Tag Archives: midwifery

A Week of Appointments

This week has been full of appointments!

Well, I suppose two appointments doesn’t really count as “full” but it just seemed pretty busy.

On Tuesday, Juan went with me to the appointment with the midwives.  Since we’re getting down to the wire, I wanted him to go again.  The appointment went well.  We reviewed the birth preferences we had written up and there were no issues.  Everything was just fine, and most of the things I had listed were things that they either do or don’t do anyway. 

The only exception was the internal checks.  They usually do internal checks, but she said there’s no reason why they need to do them.  If I prefer to skip them, that’s just fine.  She even said that she wouldn’t need to check me if I suddenly feel the urge to push.  She said if I did a little trial push and felt the baby moving down, we were ready to go!  If I do a little push and it hurts, then we know I need to give my body more time to dilate a bit more.  So there’s no need to 3 nurses and 2 doctors to be reaching up in there.  That’s so refreshing and comforting to know.

Tuesday was also the day of my Group B Strep test.  We won’t know for a while what the results are.  Once we know, we’ll be able to finalize a few of the items in the birth preferences list and I’ll post the final draft so you can see it.

Aside from those things, it was a usual appointment.  I got measured and I’m measuring right where I should be.  We got to hear the baby’s heartbeat.  And feel her position.  She’s still head down, although, she did roll around while the midwife was feeling her so that her back was up against my back.  She seems to have rolled back into place later, though, and there’s still plenty of time for her to move around.  She’s doing great in other words!  Headbutting my bladder as much as possible!

Thursday, I had my first appointment with the therapist.  I won’t go into all the details here, but it went really well.  We talked a lot about feelings of powerlessness and where in my life I am powerful.  It was amazing how good it felt to have someone validate what I’d been through in the hospital that one really bad Friday night.  She’s a medical professional who works with people with eating disorders in addition to being a counselor, so she was able to point out why what I had been through and validate just how serious my situation was.  Hearing her tell me that, yes, I was actually pretty close to dying that Friday night really helped me come to terms with things and let go of the guilt I’ve been carrying for being angry over the lack of treatment I received at the hands of the hospital.

Anyway, it was a good experience.  I really felt like I was able to connect with her, and I appreciated that she didn’t try to logic me to death like the previous counselor I saw (way back in January).  I’ll keep going back to her for a while.  It’s really seemed to do me some good.

So, it’s been a busy week.  Tomorrow I’ll be 36 weeks.  I think I posted previously that 36 weeks is considered full term, but that’s not correct.  37 weeks is full term.

I’ve got 4 working days next week and 5 working days the week after.  Then I go out on maternity leave.  I can’t wait to be done with work!  One less thing that I will have to worry about.

Writing My Birth Preferences

This is one of those posts that I’ve actually been pretty excited to write about.  Birth preferences!

Writing out my birth preferences this time around is so different from writing my Birth Plan from when Gabi was born. 

The hospital where I had Gabi provided a template, so I based my plan off of that so that I could give them information in a format with which they were already familiar and comfortable. 

With the hospital birth, there was so much more to worry about.  The Birth Plan, while certainly not adversarial, was much more of a defense against unnecessary interventions.  I had to specify things like no episiotomies, no continuous internal monitoring, give the baby to me immediately instead of delaying with newborn procedures, don’t give the baby formula or pacifiers, etc.  Even using the format provided by the hospital, the Birth Plan was very much a defense for Gabi and I against the standard protocol of the hospital.

I don’t have to do that this time and it’s blowing my mind!  All of those things I have to prepare for and defend against?  Those are things that my midwives don’t do anyway.  This notion of having my midwives working with me as a team that I already know and am totally comfortable with as opposed to a nurse I’ve never met who may or may not respect my right to informed consent is just incredible.

I’m not The Patient in Room 326.  I’m me.  They know me, and they respect me as an individual.

Because of all of this, my birth preferences are much shorter than they were the last time around.  I’ll list them here, and include my reasoning for each one.  The preference itself will be bold, and I’ll follow with the reason behind it to make it easier for you to skim.  If there’s something that’s not on this list that you’re curious about, let me know and I can talk more about that item and why I didn’t include it.  I promise I’ll be better about responding to my comments this week.

