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Living With Congenital Heart Defects by Ben's Friends

ASD/Septal Defects - Aortic and Vessel Defects - Single Ventricle Defects - Tetrology of Fallot - Transposition of the Great Arteries - Valve Defects

Living With Congenital Heart Defects

Home birth/midwife with pregnancy after ASD repair anyone?

Hi all,

I am a mother of 2 beautiful daughters - 5 and 6 years old. I have been a professional dancer dancing most of my life. I am an active and busy person and even pursued both my Masters degree and PhD in dance - dance has been a significant part of my life. My husband and I always talked about 3-4 kids but during my doctoral studies I held off on having any more children for a moment to finish my dissertation. When my husband and I were ready to begin trying for our #3 we would get pregnant but my pregnancies would end in miscarriages. I did not understand what was going on especially since I had two successful pregnancies having both of the girls with no problems at ages 25 and 27. I also danced - choreograph, performed and taught through both my pregnancies (as well as continued working on the PhD with my course work and all). I birthed with a midwife for both girls having our oldest in a free standing birthing center with no medical intervention and the second at home in a birthing pool with the same midwife - again with no medical intervention (pitocin, epidural, etc).

At the very least, I did not understand why all of sudden we were having these losses just after turning 30. We saw a fertility doctor as well as switched our primary doc and while I saw a neurologist, rheumatologist, and hematologist because there were concerns around apossible antiphospholipid disorder given my migraines and the miscarriages all of a sudden, my primary doc recommended I get a heart echo. She did not hear a murmur (surprisingly they were always heard during my pregnancies but I was told it was due to pregnancy). My doc thought since I had never done one before that it would be a good idea with all the other questions we had at the moment around my heath and these pregnancies.

The echo would change my life. The echo showed that I had an ASD (which was later confirmed as fenestration after a TEE a week or so later) which I had obviously had since birth but the amazing thing is that it went undetected my entire life, up until I was 31 years old and only due to a random echo (I am 32 years old now). I had had two children out side of hospitals as well and danced and never really noticed anything with feeling winded or fainting etc.

My cardiologist said that we could continue trying for another baby but that the ASD needed to be repaired as I had shunting, my heart was enlarged, and my levels of pressure in my longs were a little elevated. It was my migraines though which has become unbearable in the last couple of years. My cardiologist also said though that I can return to a normal active life after the repair and still dance professionally etc. Regarding the pregnancy he said we just needed to wait at least 6 months post my repair. I had my repair November 15, 2012 and it was confirmed we were pregnant May of 2013. Talk about timing. This little guy has been okay throughout and I past the first trimester the time period when I had all the miscarriages - the 2nd to last almost in my 2nd trimester.

Things have been okay since the repair, despite a couple of episodes of SVT and ablation has been recommended by my cardiologist (which he said can be done during this pregnancy or after). Our littel boy is due January. Myy cardiologist said that I could still have a home birth and use the midwife I had with our daughters. I have since moved across country (within the last month for my hubby's work) and now have a new cardiologist who also says that I am not high risk and that a C-section does not need to be planned but that he would like to coordinate with my midwife or OB (who I have not decided on). With the SVT episodes (two) I was given adenosine once at 6mg which worked and the last time 6gm two times and then 12mg which did not work but the valsalva maneuver worked just fine after that. I have a beta blocker I can take as needed (but have not had to) and I am also aware that it can cross the placenta so Im staying away from it as long as I can. This no cardiologist though recommended ablation as well which we will do after we have our son (could use some feedback on that as well).

With all that said I have considered a hospital birth given the change in my medical history HOWEVER I would rather birth and labor with a midwife with access to certain things not in a hospital - birthing pool (which helped me with both my girls and the 2nd was born in the pool), being able to eat what I want and when I need to, being able to move around at my leisure, wear what I want etc. I also haven't had a hospital birth and maybe its not as extreme but from what I have read and learned on tours I think some of the restrictions would actually stress me out rather than work for me. I had great experiences with my births outside of hospitals which were private, intimate, and sacred and all the while I had the girls with my fenestration ASD out side of hospitals as well before the repair.

I feel that if I were to go into a hospital with my pregnancy that unnecessary things would be done because I have this implant and people may freak out because of the general concern of my situation. I feel that those unnecessary interventions could cause more issues as I have already met with two OBs who have said that I was high risk. There is unnecessary intervention done to people without my situation who are perfectly healthy - I have tons of friends who end up with C-sections due to labor and birth as being a "scary", medical and extreme thing - when it doesn't have to be. I am proof. Again, I am 32 years old - not even considered to be in advanced maternal age. I obviously want the safest experience for both our child and myself and would not put us in an unsafe position but I do not want to subject either of us to unnecessary things because of my "new" (or new known) situation with unnecessary interventions which could cause more issues which is usually the case. I apologize for the length of my post :) but wanted to put some background info here. So here is my question:

I am wondering if anyone has had a home birth or used a midwife post an ASD repair or with an ASD?

I know everyone's situation is different but I just wanted to get some feedback. While the ASD has been discovered, I do not consider myself sick or unable to do things I did before. I have experienced more of a change emotionally if anything - within myself and from people around me in particular. But I am okay! I think it can be a bit different when these things are discovered later in life than opposed to as a child growing up. I am still trying to develop a healthy balance around the fact that I have this - is life still all normal or do I need to be making decisions completely differently now??. Like am I out of my mind to consider a home birth like my first two pregnancies with a repaired fenestrated ASD??

Thank you in advance and I love reading everyone's comments and questions. This community has really helped me through my journey. Bless all of you!

PS) I have the 35mm Amplatzer Occluder

I had my children at 2 different hospitals - the 2nd hospital had a "natural wing". In this wing parents could opt for a "natural birth" the rooms had regular double beds in them, no IVs, they were attended by midwives etc. Basically it was a hotel room in the hospital. Considering your heart condition this might be a good option. You could have your natural birth but be located in a hospital if a emergency arises. The number #1 outcome from a birth is health mom and healthy baby - water births, epidurals aside. What really matters is the health of you and your child.

best wishes!