Second Trimester Pregnancy Update and Birth Plan Journey with Crystal Sikes

Hey everyone, Robert Sikes here. In this blog post, I'm sharing a heartfelt and detailed update from my wife Crystal as she navigates her second trimester of pregnancy with our second son, Hazen Wilder Sikes. This episode is a follow-up to her first trimester update, and it gives you an inside look into the challenges, triumphs, and decisions we're facing together as a family preparing for this new arrival. 

From managing pregnancy symptoms and physical discomfort to the complexities of planning a VBAC (Vaginal Birth After Cesarean), Crystal opens up about everything. So grab a cup of coffee and join me as I share our story and insights from this exciting and sometimes stressful journey.

Second Trimester Symptoms and Physical Changes

Crystal was still feeling sick going into the second trimester, and that nausea lasted until about sixteen weeks. Around that time, she also began experiencing SI (sacroiliac) joint and sciatic nerve pain, which has been persistent throughout the trimester. "That's just like a dull achy pain, but the sciatic pain is like literally someone just pinching my nerve," she described. This combination of tightness and looseness in her pelvis has been tough to manage, especially since the ligaments and tendons loosen naturally during pregnancy to prepare for birth, but her muscles remain tight.

Travel also brought on some challenges. When Crystal and Rigel, our older son, flew to California in January to visit family, it was the first time she had been on an airplane for such a long stretch, and that seemed to trigger the onset of her sciatic pain.

Weight Gain and Physical Activity

Weight gain has been steady but manageable. Crystal shared that by twenty weeks, she had gained about ten pounds, and by the later part of the second trimester, that number grew to twenty-three pounds. She noted that the typical recommended weight gain for someone with a normal BMI during pregnancy is around 30 to 40 pounds, so she feels she's right on track.

Despite the discomfort, Crystal has stayed active. She's been lifting weights consistently with her trainer Ellen, hitting sessions three times a week. "I'm still going heavy on everything," she said, benching 135 pounds for seven reps recently. However, she's cautious with squats and deadlifts, opting for lighter weights and modified ranges of motion to protect her hips and pelvis.

She explained, "My hips and pelvis muscles get super tight, which is why I'm having a lot of SI pain, but it also feels really loose at the same time because your tendons and ligaments are loosening to allow for the baby to come out." This tight-loose feeling is difficult to describe but is very real for her.

Nutrition and Blood Sugar Monitoring

On the nutrition front, not much has changed from the first trimester, but we did decide to use a Continuous Glucose Monitor (CGM) to keep an eye on blood sugar levels. Instead of taking the traditional oral glucose tolerance test—which Crystal would likely fail due to her metabolic flexibility and low carbohydrate intake—we opted for the CGM as a gentler alternative.

For two weeks, the CGM showed excellent blood sugar control with the highest average reading around 104, which is well within the healthy range. Interestingly, stress seemed to have more impact on her blood sugar than food. "I was trying to get Diesel fed, me fed, Rigel fed, snacks packed, everything ready to get out the door," Crystal explained. "That induced stress made my blood sugar spike a little." This insight has helped us think about managing stress better during busy mornings.

Reflecting on Our First Birth Experience

Our first birth experience with Rigel was quite an event. We initially planned a natural home birth with a midwife, embracing a very natural approach. But when Crystal went past her due date—being at 41 weeks and 6 days—we discovered that in Arkansas, home births aren't allowed beyond 42 weeks. This forced us to head to the hospital, where things quickly escalated.

Crystal was induced with Pitocin, but she didn't dilate well. Eventually, the hospital staff broke her water and an emergency cesarean section was necessary due to Rigel's face presentation posterior position. This means Rigel was coming face-first, but facing Crystal's back, which increases the risk of spinal injuries during vaginal birth. "It's so much harder to get them out because the space between your chin and the top of your head is a lot bigger than the crown of your head," Crystal explained.

The cesarean was a difficult and traumatic experience for us both. I recounted, "I was in the operating room. There was no curtain. I was there watching them cut you open, having a hard time stopping the bleeding, trying to make sure they didn't cut the cord too soon." Despite the chaos, we were blessed with a healthy baby boy, Rigel, who has been a bundle of energy ever since.

