Monthly Archives: July 2008

Next day feelings and findings…

Well first of all I was able to talk to my midwife.

I don’t want to completely throw my OB’s opinion out the window at this point, but some of the things he said yesterday were just so erroneous that it is hard to take the other things as seriously. It doesn’t completely discredit what he had to say, but it does call his credibility into question.

The sterile thing is just a big load of crap, obviously. This is for a lot of reasons. First of all L&D wards are not by any means sterile. You have people coming in and out (like dads, family and friends), eating snacks, going to the bathroom, etc. Nurses and OBs do wash their hands, but not like they do when prepping for a surgery. Also, Stephen’s point about super-bugs was very valid. The antibacterial soap they use to wash their hands is what causes the super-bugs because it doesn’t kill everything and what stays alive is stronger and resistent to the soap, etc. And what else is in hospitals? Sick people and diseases. Furthermore, if doctors were really concerned about home environments being sterile enough they wouldn’t let you bring your baby home 24 hours after the birth (sometimes less), or maybe not ever. We would all raise our kids in hospitals, wouldn’t that be fun?

Then the fact that he just went into the general homebirth is unsafe thing until we actually prodded him makes me think that he was just going to say anything he could to make me think I was making a dangerous decision. Plus the research at this point does not support the statistics he tried to throw at me. If that was the case the UK’s ACOG equivalent wouldn’t be trying to increase the number of homebirths. Countries where homebirths are something like 30% of the population wouldn’t be doing better than us as far as infant/maternal mortality is concerned.

As far as pre-eclampsia/eclampsia and stressed out heart rate concerns… those things don’t just show up suddenly in labor. Yes, hyperthyroidism does put me at a higher risk for them (if left uncontrolled), but we would know through monitoring whether that was an issue before the birth. Also part of the reason my midwife has me continuing my care with my OB is to have these things monitored if something serious does come up. And she assured me that if anything with either my heart rate or the baby’s heart rate was abnormal that would be immediate cause for transfer. She’s not going to ignore the signs of something going wrong. Plus, something I think I haven’t mentioned on here is that she’s also worked it out with one of the other licensed midwives in town to have her attend my homebirth as well. So I will have two trained women at my birth monitoring me and making the situation as safe as possible.

Baby breathing difficulties… my midwife was able to find one study last night that dealt with this issue. It was a really small study though. Out of 248 births, two babies had breathing difficulties. One was exposed to high levels radio-active iodine (one of the drugs used to treat hyperthyroidism, but you’re not supposed to take it in pregnancy) and had a goiter so big it caused the collapse of the baby’s esophagus. The other baby’s mom was treated with PTU and had some difficulty breathing upon birth, but there isn’t much information given about this case including the dosage of PTU that the mother was on. We could have a late ultrasound to see if the baby is doing things that are helping it to practice breathing too like swallowing amniotic fluid (something I’ve witnessed on our previous ultrasounds). Also the fact that she gets the hiccups all the time is another good sign that she’s getting prepared to breathe.

So after she found this study my midwife called me again and told me about it. Then she said that she was going to call my OB and talk to him about his reasoning for declaring my pregnancy high risk. She also wants to know what information/studies he is basing his opinions on.

I’ve also gotten several responses to a post I put on a message board about this and everyone from midwives to those with the same condition as me have said that thyroid issues do not risk you out of homebirth as long as your TSH levels are closely monitored throughout the pregnancy (which mine have been). Also hyperthyroidism is more of an issue if it is something you’ve had for many years rather than something that developed as a result of pregnancy. My midwife said if the former had been the case she would have told me that I needed to have my baby in a hospital.

It was very nice of my doctor to make the offer that he did as far as attending my birth. That has not gone unnoticed in my mind because that was actually a concern of mine. To go from a 1 in 10 chance to 95% is pretty good.

Also he did say that he wouldn’t run from caring for me even if I did decide to ultimately go ahead and homebirth. My midwife has had many patients with OBs that have refused to see them anymore for making this decision.

Stephen said he’d still support me in my decision, but he also thinks that based on what the doctor said the best of both worlds for me would be to go to the hospital and have our midwife as our doula.

At this point I’d say things are more up in the air. I’m just really anxious to see if my OB is going to be willing to talk to my midwife and what will come of that conversation. I’ll probably know more tomorrow. I just didn’t want to leave things hanging like I did yesterday. I covet your prayers and even little tidbits of information/research you come across (thanks Ruth!). I definitely have a lot to think about.

