Why A Birth Center and Midwife

I want to be clear first: I think modern medicine and hospitals are awesome. Seriously, they have been my good friend this pregnancy. Rehydrated me 6 times now due to hyperemesis. My son bashed his chin open a few weeks ago and the wonderful local children’s hospital glued him back together. I had repeated tonsillitis and ear infections (so bad it was damaging my immune system) in college, my amazing ENT took out my tonsils and my hospital took great care of me afterwards. Seriously, wonderful and totally awesome when you need that kind of treatment. But I don’t view a pregnancy with no major complications as a something that needs that kind of treatment.

 

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Jack was a few hours old, both of us doing good.

Jack’s birth was good. Nothing horrible happened and we were both given reasonable care. It was very standard Medical Model of Care. They followed protocol and did all they could to ensure we both were healthy and alive. I gave birth in a very busy county hospital, so some resources took longer to get. But when they did come, they tried hard to give us good care with the limited time they had. Overall, I say it was just good.

However, now that I am more educated on birth, I want better than good. I want my requests respected (within reason). I want the Midwife Model of Care this time. In a nutshell, the Midwife Model of Care believes that birth is a natural process that your body already knows how to do on its own. You just need a little guidance and enough time to relax to do it. There is still medical care offered—a midwife doesn’t just leave you alone for 40 weeks and only show up if you have a problem in labor. Standard procedures like blood tests, ultrasounds, and exams are offered. The key difference is you build a closer relationship with your midwife, so you feel comfort and trust her during the birth process.

That last part was what drew me to midwife the most. My OB with Jack was not the person who delivered him. I adored her and wish she had delivered him, but that’s not how my clinic worked. The on-call OB at the hospital at the time delivered Jack. I had no idea anything about her, only her name and that she was a doctor. I didn’t know her stance on natural childbirth practices, c-section rate, or anything else. And I had no choice but to just trust this random woman when I was the most vulnerable. It was worked out okay, but it’s not something I want to do again. There are a few things I want to avoid now that I know better.

First of all, when I got to the hospital, they did not believe me that my water actually broke. The triage nurse looked at me like I was lying…despite the fact that I was carrying a SOAKED towel between my legs. She left me standing next to the bed leaking and gave me no instructions. I had a contraction, so I leaned over the bed and set my towel on the tray. She came back in and freaked out! Threw the towel at my husband and said NO NO NO! She immediately got cleaning supplies and sanitized everything again…leaving me hunched over wanting to cry from the contraction and still no instructions. Then she left again. I just grabbed the gown on the bed, got undressed, and laid down. She came back in and asked if I was having contractions. I looked at her crazy and said yes. I told her they were 2 minutes apart and 90 seconds long. She kinda rolled her eyes. She hooked me up and looked very surprised to see I was right. Then she asked for a urine sample. I told her I did not have to pee and really needed to lay down because my contractions were coming faster. She said I had to, they needed a urine sample to admit me. So Michael helped me hobble to the bathroom. I tried, but only got a big gush of fluid. I came out and told the nurse I couldn’t. She took the cup and said fine, she will check to see if it’s actually amniotic fluid. Then she announced it indeed amniotic fluid and without saying anything else really, she checked me. I was 2 cm. I was kinda bothered that she didn’t ask first, but it got me away from her faster so I didn’t argue. She left without saying anything again and came back close to an hour later. At this point, I was starting to transition. I couldn’t talk during my contractions and was started to shake. While Michael was asking if I wanted him to sign the epidural form just in case, I started to vomit. The nurse once again couldn’t believe it so she checked me again, I was close to 5 cm. They quickly took me to my room and I was so happy to be away from that nurse. Looking back, I can understand her attitude. She had to follow the Medical Model of Care and I was not following the procedure she was set to do. I didn’t come in as a women not sure if she was in labor who had the time wait as she checked all the boxes. That being said, she did have poor bedside manner.

In my room, I was progressing so fast and was exhausted. I knew I needed an epidural to relax. They needed my blood work results before the anesthesiologist could come. One nurse really fought for me. She put a STAT order on my blood work and refreshed the screen every 5 minutes to check. Then once the results came, she called the anesthesiologist immediately. She held me while the needle went in and stroked my hair when I had contraction at the same time. So, I know nurses can be very amazing and really help you when you need it.

 

Would you keep telling this face they need to flip on their back?
Would you keep telling this face they need to flip on their back?

However, there were some other issues. She and another nurse kept insisting that I had lay on my back for continuous monitoring. I physically couldn’t. That made contractions unbearable. Plus, I knew on your back is the worst position possible for labor progression. And continuous monitoring is unnecessary if there are no complications. I did go onto my back for a bit every hour or so to check if Jack was still okay, but flipped back on my side once they said it was good. I finally asked if there a major reason why and they said no, just protocol. Then they backed off. Once again, they didn’t do anything bad really. They had a system to follow, but my body’s needs didn’t fit into it.

 

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Taken the day I posted this. The red mark is permanent. It should have been our consent to give it to him.

