I really want to have a healthy and safe pregnancy for  both of us. I am now halfway thru the pregnancy. My gynecologist  told me that I needed a Caesarian for any pregnancy because I have had two operations to remove fibroids. We weren't sure  I  would conceive, but I did  - about 6 weeks after the second operation. My husband and I are delighted, but  I  wish I could have a normal birth. My family doctor  says no, and she has sent me to an obstetrician, who also says I will need a caesarian. What advice  would you give? Also, since we live in a small community we will be going to a city almost two hours away, where the obstetrician delivers, because the small hospital near my home doesn't have a paediatrician, and the  baby may have  some issues  because it will  not be full term.   And I have another problem - I have  colitis, and as a result I have been taking  iron pills for a long  time. My internist said I shouldn't stop taking  the pills because I am now on a dose that seems to work well, after many years of difficulty. He feels that if  I stop the pills that   the complications and  childbirth may make me really ill and affect the baby.  Now I am reading so much about how important breastfeeding is - and  many articles about pregnancy  make it seem like  mothers who don't breastfeed are evil. It is really bothering me. I'm thinking about stopping the medication on my own -  the internist hasn't contacted me since I said that I was pregnant and couldn't go  for  an appointment, and my famiy  doctor and  obstetrician really haven't discussed the  colitis with me . My husband thinks I should talk it over with them now -  and not wait  unitl later - our  due date is  early October  so the C-section will likely be the end of  September.  I told my mom - she  isn't  exactly excited about my idea - but she breastfed us and  has always told me - before we knew that the iron would affect it - how  pleasant and enjoyable she found nursing to be.  

I look very healthy, and so far I am having a pretty easy pregnancy. We've always done a lot of outdoor activities - skiing, walking, snowshoeing, camping, canoeing, kayaking, gardening, etc. I am a full time kindergarten teacher. We have a home and a room we are getting ready for the baby. We are  pretty careful consumers - and  won't be spending a fortune on all the  overdone baby items you can buy now.                                                            

So I am very confused, and when I think about not nursing I am sad and upset, and I don't want to risk the baby's health or mine by not taking the colitis medication but I also want to experience  nursing, both for the bab'ys well being and to be the best mom I can be. What advice can you give? Are there any  websites that I can  go to to get    various perspectives  on both topics?  I'm looking forward to  hearing from you. I feel that there are very  few people who will understand these concerns that I have.

Thank you,   Jane S

It is not likely that you will find an ob willing to allow  planned vaginal birth after having had uterine surgery, especially since your options are so limited. If you are still  interested in vaginal birth, the best I can recommend is finding an ob to consult who attends vaginal births after cesarean (VBACs), and ask her or him to evaluate your case. The International Cesarean Awareness Network (ICAN) might be able to help you find the closest VBAC-friendly ob. That way, if the ob recommends planned cesarean, you can have confidence that it isn't just an automatic answer.

If you are ok with the planned cesarean, this page on the ICAN website can help you plan a family-centered experience. Also, to minimize the possibility of your baby experiencing respiratory problems, it is recommended that in the absence of strong medical indication for delivering the baby sooner, the surgery should be scheduled after 39 completed weeks of gestation, that is, no sooner than the week before your due date.

As for breastfeeding, I am not clear on why you are being told not to breastfeed. Certainly iron pills are no obstacle, and most medications can be continued while breastfeeding. I think your best source of information is La Leche League. I searched their website on "medications" and came up with this page and this one that should prove helpful. 

~ Henci