Tag Archives: homebirth

Cousins

My sister had her baby boy Feb. 12 (exactly 4 weeks after Sprout was born). A homebirth just like me with the same midwife. She had a perfect Bradley birth and her friend/coach said that she makes labor look good. I am so proud of her.

I finally got to go up and see her and the new little guy this weekend. We both agreed that we are going to have a couple of lady killers on our hands later on down the road, but we’re just the biased mommies. Judge for yourself…

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Sprout is here!

Hopefully I’m not too long winded here because everything happened so, so fast!

Here goes. I was feeling a bit down last night. Texted my midwife and was telling her I was having a hard time with all the “what-ifs” because of the past few days. What ifs like, “What if I don’t have my baby by the end of the week?” or “What if something is wrong and that’s why I’m not going into labor?” That was about 9:18pm.

We watched a couple episodes of The West Wing (on DVD) and went to bed.

At 1:40am I woke up to pee. I got to the bathroom and felt a gush before I had a chance. I was kind of confused because with Bean I felt a big bubble and then felt it pop and then felt the gush. This felt more like the fluid had just been sitting in there for awhile and came out.

So I told Stephen that I thought that maybe my water broke, but I wasn’t sure. I told him to call our midwife. He kind of ho-hummed about it. I still wasn’t having contractions.

Got back in bed and another gush. Ran back to the bathroom. Another gush. Yep water definitely broke.

Stephen still hadn’t called our midwife. I was kind of annoyed. I nagged, he called at 1:45am.

By about 2am I was definitely having contractions.

We started timing them.

Called the midwife again. I told Stephen to make up the bed (for a homebirth you make up the bed with two sets of sheets with a giant plastic sheet in between… you get the first set all yucky and then when you pull those and the plastic off you have a nice ready to go made bed).

I decided I wanted to take a bath. Yesterday in the shower I forgot to shampoo my hair and thought I might try to wash my hair too while things were still light. Except then I’d have a contraction and decide I didn’t want to afterall. I stayed in the tub until about 4am. This time the water actually did help me manage the pain for most of my labor a lot better. The key was a folded up towel on the bottom of the tub so that it wasn’t so hard to sit on.

Then I started to feel like I really did not want to be in the tub. I just had a feeling things were about to change and that I wanted out.

Made it to our bed. Contractions got much more intense. I didn’t scream much like last time, but I did have some issues with breathing. I started to hyperventilate a little at some point and felt all tingly all over. Stephen had to really coach me to breathe and I still wasn’t doing that great of a job. I’m pretty sure this was transition.

I know my brother-in-law came at some point during that and picked up our daughter. Stephen wanted to go talk to him, but I needed him so he didn’t. Eric managed to find the keys to our van and everything Bean needed on his own and get out without me basically even knowing he was there. Awesome.

Right around 5am I started feeling the need to push. Did two contractions on my side laying down like this. Then I told Stephen I needed to push. He said I didn’t, but I knew I did. After the first few pushes our midwife arrived. Pushing seemed to take forever this time, but really it was less than an hour. I guess Sprout was slightly transverse at first, but then he turned posterior. He was also much bigger than Bean. The sliding back part after you’ve pushed during a contraction is still the part I hate the most, it is so uncomfortable.

Stephen says he’ll likely not forget the point when Sprout was crowning and I yelled, “Burn! Burn! Burn!” instead of my usual grunt. He said I sounded like a Puritan which hunter. Someone’s been reading a little too much colonial history lately, I think.

Anyway, at 5:49am he was out and up on my chest. For all the worry about being post-due Sprout was born completely covered in that lovely white cottage cheesey vernix stuff. At 41+4 Bean only had a couple of very small chunks. So my midwife is fairly certain he was born right on time.

So here’s a testiment to my husband’s improved Bradley Method coaching skills. Sprout weighed in this morning at a whopping 8lbs 14oz (Bean was 7lbs 4oz), but I managed to only get one tiny little tear and that was because Sprout came out with his hand up by his cheek. Stephen helped me breath correctly and mostly stay calm through almost every single contraction. I couldn’t have done this well without him.

And because pictures make the story here are the first few we have:

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Annoyed, flabbergasted, huh?