So, without further ado…

My Birth Preferences

I don’t want to know baby size until after she’s born.  No estimates please.  I know I can birth her “big” or not.  Baby size estimates can be off by more than a pound, and since I’ve already had a baby vaginally, I know that I don’t have a pelvic issue that would prevent my pelvis from opening to allow the baby to pass.  At 8 lbs 6 oz, Gabi came out at a pretty respectable size.  Women have “big” babies all the time.  It’s just not something I want to have to worry about.

I don’t want to have internal checks until I am ready to push.  Last time, knowing that I was walking around for a month at 3 cm weighed on my mind, and when I got to the hospital I found I was “only” at 5 cm.  Knowing this just shattered my belief in myself, so I’d just rather not know.  Realistically, it’s perfectly possible to go from 5 cm to 10 cm in an hour or less.  I know this rationally, but emotionally, those kinds of cold, hard numbers can be disheartening.  If I’m in active labor, I have faith that my body is doing its job in its own time. 

For those of you who may be considering this as a preference, you may encounter a health care provider who just really wants to start doing internal checks once you reach a certain number of weeks.  They may do this just out of habit or they may tell you they need to “establish a baseline.”  This is completely bogus.  The baseline for dilation is… not being dilated at all!  This isn’t a subjective thing.  You’re either dilated or not.  This is a measurement on a ruler.  There is also absolutely nothing you gain from knowing this number as it will give you no indication of when you’ll go into labor.  You could go from 0 cm to 10 cm in the space of 8 hours.  Or you could walk around dilated to 3 or 4 cm for weeks.  There’s no value in knowing this number, and every time someone reaches up in there you deal with risks: introduction of bacteria, accidental rupture of membranes, the temptation to strip your membranes without your consent, etc.

So no thanks on the internal checks for me!

Please feel free to suggest position changes!  I tend to freeze up when I’m in an unfamiliar situation and don’t know precisely how things are going to go.  I know that everyone says your body will tell you what to do when you’re birthing, but I really do tend to freeze up.  I’m so glad to have a great doula and team of midwives who will be willing to make recommendations if they notice me getting stuck.  Last time I felt like I just sat on the bed and didn’t know what to do.  I asked for the epidural so quickly that I didn’t really get the chance to see what my body would tell me.  I’m just not sure what to expect, so I’m very open to suggestions!

Please avoid using the word pain?  Instead, I prefer to talk about things like “intensity” and “pressure.”  This is a Hypnobabies thing.  In so many of the Hypnobabies birth stories, it seems like the mom is doing great until a nurse comes in and asks about pain level.  Then, suddenly, she loses her focus and starts feeling out of control.  Since “pain relief” in the form of medication really isn’t an option, I just prefer not to visit this area at all.  We can use words like “intensity” and “pressure” instead.

Please no AROM.  AROM stands for Artificial Rupture of Membranes.  That’s when they go in and manually break your water.  There are about a gillion reasons why this is not a very good idea, but rather than list it all here, I’ll simply refer you to this article from Midwife Thinking in Australia: In Defense of the Amniotic Sac.

I would like to birth my baby in the water.  That’s right!  We’re planning to have a water birth!  There are many reasons why water birth can be a great option:

  • The warmth from the water serves as a natural way to ease the discomforts of labor.
  • The weightlessness that the water provides allows women to move and change positions easier.
  • The water helps to soften the tissues allowing the perineum to stretch more easily to accommodate the baby.
  • The warmth of the water provides a much more gentle transition for the baby from the womb into the outside world.

I’m just really pleased to have the opportunity to use the birth pool at the birth center to have this baby.  I know this will help me so much during my birthing time to stay comfortable and composed.

GBS+:  I’d like to get the IV line placed and the antibiotics run as fast as possible.  Then I would like to have the line pulled completely.  I just don’t want an IV hanging off me.  They’re distracting and upsetting to me right now.  I don’t know for sure if I am GBS+ (group B strep positive), but I’m operating under the assumption that I am.  This way, if I am, I won’t feel disappointed, and if I’m not I can feel pleased about having one less thing to deal with.  I am also exploring the options of hibicleanse during my birthing time to help with this.  It’s a bit up in the air at this point, but since I don’t know if I have group B strep or not, I think that’s okay.

Please no directed pushing.  I would like to follow the signals of my body and allow it to do its work gently and naturally.  Also please don’t count while I push or have a contraction.  What I’m really trying to avoid here is “purple pushing.”  That’s where you hold your breath and pushpushpushpushpush until they tell you to stop.  This can reduce oxygen flow to the baby, and it’s really exhausting.  On top of that, this kind of hard pushing can cause tearing as the baby moves too fast down the birth canal.  So I just don’t want to do it.  My body will tell me when to push.  We’ll just listen to that and go with the flow.  In Hypnobabies, we learn about “Aaaahing” the baby out.  That’s just what I intend to do.

