Friday, April 22, 2011

We have a decision.

We are going to start interviewing midwives for our home birth.

What is a midwife? According to : a midwife is a person qualified to deliver babies and to care for women before, during, and after childbirth. A Certified Nurse Midwife (CNM) is a nurse who has completed a master's degree program for the midwife profession and is professionally licensed. Basically, a CNM has the same level of education as a nurse practitioner, and many of us are just fine seeing a nurse practitioner for other health needs. At this point, I may very well keep leaning very far over into the "I definitely want to be a CNM when I grow up".

John and I have been doing research. Mostly me, but he has watched one documentary on me so far, and we have another on our Netflix. At first, John didn't understand why I wanted to even have the conversation. I'm sure many of you have the same question. Well, here's my explanation.

Directly from the World Health Organization :

With the global phenomenon of increasing urbanisation many more women are delivering in obstetric facilities, whether they are having normal or complicated births. There is a temptation to treat all births routinely with the same high level of intervention required by those who experience complications. This, unfortunately, has a wide range of negative effects, some of them with serious implications. They range from the sheer cost of time, training and equipment demanded by many of the methods used, to the fact that many women may be deterred from seeking the care they need because they are concerned about the high level of intervention.Women and their babies can be harmed by unnecessary practices. Staff in referral facilities can become dysfunctional if their capacity to care for very sick women who need all their attention and expertise is swamped by the sheer number of normal births which present themselves. In their turn, such normal births are frequently managed with "standardised protocols" which only find their justification in the care of women with childbirth complications.

Pregnancy isn't a sickness. It's not dangerous and life threatening (if everything is normal). Birth isn't a serious medical emergency that requires IVs, nothing by mouth, laying flat on your back with everything exposed and your feet in the air, and a million different drugs. Birth is natural. Very natural. Women have been getting pregnant and giving birth since the beginning of our species. We have been having babies long before there were doctors, hospitals, medicines, surgeries, policies. Yes, I know your next thought is "well, a lot of babies used to die during those times". You're right. Modern medicine is great when it is needed. Some women need to give birth at a hospital with lots of monitoring, emergency medicine, and doctors and surgeons to save both the mother's and baby's (or babies') life. However, it's not always necessary.

Don't get me wrong; I'm not dissing a woman's choice to go to the hospital rather than birth at home. Not. At. All. I do feel that women should have a choice. I know some women do not tolerate pain and want the pain medications. I know some women are too nervous that something may go wrong. I know many, many women just don't realize there is another choice. But this isn't about any other woman and her choices. It's about me, my choice, and my reasons for choosing this way.

I'm not considered high risk. I'm not even considered moderate risk. I am low risk. If something changes and I do become moderate or high risk, my decision will be obsolete because I will have no other choice but to deliver my child at the hospital. For now, we're going to stick with the low risk status which allows us choices.

I have chosen home birth because I know what I want to get out of the birth experience. For me, it's not just about the end product: the baby. It's an entire experience that I want to feel! I want to be able to listen to my body during this life changing event just like I listen to my body about other issues. I listen to my body when I get the heebe jeebes about someone or some situation. I listen to my body and move into comfortable positions when I'm not comfortable. Why should I ignore my body during the one time that my body will be doing the second most important thing it's made for (the first being keeping me alive)? Every woman who has been through labor knows that some positions make her more comfortable than others, some movements help speed labor while others seem to almost stop it, and doing some things can completely keep her mind off the pain until she is far enough along in the labor that she can receive the pain medications she wants. I want to be able to do those things (except for the waiting for pain medication part - I know, another far out there thing in today's world). Also, when I was 16 or so, I was watching "A Baby Story" on TLC. I watched a water birth, and I knew at that moment that is how I wanted to give birth. It looked so comfortable and natural. The mother and baby appeared so relaxed and happy. It was simply amazing. I want that. I want to feel in control, be able to listen to my body, and give birth the way women were designed to do so from the beginning of time.

