yesterday i had my first appointment with dr. joseph tate. he's famous in the birth community for his skills as an obstetrician- doing old school tricks like delivering triplets vaginally. he's also a very devout jewish man whose staff is like family, because they are family. the office reminds me of my family get togethers- kids running around, a dog whining, someone chiding the dog, people bickering, older women giving sage advice, and nobody taking anybody too seriously.
when he sat down with me in his office one on one, it was about 3 hours after i first got there. as a one man practice, he takes time to personally handle each patient and my wait time was because another woman was facing a dire emergency. but once he was face to face with me, he was engaged. i felt more than just a chart to him. he looked over my records and asked several questions.
once he looked them all over he announced that he felt no need to advise me to get an amnio- that there was enough devastating evidence, an amnio would be pointless.
i have turned things over enough in my head and prayed alot about it, i believe, at this point, i don't want to have a c-section. i have had a c-section, and even with a healthy living baby to enjoy, i still had trouble with a little post partum depression. basically bc i couldn't take care of my family, let alone myself, for almost a month!
we are also creeping into the fall, and ultimately the winter- not months that i'm known for being cheery.
so i asked him, "if you wouldn't advise a c-section for me, if the baby was in distress, can i just not be on monitors?"
he wasn't comfortable with that. a baby being in distress could also indicate a uterine rupture. so he said he'd keep them on, but turn off the monitor in the room and only have it on at the desk out in the hall. that way if there was distress, he could assess other signposts for uterine rupture to rule that out.
then i asked him if we could just scrub the group b strep test. he agreed.
we talked about how far over he'd be comfortable letting me go. 42 weeks was thrown out there. we talked about how sometimes with brain matter absent, pregnancy has been known to last for 43+ weeks.
we then moved over to the belly check room and he hooked up his new ultrasound macihne. he likes to do heart tone checks with ultrasound because it gives off less radiation than a fetal doppler. he scanned for a bit- looked at jedidiah's brain, couldn't get close enough to look at his heart. he announced that jedidiah was breech.
this confirmed my choice in ob/gyn immediately. if i was in any other care provider's hands i'd have no choice but to have a c-section. doctor tate regularly delivers breech babies vaginally- a lost art in the ob/gyn and even midwife world.
jedidiah's head was measuring 28-ish weeks and his abdomen measured 26-ish.
dr. tate did a quick head circumfrence/abdomen circumfrence check. if the ratio was too high, and i delivered him breech, his abdomen wouldn't adequately open my cervix for his head. dr. tate said he was comfortable with a ratio of 1.1.
currently jedidiah has a hc/ac ratio of 1.18. at our ultrasound in july he had a hc/ac of 1.25, so it is coming down.
i would love to be able to turn jedidiah. i feel breech deliveries are more stressful on the baby than a vertex delivery. not by a big measure, but just enough that a baby who is already compromised doesn't need the added stress. i asked about the added stress- he said that if my pelvis could allow a 10+ pounder to pass- it shouldn't be a problem.
i still wasn't satisfied, so we discussed version(manually turning the baby). he felt that since i had had a bunch of kids and my utereus is pretty roomy, we should turn him at the next appointment. jedidiah has so much room in there that he would just float back up and not keep his head down. when he fills out a little more and takes up more space, then it's a better idea.
after the tummy check he said he was glad i was with him, but that he was very sorry that it was under these circumstances.
i feel so at peace with my decision. he's like a a very skilled and experienced dad more than a doctor.