Please delay cord clamping. Since we donated Gabi’s cord blood, delayed clamping was not an option for us.  This time, however, we won’t donate the blood.  Instead, we’ll be allowing all of our baby’s blood supply time to move from the placenta into her body.  According to this article, around 21% of her blood is in the placenta.  She needs all of that iron- and oxygen-rich blood.  It’s hers.  I often wonder if some of Gabi’s early sleepiness and weakness during nursing would have been helped by delaying the cord clamping.  For this baby, we’ll wait until the cord stops pulsing, and then we’ll clamp and cut the cord.

For the baby, no Vitamin K shots and (if I am not GBS+) no eye drops.  Vitamin K shots are really only needed if your family has a history of blood clotting disorders.  That’s not an issue for us.  Unless the baby comes out with significant bruising, there’s no reason to give this shot.  The eye-drops are only needed if the mom has chlamydia.  They’re also recommended if the mom is GBS+.  I definitely don’t have any sexually transmitted diseases, so as long as I’m not GBS+, there’s no need for the eye goop.

I would like an unmanaged 3rd stage and deliver the placenta on my own.  Would also like to avoid the shot of pitocin unless it’s really and truly necessary.  The 3rd stage of labor is the part where you deliver the placenta.  During a managed 3rd stage, the healthcare providers may tug on the cord or “massage” the mom’s belly to help the placenta come out more quickly.  The “massage” is pretty forceful and brutal, so banish the thought of a comfortable, relaxing belly massage.  Picture instead people shoving against the mom’s belly with all their strength to manually push out the placenta.  Really unpleasant.  The cord pulling and the “massage” can also cause increased bleeding, hemorrhage, and the risk of the placenta breaking up and leaving pieces behind.  Hello infection!  I’ll pass.  The pitocin shot is something to help curtail bleeding.  If I’m not bleeding heavily, I’ll just skip that as well.  As they say, “If it ain’t broke, don’t fix it.”

 

Those are my birth preferences.  It’s a fairly short list.  I’ll be talking about these with my midwife at my 36 week appointment later today.  It’s so refreshing not to have to worry about defending myself against unnecessary hospital policies.  I love that I am included as a member of my own birth team this time around.

World Breastfeeding Week – What am I doing to prepare to breastfeed the new baby?

Gabi and I did not have an easy start to our breastfeeding relationship.

My milk was slow to come in (thanks pitocin).  She struggled with latch due to flat nipples.  I got engorged.  Then I got mastitis because she wasn’t able to latch to remove the milk.  I didn’t know enough about pumping and thought that the milk I was pumping was “not real milk” because of the whole not-coming-in thing so I dumped what little I did pump.  Gabi got dehydrated (no poops, no wets over a couple of days)  so we supplemented with formula through a bottle and then through a supplemental nursing system via finger-feeding.

Then, right as she was starting to latch, I got thrush, which took forever to figure out because Gabi never showed signs.  It was all in me.  By then, my milk supply was almost gone, so I essentially had to relactate.  The Boppy nursing pillow that I got was sliding all over God’s creation, so I was trying to hold the pillow in place, hold the baby, deal with the stupid nipple shield, get the baby latched, keep the baby latched, ignore the agony in my back (thanks epidural), and just fight fight fight fight fight.

Meanwhile, the “help” I was getting from hospital “lactation consultants” was vague and not helpful.  We could manage to nurse in the office, but not once we got home.  And when I would call for help they wouldn’t call me back.

It was a really difficult time.

Finally, we managed to turn the corner at around six weeks.  I ditched the Boppy for the My Breast Friend pillow (they’re WHO code compliant and the BEST nursing pillow on the market!), I threw the nipple shield across the room, I found the kellymom.com forums where I could get some real help, and suddenly Gabi was alert enough and started latching and nursing.  I also dropped in to a local baby shop that had an IBCLC on staff, and she proved to me that I actually had milk by doing pre- and post-feed weighs.  Having this confidence is what ultimately saved our nursing relationship.

