that going into labor and then needing a c-section really takes a lot out of a patient and he also warned me on the necessary recovery after a c-section. I decided to have the c-section and everyone is on board and seems to prefer it since I will be more closely monitored in the operating room.

As for the water birth, that is an interesting thought since most POTS patients do well in water but I would wonder about pain management. And a typical hospital where you could be closely monitored may not have that as an option. Personally with POTS I would prefer to be in a hospital setting.

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I had a baby 4 years ago and went through labor and delivery as naturally as possible. Just a few days ago I had a baby, but had to have a c-section (for reasons other than POTS). I'd be happy to share about my experiences with both. I can't do so at the moment, though. I'm still very tired and recovering, but I'll be back. If I forget to come back to this topic, please feel free to send me a personal message and remind me to do so.

Rachel

Congrats! I'd love to hear about your c-section experience when you are feeling up to it. Hope you have a speedy recovery!

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I had a baby 4 years ago and went through labor and delivery as naturally as possible. Just a few days ago I had a baby, but had to have a c-section (for reasons other than POTS). I'd be happy to share about my experiences with both. I can't do so at the moment, though. I'm still very tired and recovering, but I'll be back. If I forget to come back to this topic, please feel free to send me a personal message and remind me to do so.

Rachel

Hi Rachel!!! Congratulations on your new baby :) I would love to hear about your experiences someday when you are feeling better. I hope you have a quick recovery.

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I had 2 vaginal births. One with an epidural and one without. My blood pressure held through both of them.

I've heard some people say that an epidural can really lower blood pressure. But I guess that wasn't true in your case... if I wind up having a vaginal birth I would probably pass on the epidural. Not necessarily because of the blood pressure issues, but more so because of the risks involved with it. I've already had one experience at a dentist with a shot gone wrong, and now I have a nerve on my face that goes in and out of numbness and is very annoying.

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During my last pregnancy, I know that I had undiagnosed POTS. I was actually diagnosed a couple months after delivery.

I always had very easy labors. The last, however...not so much. Big baby with her head not positioned quite right and therefore causing difficulty with engagement. Simply put, her head would seem to go down, then pop right back up into the pelvis again. I did this at home for at least 24 hours. Only time I ever had back labor. Anyway, at some point, I decided to try getting into the bathtub as other people raved about the soothing effects of warm water during labor. DID NOT WORK. In fact, it felt far worse for me. I suppose the warm water contributed to vaso-dilation? Out of the water, during contractions, I think my blood pressure probably went up and then would plummet after each and every one. After awhile, I was in effect passing out between them due to this. Being in the warm water seemed to contribute to this. Ofcourse, I was also on my back in the bathtub....the worst position to labor in. Any other position feels better than laying down.

Very interesting story! That must have been rough to have been in labor for so long :)

You know, that is a good point about the vaso-dilation in warm water. I hadn't thought about that... I was only thinking about water from the aspects of it causing the labor process to be shorter and easier in some cases.

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I will be having a scheduled c-section in January. You CAN just ask to have one but your doctor will probably fully educate you on the recovery process. I have no idea about insurance and that hasn't even come up. I would assume having a condition like POTS can make it easy for the doctor to write it as a medical necessity. My OB and cardiologist kept going back and forth on what would be better for me. I have had a pretty smooth pregnancy. We all did our homework and put a lot of thought into the delivery. My OB told me he was going to leave it up to me. I could have a c-section or I could try labor and if it was too much then I could have a c-section. He did warn me that going into labor and then needing a c-section really takes a lot out of a patient and he also warned me on the necessary recovery after a c-section. I decided to have the c-section and everyone is on board and seems to prefer it since I will be more closely monitored in the operating room.

As for the water birth, that is an interesting thought since most POTS patients do well in water but I would wonder about pain management. And a typical hospital where you could be closely monitored may not have that as an option. Personally with POTS I would prefer to be in a hospital setting.

Wow, sounds like you have a great team of doctors to work with! That's neat that they discussed all the options with you and let you choose.

I am a little confused now about the whole water thing. It seems that warm/hot water can be hard for POTS people to tolerate due to vaso-dilation... so is it only water that is at a neutral temp or cold that is good for us? Do you know?

I know that some hospitals in the USA now having birthing pools (I think it's over 100). Being in a hospital setting might be good.

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I think that for anyone with a significant medical condition that being in a hospital to give birth is a good idea. I know not everyone agrees with me, I guess it is based on my personal experience. These days hospitals and ob-gyns do more to make the mother comfortable without being overly institutional and without forcing meds on you that you don't need or want. However, in the event medical intervention IS needed (as was in my case, I would have likely died and my daughter would have for sure if I had not been near a hospital when I had a severe abruption) it is right there.