Also, I want people to be there with me, mostly women. I want my husband and my dad, but I also really want some love and support and estrogen. Mostly, I want women who will help me through this. I don't know exactly what will go on during labor, but I may want someone to climb in the tub with me while I'm laboring. I may want one set of hands rubbing my back, one set holding my hands, one set running fingers through my hair, and one set just rubbing my arms. I want people who will help me when I need it and leave me alone when I don't without feeling put out or put off or offended when I ask to have everything stop or ask for some time in the room in the tub alone. I may want someone to grab me a glass of milk and a piece of chocolate, adjust the lighting in the room, adjust the music, turn off that damn song, whatever. Rochelle will be doing a lot of this as part of her life's passion, but I want others there to feel and be involved as well, even if the being involved part simply means being silent support. Then we can all meet my Peanut together. We will all experience the empowerment that comes from doing it on your own how you were born to. Oh, and everyone will have to be ok with me being at least pantsless, but possibly completely naked. Whatevs, it's not sexual. It's what happens as a result of sex. Ha!

Oh, and let's not forget about the position! Other than standing on your head, lithotomy (laying on your back with your legs in the air) is the worst position to give birth. It's used because it's convenient for the doctor. My doctor told me point blank that he allows birth in no other position than lithotomy because he needs access. Eh, you can see the vagina pretty well in other positions also. Why is lithotomy so bad? Well......
  • lying on your back puts pressure on the vena cava which is bad for both you and your baby. It reduces blood flow and therefore oxygen to both you and your baby. It can lead to fetal distress.
  • It decreases the diameter of your pelvis by as much as an inch.
  • It is uncomfortable. It can even cause contractions to be more painful. Most women if given the option do not lie on their back during labor and birth.
  • In this position you are pushing against gravity. Because of the unique contours of the birth canal you are actually pushing uphill in the lithotomy position. During birth you want to get gravity to work for you. This means that in almost all cases you want to be as upright as possible so the baby can come down.
  • The lithotomy position can make you feel like a stranded beetle. You really don't have much control in this position. It can be hard to hold or grab onto anything and the stirrups or attendant's arms aren't as sturdy as a solid surface underneath you.
  • This is the position used for pelvic exams which might not be the association you want when you're giving birth. It exposes all of your parts to everyone else present. Laboring and giving birth in upright positions faces your yoni/vagina/private parts to the floor.
  • It puts strain on the perineum and in combination with forcible pushing makes perineal tears more likely to occur.

Yeah. That's why I don't want to be forced into that position.  I'd rather follow my body's cues.

Now, we all know what I want now. If something does happen and I need medical intervention, we will not hesitate to go to the hospital. I live within 15 minutes of the nearest hospital that also has a NICU, so just because I'm going all "hippy" doesn't mean I won't let medicine intervene if it is necessary. I want a natural, loving experience, but I also want to live and have my child live. If it comes down to it, we will go to the hospital without question. Our midwife will be trained, and she will know what signs to look for and when we need to go to the hospital.

The best parts about giving birth at home, to me, are 1) the baby doesn't get taken away from me away into another room and left under a heat lamp and possibly given a bottle or a pacifier, and 2) our midwife will come back to my house at 24 hours and one week postpartum to make sure everything is going ok. No hospital stay. (Means we save big $$$) Oh, and no flipping IV. Yesssssss. That makes me super happy.

Hopefully now you all understand a little more the reasons for John and I choosing this. After I explained these things to him and had him watch an amazing documentary with me on Netflix, he has started to really think about what this means to me. He also realizes I am not an unreasonable person, and I have looked into this and not just making a blind choice. We watched Pregnant in America, and we have The Business of Being Born lined up for another night. With Pregnant in America, we follow a couple who are having a baby through their research, experience with doctors and the healthcare system in general, and their experience with their birth. Trust me; it's definitely worth the watch.

