Thursday, November 1, 2012

External Version Experience

Last week I mentioned that Juliet was breech.  We were hoping she would turn on her own again, as she had been routinely doing so off and on for a few weeks, but otherwise I had an appointment lined up to discuss trying to turn her manually.  On Monday morning she was still breech so I went to see a Maternal Fetal Specialist for a consultation. A lot of women have a choice to make when finding out their babies are breech, and I want to share my experience and my thoughts about it all. 

The ultrasound and consultation showed that I was a good candidate for an external version, and even though the chances of her turning from breech were only 50/50, I was willing to give it a shot.  If it wasn't successful, then at least I had been proactive in trying to avoid a c-section.  The procedure has to be done at a hospital in case there are complications, and although it felt like everything was moving so fast, they were able to fit me into the schedule that same evening. 

Michael and I arrived at the hospital a couple of hours before the procedure was going to take place.  It was a bit of a whirlwind with what felt like a million people asking me for my medical history and all this activity going on around me.  Because a version can be painful and the best chances of success occur when a mom is completely relaxed, I had an epidural put in.  Let me just say the experience is a lot different when you aren't distracted by the pain of labor.  I barely even remember getting my epidural with Evie, and the whole process felt pretty easy and painless--this time around, I was a ball of nerves and it seemed like it took FOREVER.   I was also given a shot of Terbutaline to relax my uterine muscles.

Once I was numb, the doctor started the version.  Basically, he used the images on an ultrasound screen to help him try to manually manipulate Juliet into turning.  It's a lot of careful pushing and prodding, and I'm told by Michael that it looks very weird.  I just stared at the ceiling the entire time, chanting "turn, turn" over and over in my head.  I didn't feel any pain, but I could feel the pressure of her being moved around--it's a very odd sensation.

 In order to get the best angles to try to manipulate her, the doctor occasionally had me roll slightly onto either my left or right side and finally onto my back.  Within a minute or two of that position, all hell pretty much broke loose.  Suddenly the ten plus people in my room (that is not even an exaggeration) were scrambling around, and the doctor was explaining to me that Juliet's heart rate had dropped really low and we needed to get to the operating room as a precaution.  He was almost positive her heart rate would jump back up before we even got there, but he didn't want to take any chances.

Thankfully the doctor was right and the approximately three minutes it took to get me wheeled into the next room was enough time for Juliet's heart rate to come back up to normal.  It was such a relief, and I'm just glad I didn't have enough time to process it all. However, although her heart rate was up, my blood pressure had dropped drastically.  They had to pump a few doses of ephedrine into me before it came back up--it felt like it took forever though it probably only took a few minutes.  Michael was finally in the room at this point, decked out in his paper scrubs, and I can only imagine what was going through his head.

Once both Juliet and I were stable, the doctor attempted the version once again.  We stayed in the operating room for the remainder of the procedure as a precaution, but no more theatrics occurred.  Unfortunately, Juliet was being completely stubborn and would not get past laying horizontally.  The doctor was able to get her butt up out of my pelvis which is a huge plus, but she just wouldn't turn that last little bit to get head down.  The doctor was only willing to try so long before calling it quits.  No one wanted a repeat of the earlier drama.

I was wheeled back to my room shortly afterwards, and was ready to wait out the two hours of observation required to make sure both Juliet and I stayed stable after the procedure.  The two hours turned into almost six as Juliet wasn't quite ready to stop being a drama queen.  Apparently she's an adrenaline junkie, and the three shots of Ephedrine on top of the Terbutaline were enough to keep her heart rate high for a few hours.  Poor baby went from low heart rate to high heart rate all in the same day.  Thankfully after a few hours of monitoring, her heart rate finally started to slow down and eventually got back to her normal range.  After nine hours in the hospital, we were finally able to go home.

It was quite an experience, and not one I'd be willing to go through again during this pregnancy.  Every person on the medical staff was awesome and through all the drama and craziness of the evening, I never once lost my cool because I felt completely safe in their hands.  I had one moment of pure panic on the way to the potential emergency c-section, but otherwise my nerves were steady.  It's amazing what you can learn about yourself in moments of such intensity. 

Although I wouldn't attempt another version this pregnancy, if I were ever to become pregnant again and was faced with this option due to a breech baby, I would consider trying it again.  I'm just not willing to put my body or Juliet through that stress again so soon after going through this.  Even with the heavy disappointment of going through it all and the procedure not being successful, I don't regret doing it.  Especially because I am almost certain Juliet turned the rest of the way that night while I was asleep!  I'll find out today at my doctor appointment for certain, but either way the whole process was quite a learning experience.

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