We are officially going to attempt a homebirth.
After our Bradley class on Friday, Rob told me that I'm just too anxious about a hospital birth and that he thought it would be better for us to do a homebirth. I called the midwife this morning to let her know. She is going to call me back later today to schedule an appointment to start my chart and collect our deposit.
What a relief this is! I feel so much better about the birth process. And hopefully, if everything goes well, we will be able to welcome our little bundle of joy in the comfort of his home.
Now we just have to paint the nursery and get everything set up and ready to welcome him.
Monday, May 17, 2010
Thursday, May 13, 2010
Thoughts on Homebirth
I've really been interested in the concept of a homebirth ever since I started reading up on the birthing process. So far, I have read the following books:
1) Natural Childbirth the Bradley Way
2) Ina May's Guide to Childbirth
3) The Birth Book
My Bradley instructor has also recommended a homebirth for us, due to our insurance situation. The first thing that any of the books on birthing will tell you is to find the right doctor - one that is pro-natural birth and that you can develop a relationship with so he/she will understand your concerns. With my HMO insurance, I can't do that. Whoever is on call at the time I go into labor and check into the hospital will be who delivers my baby. I may never have met the person before.
Another thing the books say is that the more comfortable you are with your surroundings and the situation, the better labor will go. The easier it will be for the woman to relax, open up, and allow her body to do the work it needs to do. With my huge fear of needles and interventions, the higher than necessary Cesarean rates these days due to all the malpractice litigation, and all the anxiety that goes along with those things, I just don't feel that I will be comfortable enough in a hospital setting to relax. I will be constantly looking at the clock worried that my time was running out and that I am getting closer and closer to them forcing some intervention on me.
I equate this to having sex. For a man, if you tell them that they have 10 minutes to have sex. After then end of the 10 minutes, their mother is going to come in the room, and they will have to immediately stop whatever it is they're doing. If they have that thought in the back of their mind, they will either 1) actually be able to perform because they don't want their mother coming in during the middle of the act, or 2) they will get performance anxiety and not be able to even start in the first place. Either way, it probably isn't going to be the most pleasurable experience for either the man or the woman.
Although the birthing experience isn't exactly like sex, a lot of the same organs are being used. All my lady parts will be exposed for the world to see. Most women who have gone through it say that it doesn't matter at the time...all they want is that baby out of them. But it just doesn't seem like an experience that would promote relaxation, which is needed during the first stage of labor.
I feel like, due to my huge fear and the anxiety that comes along with possible interventions, I will be much more comfortable at home. I will know all the people who would come in the room. I could walk around naked if I wanted to. I could have the freedom to determine the best laboring positions for me, labor in the tub, eat when I need to eat, etc without someone looking over my shoulder and watching the clock. The midwife is trained to know when intervention is truly necessary, and to ensure that I get to the hospital in time should the need arise. I won't be afraid of someone pushing an unnecessary intervention on me just because it makes them more comfortable. Intervention would only happen if it was truly medically necessary. Just knowing that would make me feel more comfortable and would take away the anxiety.
I know that homebirth is a crazy concept these days, because it is so infrequent. People who have a homebirth or are considering it seem to be labeled "hippies" or old-fashioned. If you say you're going to have a homebirth, the first reaction is that it is dangerous and wouldn't you want to be in a hospital in case anything happened?
Homebirth used to be the norm. And, yes, both women and babies did die sometimes. But only 5% of the population truly needs an intervention and would have been saved by a Cesarean. Today over 33% give birth via surgery - that's 1 in 3 babies! I cannot believe that women's bodies have "broken" that much to cause the 5% to increase to 33%. The only reason for the increase in the rate is because of the doctor's fear of litigation. If the doctors "do all that they could to save the baby" then a jury won't rule against them. So many babies are born via Cesarean that would have been completely fine if their mothers had been allowed to labor longer.
And both women and babies still die sometimes in the hospital, so there's a risk either way. If it's so safe to have babies in the hospital, why is the maternal mortality rate worse in the U.S. than any other country except one? Most other countries use midwives primarily and have a much higher percentages of babies born at home. These countries have a much better maternal and infant mortality rate.
As you can probably tell, I'm completely convinced in having a homebirth. Now I just have to convince my husband...