Wednesday, April 13, 2011

Whoah. It's been a while.

Well, nursing school has certainly been keeping me very busy, so blog updates have been few and far between.

Today is 15 weeks, 5 days. John and I heard Peanut's heartbeat again yesterday. I love that sound. I can't help but smile every time I hear it. We will know if Peanut's legal name will be John Tyler or Lilly Katherine on May 10 (hopefully, if Peanut isn't shy). That also happens to be the day before my Adult 1 final, so that break from stress will be awesome. Also, I will finally be able to tell people what I'm having instead of "well, we just don't know yet. It's too early to tell." It's getting to where it hurts to lean forward, and it feels pretty uncomfy to sit up straight. I suppose that's a good thing... Peanut isn't a fan of being crushed. My belly is sticking out farther every day. I'm down to very few pairs of pre-pregnancy pants that still fit. The only reason they still fit is because I bought them before I lost 40 pounds last year. I'm getting down to the bare minimums on shirts too. Bleh. Suppose I'm going to have to go shopping again soon, which makes my bank account and my husband very sad.

Speaking of shopping, Brooke and I are going to be having a yard sale very soon. I have clothes and some other things in my house I need to get rid of, and she has a ton and a half of clothes. Both of our men have clothes they don't wear also. Plus she's super crafty and makes super neat things.

Brooke is making our costumes for the Renaissance Fair. Super excited!!! Going to be an amazing way to spend my birthday!!!

Now, serious stuff.

People. I'm going to breastfeed (unless Peanut can't). Yes, I know it will cause pain. Yes, I know I will be the only one feeding the baby for a while until I feel like enough of a BFing relationship is established that I will be ok pumping into bottles. Yes, I know I may shoot my husband with milk during intimate moments. Yes, I know that means no one else gets to bond with Peanut during feeding time. However, that doesn't mean no one else can bond with Peanut. Bathing, playtime, diaper changes, snuggles. All very good ways to bond. Yes, I have done my research. Breastmilk is FREE, and it's THE best superfood on the planet! Also, never having to warm up a bottle? Yes please. Pop out a nipple and let's go. No fumbling for a bottle, no measuring out of a can, no worrying about making sure it's warm enough, no hoping my baby is getting adequate nutrition. Seriously, please stop hounding me about my choice to breastfeed. My husband is super supportive, as are 90% of my friends. Lets all just agree that if you don't like my choice, we should all realize it is my choice with my child and call it good. While I may disagree with your parenting choices for your kids, they are still your kids. Besides, do some actual research of breastfeeding and breastmilk, then tell me how horrible it is compared to formula. Oh, and one more thing. Stop telling me that as a breastfeeding mother, I will give up all my independence and my baby will be clingy and I can never go anywhere. Well, 1) as a new mother with an infant, I don't plan on going places without the little one, and 2) breastfed babies show to be MORE independent because they are so closely bonded with mommy. Seriously, I could go on and on about the benefits.

Yes, I have lost weight during my pregnancy. 12 pounds so far. No, I'm not purposefully trying to lose weight during pregnancy. Yes, I do eat. I promise, I EAT. John can attest to this. I don't know why I'm losing weight, but I am. Yes, my doctor knows. I brought it up again yesterday at my OB appointment. I said "your nurse is worried about my weight loss." He looked at my chart and said "I'm not. You're overweight to begin with, and the baby will take what it needs from you. As long as you're eating and holding food down, I'm not worried. We like to see a steady weight gain starting at around 22 weeks even if it's only 1 pound a month, but some women lose weight their entire pregnancy and have perfectly healthy babies." So, that's all there is to say about that. When my doctor gets worried, I'll get worried.

Ah, I'm looking forward to vacation. A week on the beach. I plan on enjoying every second of it! I love the beach. The heat, the ocean breeze, the summer sun, and the seafood (effing YUM). Ultrasound May 10, Vacation May 14. Going to be amazing.

Love you guys. <3