Gabi’s latch was never great.  I think the nipple shield had a lot to do with why.  But we managed.  She was exclusively breastfed from 4 and a half weeks until she was a little over 8 months old.  As she grew older, her perpetual bad latch became worse, but she got enough.  I’m so proud of the fact that I managed to nurse her for 3 and a half years, and I’m so grateful that those resources (seriously! the pillow ruled!) all came together at the same time.

I was so lucky.

This time, I don’t intend to leave things up to luck.

What am I doing differently this time?

Unlike last time, I have developed a network of support.  I co-founded a Lactation Support Group at my workplace, and I know that I can reach out to my co-leaders for help if I need it.  I’ve also become an active member of the Kellymom.com forum community.  I cannot say enough good things about this community.  If you’re interested in nursing or plan to nurse or are thinking about it, join this group.  This–and the Kellymom.com website of course–is hands down one of the best resources out there.  Don’t bother buying a book.  Go to Kellymom.  The information, compiled by Kelly Bonyata, BS, IBCLC,is accurate, carefully vetted and moderated, and evidence based.  It is truly second to none.  

I’m also planning an unmedicated birth.  The IV fluids and pitocin were both, I believe based on several years of reading up on it, at least partly responsible for my severe engorgement and the delay of my milk coming in.  The terrible back pain I suffered was, in large part, from the epidural.

I know now, having observed the way my body reacts to these interventions, that they are harmful to my ability to breastfeed.  To promote the gentlest and least invasive birth possible, I’m using the Hypnobabies childbirth method and birthing at a birth center with the help of midwives and the support of an experienced doula.  Based on my experience and research, I believe that these and other birth choices I’m making will help our breastfeeding relationship to have the best possible start.

In addition to surrounding myself with accurate information and having a natural birth, I will have personal support from my midwives.  They’ve got extensive experience helping moms and babies get off to a good start with nursing, and I will not be cut adrift once I go home.  They will visit me in my home the day after the baby is born to check on both of us.  Following that, they will call daily and be available for me to call if I need help.

I’ve also found a local La Leche League group and I will begin attending meetings starting this month!

I know so much more now than when I was pregnant with Gabi.  Now I don’t say, “I hope to breastfeed.”  This time I know that I can.  It is simply what we do in our family.  I know that if I run into difficulties that help is a phone call or keystroke away.  Whatever we may stumble upon, we will overcome.  Just like Gabi and I did.

***

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I’m celebrating World Breastfeeding Week with Natural Parents Network!

You can, too — link up your breastfeeding posts from August 1-7 in the linky below, and enjoy reading, commenting on, and sharing the posts collected here and on Natural Parents Network.

(Visit NPN for the code to place on your blog.)

Another Milestone! 30 Weeks!

Tomorrow, I will have made it to 30 weeks.  There’s something that feels nice and final about being in the 30s finally.  30 weeks is solidly third trimester.  30 weeks means I’m on the downhill slope.  30 weeks means I’ve only got 10 weeks left!

I had an appointment with the midwives today, and I got the opportunity to meet midwife #3.  I had met midwives #1 and #2 several times, but this was my first chance to meet midwife #3.  I really liked her.

For the most part, the appointment went as they usually do.  I weighed in (172.5 lbs) and then I got my urine dipped.  My numbers are still looking a little funky in my urine, but both midwives #2 and #3 said that because I had just eaten a bagel and had some juice for my Floradix, it wasn’t outside the norm.  It was just my body processing the sugars and carbs from the bagel and juice.  Midwife #2, who is an HG survivor, said that her numbers were strange her entire pregnancy.  The HG just messes up your body for a long time.

Then midwife #3 measured me and listened to the baby’s heartbeat.  Everything is measuring right on target for 30 weeks.  She also felt around on my belly to see if she could tell how the baby is positioned in there.  As it turns out, she’s currently laying sideways.  This would account for the increased pain I’m having in my pelvic bones and sciatic nerve.  Her feet are sticking out to my right, and her head is over on my left.  Midwife #3 explained that she is probably in the process of turning herself head down, and while there is plenty of room and time for her to go back and forth a few times, it’s likely that she’ll settle in head down and just stay that way.

I hope she finishes her acrobatics soon!  I am not living this side-lying position!  I swear I can feel her pointy little toes and toenails digging into the side of my uterus!  Ouch!