1) Natural Childbirth the Bradley Way
2) Ina May's Guide to Childbirth
3) The Birth Book
My Bradley instructor has also recommended a homebirth for us, due to our insurance situation. The first thing that any of the books on birthing will tell you is to find the right doctor - one that is pro-natural birth and that you can develop a relationship with so he/she will understand your concerns. With my HMO insurance, I can't do that. Whoever is on call at the time I go into labor and check into the hospital will be who delivers my baby. I may never have met the person before.
Another thing the books say is that the more comfortable you are with your surroundings and the situation, the better labor will go. The easier it will be for the woman to relax, open up, and allow her body to do the work it needs to do. With my huge fear of needles and interventions, the higher than necessary Cesarean rates these days due to all the malpractice litigation, and all the anxiety that goes along with those things, I just don't feel that I will be comfortable enough in a hospital setting to relax. I will be constantly looking at the clock worried that my time was running out and that I am getting closer and closer to them forcing some intervention on me.
I equate this to having sex. For a man, if you tell them that they have 10 minutes to have sex. After then end of the 10 minutes, their mother is going to come in the room, and they will have to immediately stop whatever it is they're doing. If they have that thought in the back of their mind, they will either 1) actually be able to perform because they don't want their mother coming in during the middle of the act, or 2) they will get performance anxiety and not be able to even start in the first place. Either way, it probably isn't going to be the most pleasurable experience for either the man or the woman.
Although the birthing experience isn't exactly like sex, a lot of the same organs are being used. All my lady parts will be exposed for the world to see. Most women who have gone through it say that it doesn't matter at the time...all they want is that baby out of them. But it just doesn't seem like an experience that would promote relaxation, which is needed during the first stage of labor.
I feel like, due to my huge fear and the anxiety that comes along with possible interventions, I will be much more comfortable at home. I will know all the people who would come in the room. I could walk around naked if I wanted to. I could have the freedom to determine the best laboring positions for me, labor in the tub, eat when I need to eat, etc without someone looking over my shoulder and watching the clock. The midwife is trained to know when intervention is truly necessary, and to ensure that I get to the hospital in time should the need arise. I won't be afraid of someone pushing an unnecessary intervention on me just because it makes them more comfortable. Intervention would only happen if it was truly medically necessary. Just knowing that would make me feel more comfortable and would take away the anxiety.
I know that homebirth is a crazy concept these days, because it is so infrequent. People who have a homebirth or are considering it seem to be labeled "hippies" or old-fashioned. If you say you're going to have a homebirth, the first reaction is that it is dangerous and wouldn't you want to be in a hospital in case anything happened?
Homebirth used to be the norm. And, yes, both women and babies did die sometimes. But only 5% of the population truly needs an intervention and would have been saved by a Cesarean. Today over 33% give birth via surgery - that's 1 in 3 babies! I cannot believe that women's bodies have "broken" that much to cause the 5% to increase to 33%. The only reason for the increase in the rate is because of the doctor's fear of litigation. If the doctors "do all that they could to save the baby" then a jury won't rule against them. So many babies are born via Cesarean that would have been completely fine if their mothers had been allowed to labor longer.
And both women and babies still die sometimes in the hospital, so there's a risk either way. If it's so safe to have babies in the hospital, why is the maternal mortality rate worse in the U.S. than any other country except one? Most other countries use midwives primarily and have a much higher percentages of babies born at home. These countries have a much better maternal and infant mortality rate.
As you can probably tell, I'm completely convinced in having a homebirth. Now I just have to convince my husband...
Wednesday, May 12, 2010
Homebirth Midwife Interview
We interviewed our first homebirth midwife yesterday. Her name is Debi, and I felt very comfortable with her. She is a born-again Christian. She's a Certified Professional Midwife and has performed 563 births so far. She has 30 total years of experience (including the five years of training/interning she did). She is able to suture, if tearing occurs, and even teaches suturing to others. She's delivered all of her seven grandchildren. She's never lost a baby or a mother while she was the primary midwife.
She said that she has had to transport some of her patients to the hospital, but her intervention rate is something like 0.6%. She said that some of the reasons for transport included: prolapsed cord (where the umbilical cord came out before the baby) and hemorrhaging after the birth (where she couldn't get the bleeding to stop). When she was explaining the situations, she seemed like she knew what she was doing and got both mother and/or baby to the hospital safely.