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I had a baby 4 years ago and went through labor and delivery as naturally as possible. Just a few days ago I had a baby, but had to have a c-section (for reasons other than POTS). I'd be happy to share about my experiences with both. I can't do so at the moment, though. I'm still very tired and recovering, but I'll be back. If I forget to come back to this topic, please feel free to send me a personal message and remind me to do so.

Rachel

OMG, How did I miss this-

CONGRATULATIONS, Rachel!!!!

I know you must be exhausted. When you get a chance, fill us in on all of the details, baby's name, weight, etc. Tell us how you are. In the meantime, try to get a tiny bit of sleep and enjoy your precious new baby. I'm so happy for you!

Hugs-

Julie

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I gave birth to a full-term, healthy baby girl 6 years ago. My POTS symptoms were extremely bad during the years around her birth (not because of the pregnancy). My pregnancy was considered High Risk, and I received daily injections of blood thinners to avoid clotting (a previous pregnancy had caused clots in my lungs). My liver doesn't function well during pregnancy. I also had hyperemia, which just means vomiting 24X7, so I was on Zofran and had IV fluids every few days for the first trimester and half way into the second trimester. I had preterm labor starting in month 7, so I spent the last trimester bedridden. This was horrible for my POTS because I lost leg muscle. I fainted frequently during the pregnancy, also before and after it. I was deeply concerned about passing out during the delivery, but that did not happen, thankfully. After 2.5 months of preterm labor, the last two weeks of which I contracted every two minutes, my cervix still did not dialate, which showed something wrong with the cervix. So we induced using a cerivical insert, which did not work. My OB had to put me on an epidural, then manually dialate the cervix. In all, my induced labor, from the time the contractions were unbearable to the time my daughter was finally born, was 36 hours. I had not eaten from 7PM Sunday until Wedn. morning, when she was born (they just give you ice chips)...and with ALL of that, I did NOT faint during labor and delivery, or even for three weeks afterward (although I had been fainting every day multiple times before labor induction). Nurses unfamiliar with my case history did not notice anything different about me in the labor ward. I think it's the adrenalin. I was so psyched about getting her out and holding her and seeing what she would look like and stuff, I think it all just worked out in the end.

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I will be having a scheduled c-section in January. You CAN just ask to have one but your doctor will probably fully educate you on the recovery process. I have no idea about insurance and that hasn't even come up. I would assume having a condition like POTS can make it easy for the doctor to write it as a medical necessity. My OB and cardiologist kept going back and forth on what would be better for me. I have had a pretty smooth pregnancy. We all did our homework and put a lot of thought into the delivery. My OB told me he was going to leave it up to me. I could have a c-section or I could try labor and if it was too much then I could have a c-section. He did warn me that going into labor and then needing a c-section really takes a lot out of a patient and he also warned me on the necessary recovery after a c-section. I decided to have the c-section and everyone is on board and seems to prefer it since I will be more closely monitored in the operating room.

As for the water birth, that is an interesting thought since most POTS patients do well in water but I would wonder about pain management. And a typical hospital where you could be closely monitored may not have that as an option. Personally with POTS I would prefer to be in a hospital setting.

Wow, sounds like you have a great team of doctors to work with! That's neat that they discussed all the options with you and let you choose.

I am a little confused now about the whole water thing. It seems that warm/hot water can be hard for POTS people to tolerate due to vaso-dilation... so is it only water that is at a neutral temp or cold that is good for us? Do you know?

I know that some hospitals in the USA now having birthing pools (I think it's over 100). Being in a hospital setting might be good.

I'm not sure about the whole water birth either. You make a good point about warm/hot water being a potential issue. I think it is VERY important to be in a hospital setting when you have any type of pre-existing condition. You never know what will happen.

For those that were talking about insurance, my c-section was scheduled at my appointment yesterday and on the part of the paper work that asked for the reason for insurance purposes my doctor wrote in POTS.

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  • 3 weeks later...

Hi Katherine,

It has taken me a while, but I'm back.

I have had two deliveries, one vaginal and one cesarean. In my experience, the c-section was easier with my POTS. Labor and delivery is hard work, and it completely exhausted me with my son. I wasn't able to enjoy the infant stage because I was so out of it for a few months. I hardly remember my son as an infant.

With my recent c-section I have actually been able to enjoy my baby daughter! I cand sit or lie in bed and enjoy holding her and being with her. With my son I couldn't do that much at all. If I could do my first labor and delivery over again, I would choose an epidural sooner so that I could sleep and rest more during labor. Then I wouldn't have been so tired after giving birth.

If you are only worried about the pain in labor and delivery, then you could opt for an epidural at the beginning of labor. Having an epidural during labor and delivery doesn't require as much anesthesia and pain meds as having a c-section would. For some people, it is best if they avoid as many medications as possible. But everyone is different.

When the time comes, talk over all of your options and health concerns with your doctor. The two of you can then come up with the best plan for you for delivery.

Rachel

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