The pain in my pelvis really is pretty bad.  It’s bad enough that it’s been keeping me up at night.  It hurts to lift my legs and put my pants on.  Most of the pain is right where the pubic bones meet in front, but last night my whole sciatic nerve was aching and burning.  I asked for a referral to a chiropractor, so I’m going in to get adjusted and massaged this afternoon.  I’m hoping that will help.  Midwife #3 also suggested just a few cat/cow or pelvic rocks before bed.  That should move the baby up off of my bones and help through the night.

Since I am nicely into my third trimester, we briefly took the opportunity to talk about birthing options.  It’s so strange and refreshing to think that I don’t need to worry much about telling a nurse in the hospital what not to do to me or my child!  I don’t need to gear up for any strong advocacy.  Most of the things I want, like delayed cord clamping, are things that they do just as a part of their every day procedure.

I plan to do a full post on my birthing preferences to help readers who might be interested see the reasoning behind them, but for now, here are a couple of things that I mentioned to midwife #3:

  • Delayed cord clamping
  • No internal checks until I express a desire to push
  • Allow me to birth the placenta on my own without assistance
  • Low lights and quiet voices so I can focus on my hypnobabies techniques
  • Prefer, when possible, for everyone to use the hypnobabies terminology to refer to my pressure waves, birthing time, etc

She was great about it.  She listened, took notes, and generally did not make me feel silly for asking about this stuff.  It’s just really cool that I don’t have to put in big bold letters anywhere NO EPISIOTOMIES!!! and just hope and pray that the doctor on call remembers to look at my birth plan.

It’s just so much more… peaceful with these midwives.

I’m not saying that to knock doctors.  Not at all.  My OB with Gabi was wonderful!  It was a great birth experience and he could not have been more supportive.  And of course, Dr. Awesome is, well… she’s awesome!  The birth center and midwifery practice just has such a calm, quiet vibe.  No beeping machines, no harsh lights, no weird smells, no people barging in and out.  It’s just a completely peaceful and nurturing environment.

We also talked about birth kits and what to bring to the birth center.  She gave me an order form for the birth kit (pads, some herbs, gloves, etc) and a list of other things to pack to bring with us.  The birth kid needs to be ordered and in hand by 37 weeks, which is right around the corner.  Pretty exciting!

And as a bonus, as I was making my next appointment, a brand new mom came out with her baby girl who was born just today in the very wee hours of the morning!  She had wanted to lay still and sleep for a while there at the birth center, so instead of driving home in the middle of the night, they stayed.  It was amazing to see how tiny and perfect that brand new baby was!  I forgot just how small they actually are!

All in all, it was a great appointment.  We’ve gotten past the anemia scare with the Floradix doing a wonderful job at bringing up my iron, and I’m doing great!  You know.  Aside from the HG.  And today has been a 2 Zofran day.  One before bed and one after breakfast.  10 more weeks.  10 more weeks.

The Midwives’ Back-up OB

Part of switching from a traditional OB practice to the midwifery practice involves meeting with their back-up OB.  This is to ensure that should hospital transfer become necessary, I am familiar with him.  It also gives him a chance to review my medical records to ensure there aren’t any red flags that the midwives might have overlooked.  He also told me he wants to make sure I’m not a “lunatic.” 

The man has a sense of humor!  Seriously, he does.  He has pictures tacked to the ceiling over his exam table of very, very handsome male models saying things like, “Oh, Honey.  I just finished the laundry. Tell me all about the baby’s day!”  And, “You look tired.  Let me give you a back rub.”

I like this fellow.  He doesn’t seem to take himself too seriously, which I appreciate.

The appointment was pretty straightforward: pee in a cup, weigh, blood-pressure, and meet with the doctor to discuss any concerns.  When I mentioned that I was concerned about the HG resurfacing in the 3rd trimester, he said that it certainly does happen, and he’s perfectly happy to prescribe me the meds I might need.  He prefers to start with the Unisom/B6 combo and then move on to Zofran, Reglan, and Phenargan.  He made big notes that the Reglan and the Phenargan were not options for me and asked me what meds I took when I was HGing.  Then he shook my hand and said he’d see me back next time I decide to have a baby.  Very straightforward and simple.

What I did not expect, though, was the panic that followed on the drive home.  As I was driving, I found myself thinking of the things I had gone through with the HG.  Maybe it was because he was still wearing his green hospital scrubs.  I don’t know.  Something about the visit, though, dredged up some pretty awful emotions.  I didn’t expect to be fighting off the horror of the HG while driving up the 101.  Through a construction zone.  Wiping away tears so I could see to drive.  Yeah.  Not fun.