Her care includes prenatal visits and two postnatal visits. She would visit our house once before the baby is born, at 37 weeks, to ensure she knew where to go and that we had all the supplies necessary. She would perform a comprehensive baby exam after birth, so we wouldn't have to take the baby to the pediatrician for five days after birth.
She also recommended a pediatrician - the same one that our Bradley instructor recommended - as well as another pediatrician who can perform circumcisions and is the best in town at doing it. We will be changing our medical insurance as soon as the baby is born so that we can use someone other than Kaiser for the baby.
She seemed very down-to-earth and friendly - someone you can really get along with and is easy to talk to.
I'm totally sold on the idea. I think Rob has warmed up to it, but isn't quite all on board yet. His biggest concern is that, while it is legal to have a homebirth, it is not legal for midwifes to deliver at homebirths. According to Debi, it is a misdemeanor for her to practice in Georgia. They apparently don't actively enforce this, but aren't in any hurry to change the law either. Debi said that two midwives in Georgia have been put under investigations (she is not one of them). One was dropped pretty quickly, and the other went through the investigative process and nothing was ever done.
So we now have two options: homebirth with a midwife (my fav option) or hospital birth with a Douala. We will have to interview some Doualas if we decide on the latter. We also have two other names of midwives that we could interview for the homebirth option.
We will see...
She said that she has had to transport some of her patients to the hospital, but her intervention rate is something like 0.6%. She said that some of the reasons for transport included: prolapsed cord (where the umbilical cord came out before the baby) and hemorrhaging after the birth (where she couldn't get the bleeding to stop). When she was explaining the situations, she seemed like she knew what she was doing and got both mother and/or baby to the hospital safely.
Her care includes prenatal visits and two postnatal visits. She would visit our house once before the baby is born, at 37 weeks, to ensure she knew where to go and that we had all the supplies necessary. She would perform a comprehensive baby exam after birth, so we wouldn't have to take the baby to the pediatrician for five days after birth.
She also recommended a pediatrician - the same one that our Bradley instructor recommended - as well as another pediatrician who can perform circumcisions and is the best in town at doing it. We will be changing our medical insurance as soon as the baby is born so that we can use someone other than Kaiser for the baby.
She seemed very down-to-earth and friendly - someone you can really get along with and is easy to talk to.
I'm totally sold on the idea. I think Rob has warmed up to it, but isn't quite all on board yet. His biggest concern is that, while it is legal to have a homebirth, it is not legal for midwifes to deliver at homebirths. According to Debi, it is a misdemeanor for her to practice in Georgia. They apparently don't actively enforce this, but aren't in any hurry to change the law either. Debi said that two midwives in Georgia have been put under investigations (she is not one of them). One was dropped pretty quickly, and the other went through the investigative process and nothing was ever done.
So we now have two options: homebirth with a midwife (my fav option) or hospital birth with a Douala. We will have to interview some Doualas if we decide on the latter. We also have two other names of midwives that we could interview for the homebirth option.
We will see...
Monday, May 10, 2010
Good Weekend!
This past weekend was a great weekend! I got to see my dad and sister, who I don't get to see very often. My other sis graduated from medical school to become Dr. Amy Coker. I attempted and completed a 12 mile run. We celebrated my first Mother's Day with my mom and grandmother - three generations of mothers together. And we got to use Robby's grill and eat hamburgers and hot dogs. So many fun things!
I will admit that I've been slacking a little on my running lately. I'm trying to still run 3 miles three times a week and a long run on the weekends. Most weeks I've run 3 miles at least two days a week, but slacked on the third day. I have missed my long runs several times in the past two months. It's probably because of the fact that I have no goal to work toward and no set schedule for my runs.
Last weekend I attempted to run a 13 mile run. I got to 8 miles, and was so chaffed around my upper/inner thighs that I had to stop. It was quite depressing - my thighs have gotten so fat. I probably could have run the distance if the chaffing hadn't happened, but I'll never know.
