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C-Sections: What You Need To Know

When  the Baby's in an Awkward  Position

Rebecca Sullivan, of Alpharetta, GA, was already prepared for a long labor: "After examining me vaginally, my midwife could tell that the baby wasn't in a great position."

Ideally, a fetus readies itself for birth by lying with its head down, then rotating to face his mother's spine as labor begins. At the other extreme is the breech (bottom-first) baby, who almost always warrants a planned cesarean.

Between "ideal" and breech positions are the transverse (crosswise) and posterior (face up) positions, which can make vaginal delivery difficult, though not impossible. Most babies weather the arduous journey without harm -- but some falter under the strain.

Sullivan's baby was face up. But after 27 hours of labor, his exhausted mother still wasn't fully dilated. Shortly thereafter, it was clear that the baby too was weary of the long labor; fetal monitoring showed that his heart rate was beginning to slow after each contraction. "That decided it," Sullivan remembers. "I was down the hall in the operating room."

In 15 minutes, her son, Brian, was out. "The sound of his cry was just so wonderful!" Sullivan recalls. While Sullivan's incisions were closed, her husband, Michael, took the baby to the nursery to be weighed. They were already in the recovery room when Sullivan arrived there. "I got to nurse him right then," she says.

 When  the Mom Is in Danger

Lori Dammeyer, of Silverdale, WA, sailed through her first and second trimester without complaint. "But just after my 26-week checkup, everything fell apart," she recalls. "I swelled like a balloon. I began getting migraines." At her 29-week checkup, Dammeyer got the dire news: She'd developed toxemia, or preeclampsia, a little-understood type of hypertension that develops in five to seven percent of all pregnancies. Most cases remain mild. Not hers: "My doctor said my blood pressure was sky-high, and the protein in my urine was off the scale."

Her O.B. insisted on checking her into the hospital immediately to control her blood pressure with an intravenous infusion of magnesium sulfate. Though a sonogram showed the fetus to be fine, Dammeyer's blood pressure remained at 220/140; anything over 160/110 could trigger seizures, coma, organ damage, and death for her and the baby. So her doctor recommended an emergency c-section. At 29 weeks the baby's chances of survival outside the womb were excellent, but the risk of losing both would be far greater if the mother went into convulsions, as Dammeyer could have at any moment.

Still concerned about seizures, the surgeons ordered general anesthesia. After her daughter Kelsey Renee's birth, Dammeyer woke up dazed, a day later, in intensive care. The first thing she asked her husband, Robert: "'Does she have ten fingers and ten toes?' He told me she was doing fine." So serious was Dammeyer's condition that she continued to lapse in and out of consciousness for several more days.

Five days after her c-section, she was able to shuffle to the NICU. "I remember staying a few minutes by Kelsey's incubator," Dammeyer says. "After I walked out, everything that had happened hit me for the first time. I broke down right there in the hallway."

Two days later, Dammeyer was discharged, armed with a breast pump. Kelsey came home eight weeks after she was born, three weeks before her due date. "We were lucky," says Dammeyer. "She was small but healthy."

Just like these parents, Gary and I will always feel a tumult of emotions when we think back on the traumatic yet wonderful day when Eva entered our world. To say it was worth it seems like a gross understatement. That much was already clear on day two, when all the pain was washed away by the bliss of three people bonding.

JESSICA SNYDER SACHS is a freelance writer.