So I guess my instincts about calling my OB’s office back up were dead on. Turns out the guy isn’t as homebirth friendly as I thought.

I called up this afternoon to see if I could schedule an appointment and get an NST done only to be given the “homebirths are dangerous” speech and be urged to drop in at the county hospital to be induced.

Umm. No thanks.

I’m really not worried. Actually, maybe this worries some of you, but I kind of feel relieved to not have an OB breathing down my neck about my due dates and all that.

I guess I feel more confused than anything. I was VERY upfront from the beginning with this OB about my plan to homebirth and the fact that I had Bean at home. He told me that he was perfectly fine with my plan and that patients should do what makes them comfortable. He even told me he was fine with being my backup. So I’m not sure where the extreme shift in position on his part happened.

So where does that leave us? Well today I’ve done a lot of walking (two miles at the park this morning). I’ve had copious amounts of the “bloody show” and I’ve had sporadic contractions on and off since yesterday. My midwife thinks there is a very good possibility that I will have this baby by the end of the week.

Also, she thinks the whole due dates/fertility chart thing could be completely inaccurate anyway because I was still nursing Bean and I can’t even remember if she was still sleeping through the night at that point.

I guess it all goes back to whether or not I have trust in my body and whether or not I truly believe that pregnancy is a normal thing that happens to the female body.

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“You’re still pregnant?!”

As each day goes by I still hear my former OB’s voice in my head (the title of this post) when I walked into his office at 41+4 in all my huge, pregnant glory.

That was a very nerve wracking day as I went from station to station at our medical group wondering if I was going to be given a bunch of chemicals and end up with a c-section by the end of the day.

And maybe then, as now, I should just stop viewing my lack of going into labor on my own as this horrible thing that is going to automatically spiral down into a c-section. I know quite a few of my readers have had them for various reasons and it really isn’t the end of the world or life or anything. So I should probably stop thinking of it like that. And many more of my readers have had successful inductions that did not result in c-sections.

But I really, really want another homebirth. It’s just me.

Anyway, I guess that is sort of a tangent from what I originally sat down to write about in this post.

Yesterday we made a quick trip to Bakersfield (as in drove straight there and turned around and came back) to see my midwife. I’m still growing, baby is still growing, baby is still moving, heartrate is good. She thinks the baby feels around 8lbs which has me a bit worried since I tore with Bean and she was only 7lbs 4oz at birth. I was definitely more dilated than last time (though she didn’t give me an exact number) she saw me, so I guess all these false alarms have at least been doing something.

We talked about the due date and those handy wheels OBs and midwives alike use. I guess one version of the wheel is 40 weeks plus 2 days and another version is 40 weeks. And up until 10 years ago you weren’t even considered past due until you actually hit 42 weeks, which explains to me why my mom’s OBs never gave her a hard time about her crazy cycles and when the baby had to be born by or why Stephen’s mom was allowed to go until 42 weeks with him.

Upon reviewing my fertility chart this morning, I had a very gradual temperature shift that occured between April 4 and 9. Using a simple due date calculator, that puts my due dates between December 26 and 31. So, I could just be as little as 41+4 today or I could be as much as 42+2. And then there is the admittedly inaccurate 20 week ultrasound due date of Jan. 7 which would only make me 40+4 (though a review once again of my chart suggests that there is a very slight possibility that this date works).

Anyway, I’m getting restless and nervous that things are not going to go the way I planned (do they ever?). So, I had my midwife strip my membranes yesterday. I’m sure this might sound slightly shocking to some of you since I’ve seemed so against this idea on here. Really, though I’m not against it, especially in a situation like mine where I’m overdue and I’d like to go into labor as naturally as possible.