So this weekend, I ran with some shorts that were a lot tighter - kinda like biker shorts, but without the padding. I also used Vaseline as extra insurance. It really helped. I was able to run a full 12 miles. The first few miles were sub-10 minute miles, and I finished the whole thing in about 2 hrs, including two bathroom breaks, several hydration breaks, and a short refuel break. It made me feel really good.
Next week Amy will be able to run with me. I would like to attempt 14 miles, but we'll see how that goes.
I will admit that I've been slacking a little on my running lately. I'm trying to still run 3 miles three times a week and a long run on the weekends. Most weeks I've run 3 miles at least two days a week, but slacked on the third day. I have missed my long runs several times in the past two months. It's probably because of the fact that I have no goal to work toward and no set schedule for my runs.
Last weekend I attempted to run a 13 mile run. I got to 8 miles, and was so chaffed around my upper/inner thighs that I had to stop. It was quite depressing - my thighs have gotten so fat. I probably could have run the distance if the chaffing hadn't happened, but I'll never know.
So this weekend, I ran with some shorts that were a lot tighter - kinda like biker shorts, but without the padding. I also used Vaseline as extra insurance. It really helped. I was able to run a full 12 miles. The first few miles were sub-10 minute miles, and I finished the whole thing in about 2 hrs, including two bathroom breaks, several hydration breaks, and a short refuel break. It made me feel really good.
Next week Amy will be able to run with me. I would like to attempt 14 miles, but we'll see how that goes.
Thursday, May 6, 2010
Belly Button hurts :(
My stomach has started to grow, and I can tell.
I feel this horrible stretchy feeling both inside and out. I do not like it!
I have a belly button ring. I've had it since I was about 18. I've actually tried to take it out before, but I can't get the ring open to take it off. Well, now that my belly is stretching, the area around the ring is starting to hurt. If it is touched, it hurts. It is red between the holes that the ring goes in and out of.
I put on a cammy yesterday for bed, and it looked like I had stuffed a pillow under my shirt.
I already feel like there is no room left for this little guy to grow, yet I know this is just the beginning. :(
I feel this horrible stretchy feeling both inside and out. I do not like it!
I have a belly button ring. I've had it since I was about 18. I've actually tried to take it out before, but I can't get the ring open to take it off. Well, now that my belly is stretching, the area around the ring is starting to hurt. If it is touched, it hurts. It is red between the holes that the ring goes in and out of.
I put on a cammy yesterday for bed, and it looked like I had stuffed a pillow under my shirt.
I already feel like there is no room left for this little guy to grow, yet I know this is just the beginning. :(
Wednesday, May 5, 2010
May Doctor's Appointment
Yesterday, I went to my monthly appointment. I went with a list of about 25 questions for the midwife. Several of her answers were rather disturbing. Here were some of the questions and answers.
Q: How often do you find that first-time mothers require an episiotomy?
A: Not often. We midwives try not to preform episiotomies if we can help it.
Awesome! At this point I'm feeling pretty good.
Q: What are the possible dangers of having frequent Doppler/ultrasound checks?
A: There are none. I would read up on it, if I were you, but it's just ultrasound waves, so it should be harmless.
I actually had read up on it and we also discussed it in our last Bradley class and according to what I've read and what the Bradley instructor said, it can be harmful to single celled organisms (i.e. my other eggs). So now I'm getting a little skeptical.
Q: I have some numbness on my upper abdomen (I pointed it out for her). Is this normal?
A: Oh, yes. It's quite normal. I had it when I was pregnant. It's just stretching. It may come and go.
She is the first person that I've asked that actually said it was normal. When I told the nurse before the midwife came in, she said she'd never heard of that in her 17 years of nursing. I've also asked several mothers and people who have recently been pregnant, and no one has said they had it. So are we (the midwife and me) the only normal people I know?? Again, I'm skeptical.
Q: Does the hospital require any standard procedures, such as IVs or electronic fetal monitoring?
A: They don't require IVs. That will be up to whoever is delivering your baby. You can have intermittent monitoring, where you would wear the electronic fetal monitor for 15-20 minutes of every hour. They like to have a record. You can refuse it, but then the nurses are very uncomfortable and are more likely to overreact if anything goes slightly wrong. The cable is six or eight feet long, so you can still move around.
