Today was a series of small pieces of data, woven into an answer by a very impressive woman OB/GYN. Once we'd heard the story,there was no other answer but that this baby will be born by c-section. But it took a while to get there.
Part 1: the scan
The consultant sonography doctor confirmed that the baby was breach, with her spine down my right side. Her head was a little higher than I've been feeling her recently, which I wasn't surprised about since she tends to move up at night, and sink gradually down the right side as the day goes on. He, again, did not see the fibroid that the two women sonographers I've seen during the pregnancy have noticed, measured and commented on, the one down by my cervix (note - signalling!). I wonder if this is perhaps he doesn't want to go digging down into my pubic bone, which is what it takes to visualise that fibroid. The good news was that everything looked good with the baby. Her growth is on track, the level of amniotic fluid looked good, and he even pointed out she has quite a bit of hair - on the ultrasound it looked like feathery extensions of her head into the fluid!
Part 2: Dr OB
We saw Dr OB briefly for a urine and blood pressure check (110/70, still good). He then directed us to go and see Dr big picture, who would review our notes, scan etc., and help us make a decision about whether or not she would attepmt an external version. I confessed I didn't hold out much hope it would work, since this baby has been in a very consistent position for over 6 weeks now, and he confessed he felt the same, but thought we'd all regret at least not giving it a try. So back we went to the other bit of the hospital to see Dr big picture.
Part 3: Waiting
Before Dr Big Picture could see us, we needed to have the baby's well being assessed. So I got strapped into a fetal monitor device in the day care unit, to measure her heartbeat. She was not Miss cooperative, and kept moving position after the monitor was placed on my stomach. After a while we found a position where mostly the monitor could pick up her heartbeat, but even so about every 2-3 mintues an alarm would go off as the machine stopped hearing her, and I'd have to reset it. She also got hiccups, which was quite entertaining. The heartbeat varied between 165ish and 120ish, mostly around 140 which is what I've measured with the home doppler pretty much throughout the pregnancy.
After about 20 minutes they took pity on me, agreed she was clearly very healthy and extremely wriggly, and took the monitor off. However, it then turned out that Dr Big Picture had been called into an emergency, so we'd have to wait. So we waited. For quite a long time. About an hour and a half maybe? Pob kept making quite major movements, waves of baby moving under the skin of my stomach, as if to indicate her displeasure at all this messing around. She succeeded in getting into a position which actually just hurt me, so I was getting quite grumpy. Not about the wait - an emergency is an emergency - but just about being uncomfortable.
Part 4: The answer
Dr Big Picture eventually showed up and was terribly apologetic about the wait. She took us back to an exam room, and started going through the file. She read this morning's report first, then flicked through my maternity notes. And said "ah, fibroids. When Dr OB told me about you last week, he didn't mention fibroids." (Note: more foreshadowing!!). She then started reading through the other ultrasound reports - the ones from 27 weeks and 32 weeks where the fibroid was carefully measured and commented on. She got me to tell her about the laps and hysteroscopies, and reviewed the pictures from those operations. She felt where Pob was and commented that really Pob was oblique and not breach - her head having moved down at least 10 cm since the scan in the early morning.
After some discussion, Dr Big Picture decided to scan to see for herself what the story was, and went straight to the fibroid. It's about 6x5cm and it's adjacent to the cervix, right in the pelvis. She showed us that none of the baby is down by the cervix, she's all up in the abdominal cavity. She told us how babies just don't choose to be oblique, there is almost always a reason for them staying in that position, and fibroids are the usual culprit. She sketched out very clearly what the situation is. The fibroid has taken up some of the space in the pelvis where Pob's head should have gone. Pob has probably tried to get round (that certainly makes sense given the seismic level of movement I've felt over the last few weeks) but hasn't had enough purchase to do so. In addition, the fact that none of her has been down near the cervix means that that part of the uterus hasn't stretched to accommodate her, so if we try to turn her now, she'd most likely pop back as there isn't enough space for her.
Yup, you got it. Not even worth a try.
Part 5: The conclusion
We went back to Dr OB to update him and book our c-section date. 20th September, at about lunchtime. So Kath and I will have daughters just a day apart. Not quite sure what I'll do about Yom Kippur, which starts on the Friday night, but I think I'll be forgiven in the grand scheme of things. Pob needs the extra time so her lungs can be ready to breathe.
It was good to have a clear opinion, and to really understand why we're where we are. But I really really feel disappointed. Odd, I know, given the ambivalence I started off with about a vaginal birth. But hearing from you and others about the amazingness of being able to have your body push out that baby, well, it made me want to be part of it. I am not devastated, I recognise 100% that once we have Pob in our arms, it won't matter (that much) how she got here. I also recognise it's the only sensible option at this stage. It's a very small loss in the grand scheme of losses we've been through. But I am sad that I won't get to do it in the old-fashioned way. Also, I find it a bit odd to know in advance what Pob's birthday will be. I feel like she should have some say in this. Odd, I know, but there you go, just one of my many irrational feelings.
This time, two weeks from now, we'll probably, hopefully, be holding our daughter.