Tuesday, May 15, 2007

So much to tell, so little time.

In brief: all is well, mulling over the birth already

All is still well.  I no longer wake up in the middle of the night for a toilet run. I still fit into my regular clothes, most of them at least. There's definitely something growing in my abdomen, but I don't think it really shows yet. At 16 weeks, I'm trying not to let that concern me. Let's just say there's plenty of fluff for the baby to hide under.

I'm still feeling remarkably relaxed. According to my book on PG, the hormones can cause a sense of euphoria. That might explain it.

That doesn't mean there isn't any anxiety left, oh no. A fear has nestled itself into my brain: what if something goes horribly wrong during delivery?  
It's not entirely logical for all my anxiety to be pinned on delivery, rather than spread out evenly over the entire PG. But that's how it is and I'm looking for a way to deal with it.

(Warning: this post goes on and on about delivery options)

For one, I've been looking into available options for delivery in my area (put like that, sounds like I'm having goods delivered to the house). These are the possibilities:
- hospital birth with an ob/gyn
- hospital birth with a midwife
- labour at home with a midwife and then hospital birth
- home birth or at a birthing centre

The last option is most definitely out of the question for me. If something does go wrong, I want to be in hospital already. The three other options are under consideration.

I made an appointment with an independent midwife to discuss option #2.
There are clear advantages. When you work with an independent midwife, you have her undivided attention during delivery.  She knows alternative pain relief techniques. She has time to wait while the delivery proceeds at your body's pace.
The thing is, if something goes awry, you have to trust the midwife will be able to recognize this in time and call in an ob/gyn. This is where I start to tremble.
There is an ob/gyn on call at all times, but often he/she is not in the hospital but at home. It can easily take half an hour for them to arrive at the hospital. A lot can happen in half an hour.
The midwife tried to reassure me, telling me signs of trouble generally show up early during labour, leaving the ob/gyn plenty of time to arrive. Unexpected trouble is rare.  'Rare' has lost it's soothing charm for me. Total fertilization failure is rare.

At our next ob/gyn appointment, I asked the doctor's opinion on option 2. She was less than enthusiastic, to put it mildly. Being an ob/gyn, the only times she would come in contact with deliveries led by a midwife is when complications occur. She is then expected to swoop in, take over a patient she knows little about, and fix whatever needs fixing. The stakes are high, the pressure is high, and I can imagine the doctor is less than keen on getting involved. She told me she has seen too many near tragedies over the years. After our difficulties conceiving, did we want to take the risk?
Now, some would say this is all about protecting her turf, but I believe there is more to it.

I explained to her that I was feeling anxious about the delivery and that probably I would panic because of it.  What attracts me in option #2 is having a personal coach to talk me through. The idea is that I wouldn't need to panic, I'd have the professional by my side to push the emergency button if necessary.   
The doctor didn't brush away my concerns, she suggested I talk to one of the midwives of the hospital's maternity ward.

Thus, I made an appointment with said hospital midwife. Turns out, she works at the hospital part time and with the rest of her time has her own practice. In her practice, she doesn't do home births or lead hospital births. She does monitor labour at home and then escort you to the maternity ward, where she hands you over to the hospital staff present. Apparently, my ob/gyn had consulted with her beforehand, because she said it might be possible to stay with me for the rest of the delivery, to coach me until the ob/gyn would take over.

I'm still wavering what to do, though I think I'll try to make the hospital birth with personal coach scenario happen (provided we get that far). If tragedy does strike, I don't want to be left wondering 'what if I had stuck to my ob/gyn?'. There are no guarantees, but then at least I'll have done everything in my power to make it to the other side safe and sound.



At 15 May, 2007 01:25, Anonymous Anonymous said...

I think a coach is a great idea. It can be scary, and if you are nervous going in, you have someone there telling you what is going on with your body, encouraging you, and helping you feel more in control of the situation. I wish I had that - if you have a slow labour, you just get sent home and that can be nerve wracking and frustrating. If you can't get the midwife to be your coach, look for an experienced doula. That is what they do - coach women through labour. Unfortunately, they only coach and can't do the dilation checks like a midwife, so there is less of that kind of information available to you.
Finally, your comfort with the person is as important as their training. There are excellent midwives and excellent ObGyns - and crappy midwives and doctors. I would choose based on the person and where you want to deliver and not necessarily by profession. Good luck with your choice!

At 15 May, 2007 01:55, Anonymous Anonymous said...

That sounds like sound thinking. I was on the fence about getting a doula for my son's birth, as my husband promised me he would pass out at some point in the delivery. I never did arrange a doula, and neither did my husband pass out (though he did ask the doc in the OR as I was being prepped for surgery which direction would be best for him to fall), but all was well. I think the doula might've been nice to help support me while I did labour with my husband snoring soundly on the chair next to me.

At 15 May, 2007 02:52, Anonymous Anonymous said...

I think the personal coach while labouring in a hospital would be ideal. You will have someone who can help you through the whole thing and devote all of their attention to you. Are any kind of drugs in you birth plan, or do you want to do it without them?

At 15 May, 2007 04:20, Blogger ak1908 said...

Of course I don't have much to add to this discussion, but I can say that I wish you the best in making your decision. I always thought I wanted to do a water birth, but after going through IF, I'm not so sure I will even explore that once we do get a bfp.

At 15 May, 2007 06:30, Blogger Bea said...

Glad all is well.


At 15 May, 2007 11:33, Blogger Drowned Girl said...

I had an independent midwife attend me in hospital (I needed to be there as was on blood thinners)

Here in the UK, women tend to share the NHS midwives so that 2 or 3 mws are looking after a whole labour ward. This means they prefer the fixed belt style monitoring so they can see what's happening when they pop in.. and that makes women less mobile... and things get done "by the book" ... as I had my own midwife, she let me push for longer than the standard 2 hours as she knew things were OK.

