Friday, August 23, 2013

How I got a Bicornuate Uterus, and you can too!

Kidding. No you can't. And judging from what I've read so far you wouldn't want to have one. But as it turns out, I have one, so I'm going to talk about it a little bit.

A Bicornuate (or Heart-Shaped) Uterus is a medical abnormality present since my uterus developed before I was born. So in a sense, you could blame my mother's uterus. It was sufficiently punished when it was removed a few years ago.

.1-.5% percent of women are estimated to have a BU, though these numbers are hard to determine since many women have one without knowing.

As you can see, while a normal uterus has an upside down triangle shape and the entire organ can stretch for the baby, a BU is literally in the shape of a valentine heart, with the top dipping down and dividing the uterus into two halves, called "horns." The fertilized egg implants in one horn of the uterus and often the other side does not grow at all. My baby is in my right horn, which did explain why at first I only felt cramping/discomfort in my right side.

Since the baby only has half the room to grow, there are generally three risks involved. The more common risk is preterm labor with a weak cervix. I've read about many women who delivered too early for their babies to survive, however it doesn't happen often. It is quite common to deliver a viable premie and spend many weeks in the NICU though.

The second risk is growth restriction. My midwives were very chill about my condition, but did tell me to take extra care about my eating from now on. Up to this point I really don't know if I was always getting my extra 300 calories in, and they never said I had to. I don't feel good stuffing myself, and the past few weeks I was too sick to do that anyway. I've been bloated ever since I got pregnant, so I assumed I'd put on weight no matter what. Now they said that because my baby might have issues growing I need to make sure I eat a little more and make sure I pack in the nutrients. I ate really healthily until about ten weeks, when I started to get sick. After that anything but crackers, bread, and noodles just made me throw up, especially fruits and veggies. Midwives gave me zofran last week, and I'm finally able to eat normally and work good foods back into my diet.

The third risk, and the one I hate the most, is a C-section. Because the baby usually grows in one horn, there is not a lot of room to turn. That means that if the baby is breeched, it will most likely stay breeched. Meaning a mandatory C-section. My midwife said the only chances I have of delivering vaginally breeched are if the baby comes too quickly to do anything else, or if it became easier to do so during a later pregnancy. I so want my peaceful water birth and I can't stand to think about how my chances of a C-section have increased by a minimum of 20%. I don't want to spend my maternity leave potentially in a NICU AND having to recover from being cut open at the same time. I don't want to have to fight for my VBAC when the next child comes along.

My pregnancy was so typical until the moment they told me it never was. Previously one of my midwives had told me I was "boring" in a great way. Educated, married, planned pregnancy, steady finances, excellent health, no smoking or drinking... I did everything right and my pregnancy should go swimmingly. "Welcome to parenthood!" my other midwife teased me gently, "You think everything is perfect and then suddenly it surprises you."

"Then I turn out to have a freak uterus," I half-joked back.

"You don't have a freak uterus. Your uterus is heart-shaped because you're so nice," she said cheerily. "Many many women have completely normal births with this," she assured me later.

Truly I'm not so worried. I have more or less decided to stop researching it and stop reading message boards for women with a BU. It does horrible things to one's nerves. The women who tend to reach out online have experienced the worst of the condition, and it makes it look like a higher percentage of women lose babies than what actually do. While it's great that they've found a community and comfort, I just don't need to put that in my mind. I'll forgive myself a C-section, because I know that nothing (and no one) will make me have one unless I have no choice. My care will change slightly after 20 weeks. Every checkup will include an ultrasound to make sure the baby is growing. They'll do everything possible to get me full term. I can still have a normal, natural delivery if baby grows head down. There are many things that could go wrong, but just as many things could go right. I will choose to think about the "right" until I'm given a reason no to.

1 comment:

  1. I am encouraging you to not research it too. I was told with my second one a million and one things that would go wrong because of a 2 vessel cord. she was born at 35 weeks and did great, again my water broke at 26 weeks with my last pregnancy and I delivered at 31 weeks. Girly, you have this and we will continue to pray