Tuesday, May 4, 2010

C-Section or Natural Birth?

If you're like me, you're at least somewhat nervous about how your body is going to handle "the big day." Labor. Yikes. Lyme labor--can my body even handle that? I have a hard enough time walking around a grocery store for twenty minutes--how the heck am I going to push out a baby without completely falling apart?

The biggest question for me was, what's "easier" on the body, a natural birth or a c-section?

For non-Lymies, it's pretty straightforward. C-sections, though completely normal and acceptable, lead to a longer, harder recovery. My initial thought was, jeez--I've been laid up in bed for a lot longer than 5 days at a time--but what about all the pushing? The contractions? The emotional stress of natural labor?

Both physical and mental stress can take a huge toll on the body. Until I talked to my doctor, I was all about having a c-section. Quick, painless (during the procedure at least--not so painless afterward), and predictable.

I changed my mind, however, when I spoke with my LLMD about the pros and cons to both. It really comes down to what you prefer and what your OBGYN recommends based on your health history (Lyme and non-Lyme). Here are the highlights of our conversation (I'm paraphrasing here):

Me: What's better for Lyme patients, a c-section or a natural birth?

Dr.: That's such a personal decision, I can't tell you to go one way or the other. I will say that our previous patients were divided 50/50. Half had natural births, half had c-sections. There was no difference in relapse rate; all of the moms and babies did just fine. So again, it's a personal choice.

Me: That's good, but a little vague. How about this... pretend you're pregnant and about to have your baby. Which would YOU choose?

Dr: Nice try. I'm not going to answer that. Just keep in mind that regardless of whether you have Lyme, the body will heal much faster with a natural birth. Natural is stressful on the body during delivery. A c-section means a longer, more stressful recovery.

Me: I really want to have a natural birth, but I'm afraid I won't be strong enough! I have a hard time going about small day to day stuff--what if I don't have the strength to push this massive baby out?

Dr.: You're not considering the forces of nature. Trust me, your body is going to do what it's meant to do. You will be so focused on contractions and the labor process, you won't have time to think about strength or whether you're well enough to do it. That baby is going to come out regardless of how strong you are. You're just there to help it along and tolerate the motions. Nature really does take over.

Me: So you recommend a natural birth then?
Dr: I'm saying you can do it just fine.

Me: Did your other pregnant patients carry to term?

Dr: Yes, all of them did just fine. As long as you are taking good care of yourself and you are taking your antibiotics, you can treat this as a normal pregnancy. The problems you read about occur mostly in women who were undiagnosed prior to conception and during pregnancy. Plus, you're closely monitored, so your OBGYN will be able to tell early on if there are problems.

Me: What are my chances of a huge relapse after childbirth?

Dr: Well, it could happen. A lot of women are fine throughout pregnancy and don't even have Lyme symptoms at all, and then they crash after the baby is born. This is due to physical and mental stress, as well as the sudden drop/shift in hormones. It usually doesn't last more than a few months, and you certainly won't go back to the bad state you were in when you first started treatment. Consider it a flare-up. We're going to keep you on antibiotics for a while (and maybe adjust the dosage)after the baby is born to try and keep you from crashing. At the same time, you might not be affected at all. It's impossible to tell right now. Just be prepared for it, and make sure you'll have help around the house.

Me: And if I go with the c-section?

Dr: I would tell you the same thing. You might have a flare-up, you might get along just fine after the initial surgery recovery. I'd treat you with antibiotics just the same as if you have a natural birth. Both delivery methods lead to successful births.

So there you have it. Another choice to make based on intuition and personal beliefs (though I have a feeling most OBGYNs will have an opinion on the matter, but at least we know what one LLMD thinks). The good news is, either choice has proven to yield successful deliveries. If you've had an experience with either, please feel free to share!

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