I heartily recommend it, especially for the after care/support woth breastfeeding

Here in the UK, some very very good experienced mws have gone the independent route.

I also did hypnobirthing to help with my fear of medical intervention, and in the end my labour was fast and fantastic!

At 15 May, 2007 14:24, Blogger Thalia said...

The coach in hospital sounds like a wonderful option. I have to admit to not having gone this far in the planning yet!

At 15 May, 2007 16:29, Blogger Mary Ellen and Steve said...

I am so glad that all is well.

At 15 May, 2007 16:31, Blogger Mary Ellen and Steve said...

I am so glad that everything is going well!

At 15 May, 2007 16:54, Anonymous Meg said...

Lut - I was all for birthing centres initially, and booked into our local one, which is attached to the hospital. That was what I wanted.

And that's all well and good for 99% of births, but what if youre the 1% like I was? Midwives tend to assume things are normal when they aren't necessarily. When I went into pre-term labour, the midwife in the birthing centre told me to have a hot bath and go to bed, and was therein uncontactable as I went deeper and deeper into the real thing. It wasnt until I called the regular maternity ward in desperation that I actually got some action - they told me to come in right away.

In the end, birth is birth, and you need your piece of mind. Midwives just dont know everything. Sometimes I wonder if something might have been picked up earlier had I not had midwife-led care throughout my pregnancy.

At 15 May, 2007 17:02, Blogger Beagle said...

I'm so glad that all is well!

I have nothing useful to add about all the choices, but it looks like you got some good feedback here.

At 16 May, 2007 01:15, Blogger projgen said...

I second (third) the doula suggestion! Almost all of my friends have now used doulas and most of them have been very happy with the doula.

I'm with you - I'd rather be at the hospital with a doctor who (hopefully) knows me, yet have someone I know and trust right there with me. If we ever get to that point, I know Hubby's going to annoy me by massaging the wrong spot, or not massaging hard enough, or getting distracted by something and forgetting to massage altogether.

I'd rather try to remember that I love him at that time, rather than be annoyed with him while I'm trying (Gd willing) to deliver. ;)

At 16 May, 2007 16:53, Anonymous Sassy said...

Well it sounds like you're well on your way to making the best decision for you and your baby. Which ever option makes you feel the safest and most secure is all that matters. This is such a personal decision I think it's important to remember that there's no best solution - only what's best for you and your situation.

The only useless advice I'll offer is to sit down and write up a birth plan covering every possible situation. Having your thoughts and ideas in writing like that can help visualise what it is you really want. It can also show areas where you and your husband have different ideas and expectations. And it's very handy for the who ever you decide is best suited to deliver your baby.

At 17 May, 2007 10:50, Anonymous Kath said...

Dear Lut, your plan sounds very good. I admire you for thinking so far ahead -- I'm only now starting to think about birth options, and so far only about two: caesarean or vaginal (I've got a couple factors that could make it very difficult to deliver naturally). But I won't know more for at least another month.

At 18 May, 2007 02:34, Blogger Just another Jenny said...

If I had it to do again, I'd probably get a midwife at the hospital. I was very disappointed to find out that the OB didn't come in until the last 30 min and I didn't even get my OB. Your smart to explore your options.

At 18 May, 2007 04:26, Blogger Bumble said...

So nice to hear from you. Wow, 16 weeks already Lut. So happy you're thinking about the birth now. I'm sure it will go swimmingly. x

At 18 May, 2007 18:37, Blogger fisher queen said...

I think the coach or doula plus OB care is a reaally good way to go. You have all your bases covered that way. You might also try to find out about the nurses on staff. Some are so good, and are with you for so much of the time, that you might not even feel you need a doula. If they can't promise that though, it would be a great idea to have someone else with you.

At 18 May, 2007 22:35, Blogger Angie said...

It seems like everyone I know has their entire birth planned out to the last detail, but me. Good luck planning! Glad to hear all is well.

At 19 May, 2007 17:00, Blogger Sara said...

I hear you. Five years ago, I assumed I'd have a home birth. Now I want to be in the hospital, with a doctor.

A good friend of mine planned to have a midwife-supervised birth at a birthing center without medical facilities. When she was 2 weeks overdue, she was finally sent for an ultrasound, at which point they found out that the baby was breech, AND she had pre-eclampsia. I shudder to think about what might have happened if she'd gone into labor earlier. The midwife had totally missed the fact that the baby was breech (and even claimed that the baby had flipped back to head-down after the ultrasound, only to have the breech position confirmed on the next ultrasound a few hours later).

After working so hard to get pregnant, I just can't imagine taking any unnecessary risks. However, my yearning for individualized care hasn't gone away. I think that having a doula or midwife attend your OB-supervised birth seems like a good compromise. Good luck making the decision.

At 22 May, 2007 10:43, Anonymous Ova Girl said...

It's a hard one, especially when it can seem so tempting to go what will always be presented as the "safe " option. Having a coach is great and having a plan (which may only come together closer to the birth) of what you want eg Yes to gas, No to pethedine etc for your support team is also good. But having someone you can implicitly trust and have faith in to guide you thru I think is best of all and if you are looking to have that in a doula or midwife (rather than a friend say) then starting early to find that person is good.

At 24 May, 2007 17:04, Blogger lucky #2 said...

That is a hard and personal decision. I know after our struggle we only felt comfortable with an ob/gyn at the hospital. Fortunately, it was needed as I had to have an emergency c-sec.

At least you have a long time to interview and find a person that you are confident in their ability and experience. Sounds like you will be well prepared and educated to make the right decision for your family!

PS How exciting that you are thinking about delivery already! :)


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