I just think that patients have rights including consent and the right to be informed about things that are being done to them. When I was pregnant with Bean, I actually went into my OBs office that day planning to ask him to do just that thing, but for one thing he was making me really mad and uncomfortable because of how that appointment went. I felt intimidated like he thought I was the biggest idiot in the world and now here he was going to get to tell me “I told you so,” and as such I didn’t ever get to the point where I felt like I could even ask him anything. Then, under the guise of doing a normal cervical check he went ahead and did it anyway without asking me or telling me and when I mentioned that it was the most painful and uncomfortable and long check I’d experienced the whole pregnancy he LIED and said that he was checking out the shape of my pelvis. Well after yesterday I am now completely sure that he stripped my membranes because that was exactly what it felt like. Furthermore it isn’t exactly the most comfortable thing to go through, it would be nice to be a little prepared for what’s coming so you can breathe or try to think about something else or any of the other coping mechanisms one might use.

End of rant.

So after that yesterday I was really crampy and then I even started having some fairly intense contractions on the way home (last 20 minutes of our car ride was EXCRUCIATING, I seriously don’t know how you ladies make it to the hospital in full on labor, also something needs to be done about the bumpiness of CA-23). They were 4 minutes apart, getting progressively intense and then they just stopped. Again. And my midwife is probably laughing because she said, “I can do this, but I don’t think it will do anything really. If your body is ready, it is ready. We all have our little things that we think starts labor, but I tend to think it is all just coincidence.”

So if I still haven’t had this baby by Wednesday morning she wants me to call my OBs office (that I haven’t seen since November, for some reason I feel really awkward about that phone call even though things ended on very amicable terms with their office even wishing me the “very best” and to “keep in touch”) and get an NST done and see what he thinks.

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We are going on false alarm #5 over here…

Since Sunday, I’ve had four more false alarm contractions sessions. It is getting a little annoying.

The second to last time was over 21 hours long. The contractions never really picked up in intensity, but were just annoying and strong enough to keep me from sleeping or napping. I was actually a tiny bit relieved when it was finally over with yesterday because I knew it meant I would finally get to sleep.

So last night we were blessed with pretty much an entire night contraction free and sleep issue free as well (which, those of you who have been through pregnancy know all about that third trimester insomnia). I slept straight through from about 11pm to 5am when my bladder woke me up. I don’t even remember the last time that happened.

Upon relieving my bladder, drinking a little water, rearranging my pillows and climbing back into bed, I was hit with some fairly serious contractions. Much more intense than any of the ones I’d felt in the previous days. I seriously felt like it was impossible to breathe during them. After about three of these guys I woke up Stephen because I thought for sure this was going to be the real deal.

We started timing them and they were more along the lines of what early labor should look like: slightly intense contractions that are about 4-5 minutes apart. The contractions in previous days had always been around 2 minutes apart and were not intense at all, just annoying. They were intense in that I had to concentrate on breathing through them, but still not hard labor.

So little praise to my husband here. He has actually been reading the Bradley childbirth book and it has been like a dream come true. Just in these few false alarm experiences I can tell a HUGE difference between this time around and Bean’s birth.

If you remember from Bean’s birth story, upon arriving home I had him install our carseat. This was mainly because I honestly felt like he would be more of an annoyance to me than help. A few hours later when he was asking me questions like, “What do you want me to do?” and “Do you want to wear a sports bra?” I was definitely annoyed. I was in hard labor and couldn’t really begin to think about what he needed to be doing and didn’t really want to make a decision about whether or not I should be wearing a sports bra when our midwife arrived.

This time has not been like that at all. Stephen totally takes charge of the situation. There are not 50 questions about what to do. He knows what to do and he handles it and gets it done. This morning when I was having trouble breathing while lying down and found that sitting up helped more, instead of letting me sit with no back support on our bed, he ran around the house gathering up pillows to get me propped up and as comfortable as possible. He rolled a towel to stick near my lower back and provide counter pressure during contractions since back massage wouldn’t be easy in my semi-reclined position. He was completely attentive to every body part when a contraction was going on and constantly reminding me to relax my forehead or not clench my hands. He payed attention to my breathing and reminded me to stay calm and take deep breaths. Gave me visualization cues to concentrate on during a contraction.