I just kept thinking, “I told him about the med list, but I forgot to tell him about the IVs and the PICC.  Why didn’t I tell him about that?”  And then, of course, I got to thinking about the IVs.  And the PICC.  And remembering lying there in the bed while the were trying to get the second PICC in and shaking and trying to keep it together so they could get the damn line in and hearing the charge nurse tell the PICC nurse quietly,  “Stop a minute and look at this patient.  She’s shaking.  She’s crying.  It’s time to stop.  She’s been through enough.”  And well, things just went downhill from there.

I talked to Dr. Awesome about this previously.  This isn’t the first time I’ve had to swallow back a panic attack, and I’m pretty sure it won’t be the last.  She thinks that the Hynobabies will really help in dealing with the trauma of what I went through.  I sure hope so.  It’s not very much fun.

It’s just another part of the joy that is HG.

At this point, though, meeting with the backup OB was the final step in transitioning over to the midwifery practice.  It’s official!  I’m part of their practice!  Very, very positive.  Now that we’re past the HG, we get to do the fun part!

Birth Center, Midwives, and Such

I’m not sure why I’ve been putting off this post.  Maybe it’s because there’s just so much I could say that I’m not sure where to start.  This may be rambly, so bear with me.

Last week, Juan and I went to visit with the midwives at one of the local birth centers.  It was very, very cool, and for me, it went very, very well.

She began by giving us a quick tour of the birth center.  Having never been to one before, I had no idea what to expect.  I wasn’t sure if I should expect an office-like atmosphere or what.  What I found was a very quiet, peaceful place.  It was very home-like and comfortable.  There were couches in the consultation room, a nice-sized bed in the birth room (which included a deliberately small, cavelike attached bathroom for a mom who wants to retreat), and a gorgeous room with an absolutely huge, deep tub.  Not to mention, the exam room, kitchenette, auxilliary labor room, etc. 

I really liked that she showed me the specific things in the rooms, too.  I remember when we toured the hospital in St. Louis, they brought us to a room and said, “This is one of our labor/delivery rooms.”  And that was it.  As first time parents, you don’t really know what to ask about, so you stand around and say, “Oh, interesting.  Thank you.”   I can’t remember if I asked about a squat bar, but questions like that were met with answers like, “Oh, yes, we have those.  Just request it at the time.”  The difference here was that she was pointing out specific things that you could do.  She showed me their birth stool and even showed where they usually put it and described how you’d sit on it, with your birth partner sitting behind you on the bed for you to lean against.  I am certain that if I had asked if I could sit on it to see how it worked, she would have let me.

This kind of thing is important to me.  I tend to get bogged down in not knowing exactly how things work mechanically.  For example, with the birth bar, I was intrigued by it, but I’d never seen one.  Never tried it out.  I didn’t want to fool around with the whole “Am I doing it right” thing, so I just didn’t ask.  With something right there that I can look over really carefully ahead of time and even try out just to get the feel of it, it’s just a whole different level of confidence.

At any rate, the birth center is gorgeous.  The midwife we met with really took the time to connect with me.  At one point, I was talking a little about some of my hospital experiences and becoming stressed out, and she just reached over and squeezed my hand.  Just little, simple things like that.  She just really went out of her way to validate my feelings and show empathy.  It was very peaceful and comforting and I can see, with a demeanor like that, why she has a successful midwifery practice.

She also really seemed to get the whole thing with HG.  She took a gentle look at the scars from my midline and failed PICC, and was just so gentle and sympathetic about what I’ve been through.  No suggestion to try this, no suggestion that I should have done that.  Just very gentle and kind.  Having someone in the natural birth community who really recognizes that I don’t have a choice about pumping my body full of chemicals is both surprising and a relief.  She is also willing to hold a space for me until I am off my pump and my doctor is able to release me into her care.  She’s willing to wait for me, and I so appreciate that.  No pressure, no stress.  When I am healthy enough and able, she will be there for me.

Aside from all the touchy-feely stuff, they also meet all of the requirements that you would expect them to meet.  Things like licensing, emergency preparedness, how they handle hospital transfers, etc.  All that stuff that you absolutely expect and consider completely necessary for a practice like this.  And I really grilled her.  I had a huge list of questions, and she answered every single one completely and without waffling about it.

For those curious, here is a link to the list of questions I asked.