Whose comfort is most important here?? Mine - I'm having the baby - or the nurses? And from everything I've read, having a record just means that they are more likely to jump in the intervention bandwagon at the first possible sign of problems, because then if something does go wrong, I will be less likely to win any lawsuits if they "do everything to save the baby" (i.e. Cesarean).
Q: Does the hospital allow eating and drinking?
A: When you're in active labor (more than four centimeters dilated), you won't want to eat or drink. Your digestive system slows down. And most women who eat get nauseous and throw up. It's allowed, but most people don't do it.
I'm sorry, but if labor is truly labor, and I'm working and burning calories, I will want to eat. Your digestive system slows down when you run a marathon too, but I still eat. And I had my best time during the marathon where I ate and hydrated throughout the entire marathon, rather than waiting until my body was depleted toward the end. And if I can't last more than four hours (sometimes two hours) right now without eating, I'm certainly going to want to eat during labor, unless I just happen to pop that baby out in less than four hours, which is highly unlikely.
Q: Provided there are no complications, can I have skin-to-skin contact with the baby right away before he is taken to be cleaned/examined?
A: Yes, unless there is meconium in the amniotic fluid or some sort of respiratory issue.
Okay, that's good
Q: Is there a time limit on labor?
A: No, there's no time limit. You can labor for 30 hours if you want as long as you're progressing. But if you get to, say, six centimeters and stay there for five hours, something is wrong. That's not normal, so something will be done.
Hmm...that seems like a bit of a contradiction. There's no time limit, but if I stay the same for five hours something is done? That sounds like a time limit to me.
Q: If the baby is breech on my due date, do you automatically schedule a Cesarean?
A: We don't automatically schedule one. There are things we can do to try to turn the baby. But if you go into labor and the baby is still breech, you will be sectioned.
According to our Bradley instructor, there is only one doctor in all Atlanta that will attempt a vaginal breech birth. That doctor is not a Kaiser doctor.
Q: How far past my due date can I go?
A: Two weeks. Then we will induce.
So, what if my due date is off? What if I would have gone into labor at 42w 1d? This baby better come early!
I was very discouraged when I left the appointment. I think I will just stay home until I start pushing...then if there are complications, we'll be on our way to the hospital anyway. Besides, some women push for hours. A 20 minute ride to the hospital shouldn't be a problem, right? :(
Q: How often do you find that first-time mothers require an episiotomy?
A: Not often. We midwives try not to preform episiotomies if we can help it.
Awesome! At this point I'm feeling pretty good.
Q: What are the possible dangers of having frequent Doppler/ultrasound checks?
A: There are none. I would read up on it, if I were you, but it's just ultrasound waves, so it should be harmless.
I actually had read up on it and we also discussed it in our last Bradley class and according to what I've read and what the Bradley instructor said, it can be harmful to single celled organisms (i.e. my other eggs). So now I'm getting a little skeptical.
Q: I have some numbness on my upper abdomen (I pointed it out for her). Is this normal?
A: Oh, yes. It's quite normal. I had it when I was pregnant. It's just stretching. It may come and go.
She is the first person that I've asked that actually said it was normal. When I told the nurse before the midwife came in, she said she'd never heard of that in her 17 years of nursing. I've also asked several mothers and people who have recently been pregnant, and no one has said they had it. So are we (the midwife and me) the only normal people I know?? Again, I'm skeptical.
Q: Does the hospital require any standard procedures, such as IVs or electronic fetal monitoring?
A: They don't require IVs. That will be up to whoever is delivering your baby. You can have intermittent monitoring, where you would wear the electronic fetal monitor for 15-20 minutes of every hour. They like to have a record. You can refuse it, but then the nurses are very uncomfortable and are more likely to overreact if anything goes slightly wrong. The cable is six or eight feet long, so you can still move around.
Whose comfort is most important here?? Mine - I'm having the baby - or the nurses? And from everything I've read, having a record just means that they are more likely to jump in the intervention bandwagon at the first possible sign of problems, because then if something does go wrong, I will be less likely to win any lawsuits if they "do everything to save the baby" (i.e. Cesarean).
Q: Does the hospital allow eating and drinking?
A: When you're in active labor (more than four centimeters dilated), you won't want to eat or drink. Your digestive system slows down. And most women who eat get nauseous and throw up. It's allowed, but most people don't do it.