In short it was awesome. A couple weeks ago Stephen said he has learned way more from the book than he ever did from our childbirth class. The class was useful, but the book just provides way more information about what to do in certain situations and why to practice things like breathing through a contraction standing up in case your wife has to go to the bathroom during labor and has one on the way there, etc. So for all those men out there that say they don’t need to read the book and that they’ll just get enough information from their childbirth class, I offer up this example. Books really do get the information into your head in a different way and a more thorough way, in my opinion. And I think anyone who says that they don’t need to read the book is just being lazy. You have nine months to get the reading done. It really isn’t that much. Be a good coach. Read the book. End of public service announcement for all the husbands who are probably not even reading this.

Anyway, back to my story. After about an hour of timing, my husband called our midwife and based on what we were experiencing, she too thought this sounded like the real deal. So she left Bakersfield fairly early this morning and carefully navigated her way through some soupy valley fog and an hour of LA freeway driving.

Stephen got everything arranged with his sister to watch Bean and got her all packed up and out the door.

By the time my midwife arrived the contractions were around three and half minutes apart, but still around the same intensity level. She did a cervical check which hurt like heck because I had a contraction during it. I was so disappointed when she told me that I was still the same as our visit from over the weekend which was 2cm and my cervix was still posterior. Seriously? All these contractions and intensity and no progress at all? What the heck?

She said we should go for a walk and see if that helped things progress. So we did a couple laps around our apartment complex. During our walk I stopped being able to feel individual contractions because I was experiencing some fairly instense pelvic pressure. When we got back to our apartment, I still had a lot of pressure and was not feeling any contractions. Then as I sat for a bit the pelvic pressure began to subside, but I still was not feeling any contractions. I was starting to get even more disappointed. Not only was this seeming to turn out to not be the real deal, my midwife drove two hours to hang out for nothing for a few hours and my sister-in-law and her family had to get all coordinated and rearranged to watch Bean. Plus this was false alarm NUMBER FIVE. I was starting to feel like the boy who cried wolf.

A few minutes later I got up and walked around our livingroom. I started having some contractions again, but they were really weak and didn’t seem to have any pattern. Stephen was making me some food to eat and by the time I’d finished my meal I wasn’t feeling anything. It was all over.

So completely frustrating.

Because of work schedules and vehicle coordination, my sister-in-law wound up watching Bean the whole day. While it was kind of nice to be baby-free, after about an hour of sewing and hanging out by myself I was pretty much bored and already missing Bean. So I guess if anything this helped me realize that I’m glad we’re no longer DINKS.

Anyway, that’s your second installment of Baby Watch 2009. Stay tuned…

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Thankful.

Sorry I’ve been a bit absent. Then again it seems the rest of the blog community has as well so I don’t feel so bad.

Usually this happens to me when I get wrapped up in a project or a book. Both are happening right now. Can’t really blog the projects because they are Christmas presents. And I’m sure you’d get sick of me quoting passages from the book I’m reading.

I’ve also been experiencing some “false” labor freakouts since Sunday and so I’ve been technically on bedrest. The best way to make this work with Bean when I am home alone with her is to hole ourselves up in our guestroom with some of her toys where she really can’t get into anything, can’t go running off into places she isn’t allowed and so I don’t have to go up and down the stairs 50 times a day for diaper changes, naps, etc.

So because of that it seems our decision this year not to go anywhere for Thanksgiving was a good one. Though it has made for the most different and quiet Thanksgiving we’ve had since we were dating. I actually wondered if we’d even have a traditional feast at several points or just wind up eating leftovers because nearly every activity starts me feeling like I’m about to go into labor. Not fun.

But I managed to save up most of my energy and pull off a little mini-feast for our three person family.


Herb roasted turkey half breast on a bed of brown and wild rice stuffing.


The feast, clockwise from top: rice stuffing, herb roasted turkey, cheater Trader Joe’s gravy (I’m terrible at making gravy and theirs is pretty good), mashed potatoes, and cranberry orange sauce (not from a can, once you do it homemade you’ll never go back).


This was the first Thanksgiving where it was possible for Bean to eat the food, but she just played with it instead. Gotta love my picky little eater.