 I came away feeling very, very positive.  It all felt, so… right.  Juan not so much.  He’s very much married to the idea of the hospital model of birth: lay back and let the doctor drive.  This resulted in a bit of… ah… hearty discussion between the two of us.  Thankfully, ultimately, he has found that he can respect that I have some pretty serious aversions to being in a hospital.  He may not understand why, but he accepts that I do.  And I very much appreciate his support.

Ultimately, it’s up to the insurance company.  I’ve applied for them to accept this birth center as in-network, and I’m just waiting to hear back from them.  Keep your fingers crossed that they give us the approval!

Back at work, midwives, and feeling blessed

It’s Wednesday.  Day 3 of my return to work, and it’s going amazingly well.

I was nervous about coming back.  I didn’t know what it would be like to get up early and be upright in a chair all day.  My job is completely sedentary computer work, but there is no opportunity to just go have a lie down.  After being parked on the couch for two months, I was worried about the physical demands of being back.

My first day back ended up being incredibly positive, even though by the end I was exhausted.  I had so many people stop me in the walk-ways and come by my desk to welcome me back.  It made me feel so good to know how many people had been thinking of me.  Invariably, everyone asked how I was doing, and I was pleased to say, “I’m doing so much better.  It’s great to be back among the living.”  Lots of people asked about my pump, which, oddly, I appreciated.  I thought I would feel self-conscious about it, but I think it would have been worse if they’d stared at it and tried to pretend it wasn’t there.  Somehow it’s less embarassing to be able to explain it and make a joke about it. 

One of my office friends asked about it in the break area, and another fellow, who is really more of an aquaintance piped up and said, “I know what that is!  I have one, too!”  And he pulled out his insulin pump.  It was really cool to meet someone who had a pump, too.  I had been explaining to people that it’s like an insulin pump, but I had never met someone in real life who actually had a pump.  I’d never seen one in person before either.  We ended up spending some time talking about it, and he was kind enough to let me ask some questions: How often does he have to change the sites and where does he think it’s easiest to put it.  He only changes his sites every 3 days (lucky!), and he likes to put his in the back of his arms, something that’s not an option for me because the Zofran gets pushed through at a higher volume than the insulin pump.  Like me, he thinks the belly is the worst place.  His pump is sleek and shiny and fits neatly in his pocket compared to my big clonker which I have to wear around my neck in a bag.  It makes me feel lucky, though, to know that I get to kiss my pump goodbye in a few weeks (!!!), whereas he’s got his for the rest of his life.  It’s comforting to know, though, that I’m not the only cyborg in the office.

Monday, I also called one of the local midwifery practices to set up a consultation.  I mentioned that I had been suffering with HG, and instead of suggesting acupucture or ginger (like the previous midwifery practice), she immediately asked about PICC lines and meds.  When I explained that the PICCs failed, she asked if I had a line tunneled into my chest.  Wow!  That’s exactly the order of interventions my doctor had listed!  When I told her I was impressed by her ready knowledge of HG and wanted to be sure to see her specifically for the consult, she laughed and said, “Don’t worry.  Both my partner and I know about HG.  I learned from her.  She got her knowledge through firsthand experience!”

You could have peeled me up off the floor.  I wanted to cry with relief.  One of my major concerns about seeing a midwife is that they would dimish the experiences I have had with the HG.  I simply can’t believe my luck.  How could I have stumbled into a town that has both a doctor and midwives who know so much about HG?  I feel like someone is trying to tell me something here.  It’s almost like God is hitting me over the head with the signs that this child is blessed and meant to be born here in California at this time.

These midwives work in a birth center located less than 5 minutes from the best NICU in the county.  They know about HG.  They can do waterbirths.  They are willing and able to work with my doctor in whatever capacity I need to ensure the HG stays under control.  They are willing to save a space for me in their practice until I’m weaned off the zofran pump to ensure a smooth transition.  And most of all, there’s that feeling in my gut that things are right.  The consultation is scheduled for next Thursday, late afternoon.  It can’t come soon enough for me.  I can’t be certain things are right until Juan and I meed with them, so please keep your fingers crossed.

With all of the positivity of coming back to work and speaking to these midwives, not to mention the joyful pregnancy affirmations I’ve been listening to as part of my hypnobabies practice, I am feeling incredibly blessed.  Do you ever have moments where you feel like your heart is just so full it’s about to overflow?  I just feel so full of joy and positivity right now.  It is such a good feeling to have.  I am coming out of a very dark place and the sunlight feels so good on my face.