I'm sorry, but if labor is truly labor, and I'm working and burning calories, I will want to eat. Your digestive system slows down when you run a marathon too, but I still eat. And I had my best time during the marathon where I ate and hydrated throughout the entire marathon, rather than waiting until my body was depleted toward the end. And if I can't last more than four hours (sometimes two hours) right now without eating, I'm certainly going to want to eat during labor, unless I just happen to pop that baby out in less than four hours, which is highly unlikely.
Q: Provided there are no complications, can I have skin-to-skin contact with the baby right away before he is taken to be cleaned/examined?
A: Yes, unless there is meconium in the amniotic fluid or some sort of respiratory issue.
Okay, that's good
Q: Is there a time limit on labor?
A: No, there's no time limit. You can labor for 30 hours if you want as long as you're progressing. But if you get to, say, six centimeters and stay there for five hours, something is wrong. That's not normal, so something will be done.
Hmm...that seems like a bit of a contradiction. There's no time limit, but if I stay the same for five hours something is done? That sounds like a time limit to me.
Q: If the baby is breech on my due date, do you automatically schedule a Cesarean?
A: We don't automatically schedule one. There are things we can do to try to turn the baby. But if you go into labor and the baby is still breech, you will be sectioned.
According to our Bradley instructor, there is only one doctor in all Atlanta that will attempt a vaginal breech birth. That doctor is not a Kaiser doctor.
Q: How far past my due date can I go?
A: Two weeks. Then we will induce.
So, what if my due date is off? What if I would have gone into labor at 42w 1d? This baby better come early!
I was very discouraged when I left the appointment. I think I will just stay home until I start pushing...then if there are complications, we'll be on our way to the hospital anyway. Besides, some women push for hours. A 20 minute ride to the hospital shouldn't be a problem, right? :(
Monday, May 3, 2010
Everything is going well
My sister mentioned that I hadn't blogged in awhile and the last blog that I made was somewhat negative. Everything is going well at the moment, and nothing really new has happened recently, so I haven't been on as often.
I have a doctor's appointment tomorrow, so I'll blog a little after that. Rob and I have been going to our Bradley classes for three weeks now. I have a lot of questions that I am going to ask at the appointment because of what we've learned at the classes.
We also have two hospital visits scheduled this month. We will be visiting Northside Hospital on May 15th. We will be visiting Emory Eastside Hospital on May 27th. We also have a childbirth class scheduled through Northside on May 22nd. From what I understand, those types of classes are more geared toward telling you how to follow the hospital policies, and don't really help in understanding how to best labor and deliver like the Bradley classes do.
One interesting thing that has happened recently is that I currently have a numb spot on my upper abdomen. It is right below my breasts and at the top of where my belly starts to stick out. Sometimes I can feel sort of a dull, achy pain there, but most of the time (for the past week) it has just been numb. I can pinch it or poke it and can't really feel anything. I've asked a lot of people who have been pregnant if they ever experienced that, and none of them have. I'm thinking that it may be related to my scoliosis. I'll be asking the doctor/midwife about it at the appointment tomorrow.
I have a doctor's appointment tomorrow, so I'll blog a little after that. Rob and I have been going to our Bradley classes for three weeks now. I have a lot of questions that I am going to ask at the appointment because of what we've learned at the classes.
We also have two hospital visits scheduled this month. We will be visiting Northside Hospital on May 15th. We will be visiting Emory Eastside Hospital on May 27th. We also have a childbirth class scheduled through Northside on May 22nd. From what I understand, those types of classes are more geared toward telling you how to follow the hospital policies, and don't really help in understanding how to best labor and deliver like the Bradley classes do.
One interesting thing that has happened recently is that I currently have a numb spot on my upper abdomen. It is right below my breasts and at the top of where my belly starts to stick out. Sometimes I can feel sort of a dull, achy pain there, but most of the time (for the past week) it has just been numb. I can pinch it or poke it and can't really feel anything. I've asked a lot of people who have been pregnant if they ever experienced that, and none of them have. I'm thinking that it may be related to my scoliosis. I'll be asking the doctor/midwife about it at the appointment tomorrow.
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