So anyway I am thankful for many things today. Among them:
-Not actually going into labor yet. I am hoping to at least make it to 36 weeks (Monday) and even better would be 37 weeks so that I can still have the labor/birth experience I want and have him at home with my midwife. Before Monday and we’ll be making a not-so-fun emergency trip to the hospital.
-My sister, Andrea. She dropped everything she was doing on Tuesday to help me out. She drove down here, purchased some of my homebirth supplies, went grocery shopping for me, helped me do a bunch of laundry, clean, entertained Bean and so much more. And on top of it all she’s 29 weeks pregnant. Seriously, the girl is a superstar.
-My husband. Tuesday after work he went to Target and got the rest of our homebirth supplies, some of which include items that are quite embarassing for him to purchase, I’m sure. He got up this morning with Bean, let me rest and relax pretty much the whole day and has been rocking the deep cleaning of our house and still is as I type this. He is awesome.


The giant to-do list he made today and has nearly completed!

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You have asked… a pregnancy update follows

I think I felt more connected to my pregnancy and the baby when I was pregnant with Bean than with the current bean because my symptoms were so severe that I was constantly thinking about the fact that I was pregnant.

Now, not so much.

Days go by without a single thought towards it. Then I have a day like today where too little sleep plus back to back errands leaves me achy, crampy and flat-on-my back exhausted. And then I’m like, “Oh yeah. I am pregnant. Probably shouldn’t try to do too much like that again.”

Or maybe this is second child syndrom already setting in.

Hmmm. Not so sure. I just think it is hard to forget that you are pregnant and that fact is sucking the very life out of you when you are barfing 20 times a day.

So glad this pregnancy is completely different.

I am definitely excited. I honestly can’t wait until I feel that first kick. To daily know that there is new life within me. And as much as I fear becoming a huge fat beached whale by the end of the pregnancy (brought on by the fact that I’ve already gained 9lbs… which by the way, what the heck?! I am eating healthy and stuff.), I actually like having that round basketball tummy and all the maternity clothes that go with it.

I am very excited to be so close to the end around Christmas time. Many moms that I know that have been pregnant at that time say it is a unique experience.

I am excited to have another homebirth with my awesome midwife.

I am excited to have my babies interact. For Bean to be a big sister.

And despite everyone else’s wishes, I really hope I am having a girl. I’ve got my name picked out and everything. This time I’m not sharing though. I don’t want the criticism.

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Update on home birth

So at this point home birth is a go.

My midwife did research. I did research. She conferred with other birth professionals.

Then we talked. Then I talked to Stephen. Basically we feel we are where we were at a month ago.

Yes, I have had complications in this pregnancy.

I’ve also managed to get all my problems under control.

When my midwife took me on she recommended I continue prenatal care with my OB so that if anything serious came up we’d know about it ahead of time.

None of the things that my OB listed as possible complications on Tuesday would just show up suddenly in labor.

Goiters can be detected by ultrasound ahead of time… something I plan to ask for at my next OB visit because regardless of whether I’m having a hospital or home birth I’d want to know ahead of time if my kid is going to have a goiter that could cause breathing difficulties upon birth.

I was also reminded in this situation by good friends that I can’t get too caught up in getting my way. One friend in particular said it best:

We educated ourselves so much and we set so many plans, but what we failed to do was to plan to be flexible. While we as parents have a say in our birth process, there are some things that will happen whether they are fair or not. Just like in life. We cannot control everything that happens to us and at times we may be put through unnecessary hardship. I would encourage you (and Stephen) not to get too caught up in the statistics, the facts, what the books say, what the doctors say, what your friends and families say, and what your own plans are. Its easy to lose sight of the forest by focusing too much on one tree. Especially as it relates to childbirth. I hope that my experience encourages you to do what you need to do to prepare yourself mentally for the flexibility that childbirth requires. Not every birth is cut and dry like a doctor or a book would describe. Each experience is unique and the most important part is who arrives in the end… …I would encourage you guys to do what we failed to do. Let the situation flow naturally and ask the Holy Spirit for guidance along the way. Above all else, do not let any change of plans mark your childbirth experience with discouragement. Whether you have to have a hospital birth or you end up with a home birth that goes slightly different than you had pictured; no matter how small the change do not allow yourself to get discouraged. And do not allow yourselves to look back and say “I really wish it had gone a different way.” If you are flexible, then you and Stephen will be able to have an enjoyable birth experience no matter what the chain of events.

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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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