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This is how the appointment went…

OB: So, how’s it going? Any contractions or issues lately?
Me: No.
OB: Well what about the morning sickness?
Me: I haven’t thrown up in awhile. I think the last time was 30 weeks. I have had a lot of heartburn lately. I still had some Pepcid you prescribed, but that didn’t really work. Tums seems to be the only thing that helps.
OB: Well we could prescribe something else if you are having a lot of reflux. Probably Reglan would be what I’d recommend, but only if you think it is bad enough that it warrants a prescription.
Me: I think I’ll just stick with the Tums for now. I don’t want to take something more serious unless I have to.
OB: OK then I’ll leave that up to you. Any other questions for me?
Stephen: Well yes, actually there was something else we wanted to bring up with you. I don’t know, Lisa do you want to do the talking or do you want me?
Me: Well, I know I had told you before that we were thinking about this and you gave me ACOG’s stance which I was aware of already, but I wanted to let you know that we’ve decided we do want to go ahead and birth at home with a midwife unless there are some things specific to my case that would put me at a higher risk.
OB: Well, first there’s just the risk of homebirth in general. Death is a real risk in about 2-3 percent of homebirths. There have been cases where the midwife didn’t monitor things closely enough and when signs of distress occured they were ignored. There is also a higher risk of cerebral palsey if interventions do not happen when they need to.
Stephen: Right, well we are aware that there are risks with homebirth just like there are risks with hospital births and even driving in our cars. I’ve gone through all the information with her and we discussed with the midwife what the risks were, I was very concerned about that. Ultimately though I’m not the one having the baby, so it is her decision and I want to support her. What we want to know is if there are reasons specific to Lisa that would make a homebirth more risky for her.
OB: Well you have not had a low risk pregnancy by any means. You have to remember that you have had hyperemesis gravidarum and hyperthyroidism. The PTU that you are on does cross the placenta and could have an effect on the baby. She could have problems breathing, latching on and even have a goiter upon birth that would need to be treated seriously and right away. Plus the stress of labor could cause your thyroid to get out of control. It could increase your heart rate. With hyperthyroidism you are at an increased risk for eclampsia and pre-eclampsia.
Stephen: We also want you to know that this is by no means a statement against you or your abilities. We think you’ve done a fabulous job with Lisa’s care and we’re happy with you. It’s more about her and her being in a comfortable environment.
OB: Oh yeah, I know that. I’d never think anything like that. I completely understand you wanting to be someplace that you are accustomed to. Another concern I would have is the home conditions. Homes are not sterile and babies are very susceptable to viruses and other things. Now I’m not saying that you don’t clean your house, but with a home birth one of the things you have to be concerned with is e-coli, among other things. In a hospital everything is sterilized and the baby is welcomed into that environment.
Stephen: Well doesn’t that increase the chances of the baby being exposed to a super-bug like MRSA?
OB: Super-bugs happen when doctors and nurses don’t wash their hands. We’re very diligent about that around here.
Stephen: Well I know some of the things she was concerned about was being able to move around in labor and have that bonding moment with the baby right afterwards. How likely is that?
OB: Those are all fine. You have to remember to that I’m not your typical OB. I was actually trained by and have worked with many midwives over the years both in the Indian Medical Service and when I did my residency at KMC. I don’t do routine episiotomies, if you want to labor your own way I will let you. I encourage you to have as natural a birth as possible because the more interventions you add into the mix the higher the risk of complications. However, there are just too many times I have written high risk on your chart that I cannot from a medical standpoint endorse this decision. I wish it was different for you. I wish you were a low risk pregnancy.
Stephen: And what are our chances of us actually getting you as our doctor at the birth and you being the one on call?
OB: Let’s see your due date is Sept. 13, the chance is very good. Actually, I’ll even make sure that I don’t go out of town during that time and make myself available to you guys at nights and on weekends. So I’d say your chance is about 95% that I’ll be the one attending your birth.
Stephen: Well thank you for that offer. You’ve given us a lot of information to consider. I know the midwife also tries to rule out as many things as possible ahead of time and wouldn’t take us on as candidates if it was beyond her scope of abilities.
OB: Well you see that’s what baffles me. Does this midwife you’re seeing know about your hyperthyroidism?
Me: Yes. She said she consulted with the other midwives in town and her overseeing OB and they said that it doesn’t rule me out from having a homebirth.
OB: Hmm. I just don’t understand that or agree with that assessment at all.

I measured at 33cm and the baby’s HR was 156. My TSH levels from my last blood test were normal.

I just… I don’t know where to go from here. I feel like my dream of my perfect birth story is already been ripped to shreds. I came home and cried. I left a message for our midwife to see what she has to say, but she hasn’t called me back yet. And now I’m afraid I might have put her in a sticky situation because my OB asked who her backup OB was that told her it was OK for me to have a homebirth. They work at the same practice and my OB said he was going to consult with him about his advice to my midwife.

It just feels so ruined. I wanted this so badly after 8 months of crap. I feel like I’ve been placed in this giant dichotomy of life or death though and if I go with what I really want I’m chosing death.