Freaking out a little about childbirth

But not in the way you would expect.

I’m good at childbirth.  I may suck at pregnancy, but I’m good at childbirth.

That said, I am not loving my hospital options here.  Dr. Awesome only delivers at two hospitals, both of which are part of the public county hospital system.  I will say that both are classed as Baby Friendly hospitals which is a huge deal and really great.  But I have major concerns about both.  Here are the concerns I have with both places:

Hospital A

This is where I went for my HG hospitalizations.  Anyone remember how awesome my experiences were there?  No one?  That’s right.  Because it sucked.

  • This is an old hospital.  It’s gritty.  It feels very… what’s the word… institutional.  I’m sure it’s very clean, but it just looks really grimy from being old.
  • They have you labor in one room and deliver in another room.  That’s right ladies.  When you hit transition, they make you move.  I cannot imagine the chaos of changing rooms during transition.  This just seems like a terrible idea and a terrible policy.  Dr. Awesome said they might be able to make an exception for me since we have no need for things like warming tables and the like, but I’m not sure how comfortable I am with a “might be able to.”  This is a major deal-breaker.
  • Fathers aren’t allowed to spend the night.  Juan might not be able to do this anyway because of Gabi, but the idea of being stuck in there for 3 days by myself just makes me feel edgy and trapped.
  • I had pretty bad experiences at this hospital.  Just walking in to it is enough to send my stress levels up.  The woman I shared a room with leaving blood all over the toilet seats, and the possibly crazy man walking outside my door and talking loudly all night and freaking me out that he would come into my room, and the L&D nurse who left me in the wheelchair and repeatedly told me and anyone she ran into that I shouldn’t be in L&D despite what my doctor had said, and the OBGYN not bothering to see me at all, and the evil vital signs lady who kept making my IV sticks bleed, and the OBGYN who smiled and said that if I feel persistant nausea and vomiting to come back in (idiot), etc, etc, etc…
  • Very restrictive for visitors under the age of 13.  Gabi could come visit us but only for certain hours.  3 days separated from my family.  Cut off from them when I want to be with them the most.

Hospital B

  • No showers in the rooms.  You have to walk down the hall to the shower behind the nurses station.  That means if I want to sit under the hot water while I’m in labor and labor in the shower, I wouldn’t be able to do it.
  • Only two rooms.  What if they’re full?
  • No visitors under the age of 13 allowed.  That bothers me in a major, major way.  I would be completely cut off from my family during one of the most important times for us all.
  • It’s in the next town over.  It’s not a long drive, but it is a drive.

General Concerns

  • I’m not a fan of several of her partners.  I only actively dislike one of them, but I think having him walk into the room to catch the baby would send me over the edge.
  • Dr. Awesome isn’t always on call.  I’m not sure what percentage of her babies she delivers, but if she’s not on call, it would be a major, major stressor.  The last thing I want to deal with is more stress.  That week when all hell was breaking loose with the HG, she was not reachable.  At all.
  • They don’t let you eat in labor.  I need to eat all the time!  If I can’t eat I have to get hooked up to an IV with a glucose solution.  I am really, really averse to IVs and needle sticks at this point.  Like heart racing, hands shaking averse to it.
  • No tubs.  Anywhere.
  • General nervousness about the whole thing.

This is my last baby.  Of course, it goes without saying that the ultimate goal is a healthy baby and a healthy mommy.  That’s a major no brainer if you ask me.  So why can’t birth be a pleasurable experience for me?  It was a good experience last time, but like I said in my hypnobirthing post, I want to be an active participant here.  I have absolutely no regrets about Gabi’s birth.  I just want something different this time around.  I want a water birth.  I want to do this on my own.  I want this last time to be a positive and gentle experience.  I’ve had such a crappy pregnancy.  I just want to have a positive, respectful birth.

Home birth is absolutely not an option here, but there are some lovely-looking birth centers here in town.  Juan is dismissing the idea out of hand.  It’s just so far outside his concept of normal.  I just want to find a way to help him understand why I might view that as a viable option.  The hospitals here aren’t like the awesome one we delivered at in St. Louis.  Would switching to midwife care after the HG be like a huge “Eff You” to Dr. Awesome?  “Hi there.  You get to do all the awful stuff without the little bonus prize at the end.”

I hope I can find a way to make peace with all of this.