Planning for Our Second Birth: Navigating VBAC Options

With the experience of Rigel's birth behind us, we've been carefully considering our options for the second birth. Our goal is to have a vaginal birth after cesarean (VBAC) for this baby, but it's been a complex and sometimes frustrating process.

Western medical guidelines, such as those from ACOG, generally don't recommend home births for VBAC due to the risk of uterine rupture. However, interestingly, the statistics in Arkansas show zero deaths or major issues from home birth VBACs compared to a slightly higher risk in hospitals. This discrepancy has made us think deeply about what's best for our family.

Uterine rupture, the main risk associated with VBAC, is the separation of the uterine wall where the cesarean scar is located. The risk is very low but real, and it varies in severity from minor thinning (windows) to full rupture. "The risk of rupture having increased as a result of having a prior cesarean section is pretty minuscule in the grand scheme of things," Crystal said.

Unfortunately, finding a provider supportive of VBAC has been challenging. In Arkansas, only one office legally supports home birth VBACs, and there are very few certified midwives willing to take on these births. We decided to find a registered nurse midwife who supports natural birth in a hospital setting, which seemed like a good middle ground.

Hospital VBAC Policy Changes and Provider Support

Recently, the hospital where we planned to deliver decided to stop accepting VBACs due to scheduling conflicts with the limited number of doctors and anesthesiologists available. This news was frustrating and forced us back to the drawing board.

However, after meeting with one of the doctors, we felt reassured. He reviewed Crystal's chart and said, "There's no reason why you can't have this. I can't make you go home. I can't make you have a c section." He was supportive and acknowledged that Crystal is an excellent candidate for VBAC.

The hospital requires an anesthesiologist and at least two doctors on-site in case of emergency during VBAC labor, which is part of the scheduling challenge. The doctor also mentioned that the best scenario is for Crystal to arrive at the hospital in labor, close to pushing, to minimize time spent waiting.

We're hopeful that with continued communication and planning, we'll be able to have the natural, drug-free birth we want, supported by our midwife and a doula, with doctors ready if anything unforeseen happens.

Family Dynamics and Preparing for Two Boys

On the home front, Rigel is excited about becoming a big brother. He's always "feeling the belly" and talking to the baby, whom he affectionately calls "Haze" or "Baby." We've been thoughtful about managing potential jealousy and making sure Rigel still gets plenty of time and attention.

Crystal shared, "He's such a mama's boy that he loves to snuggle me. Having another little person on me all the time nursing and needing their mom is going to be harder for him." We're hopeful that the transition will be smooth and that Rigel will continue to be affectionate and involved.

We're also mentally preparing for the first time we'll leave Rigel overnight when the baby arrives, which is a bittersweet and anxiety-inducing milestone for both of us. We're trying to stay positive and hope the birth happens during a time when Rigel is already asleep to make the separation easier.

Looking Ahead

As Crystal moves into her third trimester, we're feeling a mix of excitement and nervousness. "This has been the fastest pregnancy ever," she said. We're planning to do another update podcast after Hazen is born and possibly a third trimester episode before then.

With so much going on—business, homesteading, family life—we're grateful for the support system we have and the opportunity to share our journey openly. We're praying for a safe, successful birth and healthy pregnancy with no complications.

FAQs About Our Pregnancy and Birth Plans

Q: What is a VBAC and why are you choosing it?

A: VBAC stands for Vaginal Birth After Cesarean. We're choosing it because we want to experience a natural birth this time, and the risks of VBAC are low with the right support.

Q: How has Crystal's pregnancy progressed so far?

A: She had nausea into the second trimester, developed SI and sciatic pain, gained about 23 pounds by the end of the second trimester, and has stayed active with weight training.

Q: What challenges have you faced in planning this birth?

A: Finding a provider supportive of a hospital VBAC was difficult. The hospital recently stopped accepting VBACs due to doctor scheduling, but we found a supportive doctor and midwife willing to work with us.

Q: How is Rigel reacting to becoming a big brother?

A: He's very excited, often feels the baby kicking, and talks about sharing toys and beds with his brother, though we're mindful of managing any jealousy.

Q: What support will you have during the birth?

A: We'll have a registered nurse midwife, a doula, and doctors on call in case of emergency. The plan is a natural hospital birth without external interventions unless necessary.