I also feel like the biggest dork for crying over this and being so upset. I mean I’m lucky to have made it this far in the pregnancy. I’m lucky that I’m affluent enough that I can even make a choice between these two forms of care. I can hear the responses now, “Just remember that the most important thing is the health of you and the baby.” Or maybe even a few “I told you so” things like, “Duh, Lisa anyone who’s watched you go through this pregnancy or read your blog could have told you that you were high risk and this was a crazy decision.” Or maybe a few along the lines of, “We told you not to get your heart set on an elaborate birth plan. You can’t plan birth.”

It just sucks at this point. That’s all I have to say.

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Very random…

I have a doctor’s appointment today that Stephen is coming to so we can break the news officially to my OB that we’re homebirthing. So I’ll probably be updating later on with the reaction and all that. I’ve had quite a few random thoughts streaming through my head though and I want to get them all out before they are squashed down with new thoughts from today’s appointment. I’ve decided to make a list…

– I got the best idea ever for a mobile for Bean’s room. I bought a cheap mobile on clearance from BRU yesterday that allows for customization of the hangy-down things. I’m currently knitting little stuffed sea animals in pinks and browns. I am very excited about this project, but it is on hold until my patterns for a sea horse and a hermit crab come in.

– Since it is so hot in Bakersfield during the summer I think every store should have expectant mothers parking. Luckily I was quite the parking spot shark yesterday and managed to score some close ones, but most of the time that is not how it goes. And even then I managed to get really hot and exhausted after only half a day of shopping.

-People are going to do a craft project at my shower. I am also excited about this. A certain shower giver seems a little apprehensive about this “game” and thinks that it might be too messy. I know you all aren’t three-years-old though and will be able to handle it.

– I want my body back. Cute clothes are everywhere and I just have to walk on by and ignore them. It isn’t fair. A post pregnancy clothes shopping trip is going to be a must since everything in my closet is ginormous on me now even with the belly.

– The dietary restrictions did not work. Niether did smaller portions. I still felt gross. Heartburn is the main enemy at this point. Tums are my one and only friend that works.

-Parents/grandparents, you can’t make up for a childhood gone wrong by spoiling your child/grandchild. If you want to rectify damage done, go to the source and start working on the problems there. Also, you just have to recognize that you can’t change the past and what is done is done. Grandparents, you can’t make up for time not spent with your own child by spending it with their child. Parents, if you try to give your child every single thing that you “didn’t have” growing up and cater to their every whim you’re just going to wind up with a spoiled brat of a kid that thinks they are entitled to everything. This is no different than the parent that pushes their kid to the extreme in sports in order to live out their own sports dreams. Live your own life, let your kids live theirs. I would elaborate more, but it isn’t appropriate for all of the Internet to read so I’m just going to keep the rest to myself.

– My natural childbirth class starts next week. I felt like such a rebel when I called and cancelled the classes I signed up for at the hospital. When I read the course descriptions though I felt so awesome. The childbirth class said it would educate and prepare you for common hospital procedures. The breastfeeding class said it would go over basic principles of breast feeding and help you to know when you needed to supplement with formula.

– Cloth diapers and our carseat/stroller seat greeted me at the front door today. Seeing the cloth diapers in person gives me even more confidence about this decision. They are so cute and look so easy to use. It works/looks just like a disposable.

– I’m slightly afraid of what my OB is going to say and slightly afraid to tell him. I’m also afraid that he’s going to say something that will make Stephen freak out about our plans.

– My dad does not know that I’m having a homebirth. I don’t think I’m going to tell him before hand based on recent conversations we’ve had. I just don’t think he can handle it.

– I have less than seven weeks left (please come on time!) to endure this pregnancy.

– I purchased nearly all my home birth supplies yesterday with the exception of large trash bags and perishables. Our homebirth kit is on the way.

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Dietary restrictions…

So even though I got the sour milk situation rectified, it seems my body is still having problems digesting dairy products at this point. Actually, it would be better to say that my stomach is having problems digesting food in general.

Upon my midwife’s recommendation I began taking papaya enzyme chewable tablets to aid in digestion. They have helped to a certain extent, I’ve noticed that my heartburn isn’t as bad since I started taking them.

But it seems I’m still having some digestion issues even with that little boost.

Yesterday I had a bowl of cereal for breakfast at 8 am. At 1 pm it was still churning in my stomach and occasionally partially digested bits were shooting up my esophagus. It wasn’t acidic, so I have a hard time calling it acid reflux. It was like that concept except I would call it “food reflux”.

Well at 2 pm I finally decided I could stomach some lunch and treated myself to Rosemary’s. That meal also took forever to digest. At 7 pm yesterday I was still having “food reflux” with the ice cream I’d had with lunch.

We had Chinese at our favorite hole-in-the-wall place with my friend Megan. Our order consisted of orange chicken and beef broccoli. This caused heartburn/acid reflux.

This morning I woke up with heartburn/acid reflux.

So I think I’m going to try some dietary restrictions and see if that helps at all. I’m going to stay away from dairy and acidic foods like oranges and tomatoes for the next few days.

Restricting my diet has always been a difficult thing for me, except in the case of meat, which I successfully did for a number of years. Oh and nuts have been pretty easy too I guess.

A few years ago my mom was diagnosed with Celiac’s Disease which is basically an allergy to wheat gluten. It can be passed on genetically. I was having serious digestive issues at the time (which I believe turned out to be a result of the birth control I was taking) and thought I may have had Celiac’s as well. I was squimish about going in and getting the blood test done to see if I had it, so I just assumed I did and started trying to eliminate wheat and wheat gluten from my diet.

It did not go well. I cheated ALL THE TIME. I just couldn’t handle a life without wheat. There are so many things that have wheat gluten in them and it seemed impossible to do. Furthermore, the alternative products that were gluten-free were just not the same and in some cases really disgusting with the exception of a few kids’ breakfast cereals I found at the health food store.

I finally went in for a blood test and was relieved to find out that I didn’t have Celiac’s. I promptly celebrated by gorging myself on some of my favorite wheat products.

So life without dairy especially seems pretty overwhelming (I can probably be OK without citrus and tomatoes). Dairy has generally been my go-to food when it comes to treating heartburn without medicine and getting in some extra protein. Milk, yogurt, cheese and of course ice cream are some of my favorite things. I don’t want to feel yucky though either. It’s worth a try at least.

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Stuff!

I guess I was tempting fate to say “that pretty much will probably be the most exciting thing about today.” Not so my friends and I sure am glad.

The massage was great, actually. Don’t want to downplay it at all. It was by far the most relaxing and awesome and extensive (toes, fingers, and scalp among other things) massage I’ve ever had. I thing it was 90 minutes and she didn’t even charge me. I feel so incredibly good. I should have been getting in on that kind of massage action years ago.

Well after that I decided to hit up Rosemary’s Family Creamery downtown for my favorite ham and cheese sandwich and a petite brownie sundae. While I was there I saw Dean Florez. So of course the newsie in me had to text Megan and tell her that he was at Rosemary’s right that second. So she texted me back and said, “You’re such a newsie!” And I texted, “I know. I can’t turn it off.” So then several text messages later we decided that we definitely need to hang out especially since her “Boo” (Grant) is gone. So she’s coming over tonight and we’re going to hang out this weekend and it will be silly and fun. I can’t wait.

After eating my weight in confections I then proceeded home. This is what greeted me on my front door when I got there:

I knew some packages would be coming in the next few weeks or so because I had to help some less than tech saavy family members order the items they wanted to buy for baby Jillian. I just didn’t expect it would come like two days later and mostly all at once.

So what was in these boxes? Lots of stuff!


Aquarium crib attachment from my dad.


Travel booster seat from my dad.


Baby bath from my dad.


LittlePeople farm from my dad.


Stroller frame from my Auntie Linda (the seat is on the way).

Of all the items, the last one really hit me upside the head with this overwhelming realization that I am going to be a mom in a few weeks.

I think maybe I should say something about the level of excitement around here more often. Maybe then more exciting things will happen.

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33 weeks tomorrow…

Saturdays have not been good days for me lately, appearance wise. Either we’re doing work around the house and I’m in yucky clothes. Or I’m feeling sick and I’m in yucky clothes. So I decided to do my belly shot one day early this week.

I have a prenatal massage session in an hour and I’m really excited about it.

Karen is really sweet. She goes to our church. Every week she tells me that my bump is “so cute” and asks how I’m doing or feeling. I knew she was a massage therapist, but since I’ve been getting massages at my chiropractor that our insurance covers I just never asked her about getting a massage. Well last week she’s like, “Are you getting massages?” And I was like, “Well sorta. I get them at my chiropractor, but they’re being all funny about it because I’m in my third trimester now. They won’t massage my lower back or adjust it either so I haven’t been going for about a month.” So then she said, “Why? That’s just weird.” I told her they were afraid it would set off labor. So then she says, “I want to give you a massage. I’m certified in prenatal massage and you need your lower back massaged the most during this period.” So I was all about it and we set up an appointment right there.

So that pretty much will probably be the most exciting thing about today.

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Breakfast: The solution

Don’t eat cereal with milk that expired July 14. No wonder my body rejected it Saturday (19), Sunday (20), and yesterday (22). I went to have a midnight snack last night with a glass of milk and realized that we’d had the milk awhile and I should probably check the expiration date. Sure enough… yuck.

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