I pushed for 1.5 hours and Jack was stuck with his 1 head inch out. The doctor stuck an external probe on Jack’s head to check his vitals since he had been in there so long. No one said anything to Michael and I, just told me to stop pushing for a second. At the time I didn’t really realize what she was doing. He was fine so she told me to push again. In general, I have no objection to having this done. He was stuck for awhile and it was important that she made sure he wasn’t in distress. But, it left a scar on Jack’s forehead. If anyone was going to make the choice to permanently mark our child, it should have been ours. I would have totally understood if they said “I’m going to stick this on his head to check his vitals, okay?” It was not an emergency situation, no one was rushing, they did have time to ask. I resent the lack of communication and consent, not the actual procedure.

 

About this time is when I saw what the IV bag said...
About this time is when I saw what the IV bag said…

After Jack finally came out, they plopped him on my chest and encouraged me to nurse him. I vaguely remember them saying my placenta came out intact and no excessive bleeding. I thought yeah yeah, I’m trying to feed my child. Then I looked up at my IV and saw the bag said Pitocin. I really wanted to get mad. I said out loud and in my birth plan that I did not want Pitocin unless it was truly necessary. They started a bag to get my placenta out quickly and never mentioned it to me. They gave me a medication I did not consent to. If they said something like, “We would like to start Pitocin right now to get your placenta out quickly because we need to make sure you are okay before the doctor has to leave for the next delivery”, I would have totally understood and said okay. I know this is standard Medical Model of Care, but I resent not being informed of what was happening to my own body.

I was one EXHAUSTED and stressed mama, don't let the smile fool you.
I was one EXHAUSTED and stressed mama, don’t let the smile fool you.

I also hated my hospital stay. The nurses were all super busy because the ward was full. Many of my questions and requests barely got answered. Also, being woken up to be checked every few hours stressed me out beyond all belief. I was exhausted and the hospital was not restful. The second night there, Michael went to sleep in the car because he was so exhausted and had to drive us home the next day. I was alone in the room with screaming Jack and so exhausted I couldn’t even think straight. I burst into tears and was shaking. The nurse came in and said I just needed to sleep. I explained that I can’t because he won’t calm down, and you are going to come back in shortly to check us. She just shrugged and left. I know there was nothing she could do, that was not her role and she was just following the Medical Model of Care once again. But it was stressful and hard for me in that moment. It made me feel like I was already a horrible mother.

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This time around, I know what I want in my birth experience. And unless there is an emergency, I don’t want the Medical Model of Care. There are women who truly need this type of care all along (my friend who has Sickle-Cell Anemia and fought infections most of her pregnancy definitely did). So, it is wonderful this type of care exists. However, I want something different this time. I want a connection with the person I am trusting to touch me when I am the most vulnerable and help bring my child into the world. I want her to know right off the top of her head that I do not want Pitocin. I want to labor on my side without question and not have to argue for occasional monitoring. And I want to recover in a relaxed, comfortable setting with my husband and newborn. I want my provider to believe me when I say something is happening. With the Midwife Model of Care at a birthing center, I get all this. They are not crazy things to ask for at all. I want to be respected, informed, and comfortable. All medical patients deserve this, especially women who just giving birth.

I really suggest you check out Birth Without Fear. It really changed my views on birth and helped me process some of the issues I had with Jack’s birth.

Childbirth Class and Labor & Delivery Again

On Friday I went in for my second third trimester doctors appointment. Once again, I had lower blood pressure and a higher pulse. So my doctor decided I should go to Labor and Delivery–again–to get it checked out. Michael and I tried to say I was fine, but she insisted. She misunderstood what I was saying about feeling dizzy/faint almost everyday and thought I was having heart palpitations.

Four hours later (car crash victim came in shortly after me and I had no problem letting her go first), I was told everything was fine. Jack was prefect and I had no signs of preterm labor. My pulse was a little high, but nothing bad. And my blood pressure was lower, but not bad either. They did an EKG on me and said my heart was perfect. They gave me some juice to drink before I left, and told me to just keep my blood sugar up and relax. Dizziness is normal and as long as I am not blacking out daily, I am okay.

Even my meat-eating husband loves Veggie Grill.
Seriously go try it! source

Michael bought me a nice lunch at Veggie Grill (I am SO in love with that place, the buffalo wings and  “fish” tacos are amazing!) and then took me home to rest. We are both kind of annoyed we had to go again since we both knew Jack and I were fine, but happy to know nothing major is wrong. Just exaggerated pregnancy symptoms. At least I got yummy food 🙂

Anyways, Saturday we had an all day childbirth class. My clinic offers free classes through the counselor so I didn’t want to sign up for another class, but Michael said he wanted it. Then he was not amused when I told him the class was 9 AM to 4 PM, and the same day as Giant’s Fanfest.

The class was offered for free through my hospital and taught by an OB nurse. Not all hospital offer free classes, but most offer something so I suggest checking it out.

If you know nothing about labor and delivery, I really suggest you take any class possible. They go over stuff that is vital knowledge to ensure you deliver safely and your baby is healthy. Having a baby is scary and hard work, it’s nice to have a heads up on could/will happen. I’ll spare you from going over every boring detail, but here is some stuff I thought was really important.

  • Unless you feel something is wrong, only go to the hospital when you are in active labor. This is usually when your contractions follow the regular pattern of 4-5 minutes a part. Until then, stay at home or go about your normal day if you can.
  • If you water breaks at anytime, go immediately to the hospital. Even if your contractions are irregular and far apart.
  • When your water breaks, remember TACO: T– time it happened, A-amount that came out, C–color of the fluid, O–odor of the fluid. Remember or document this information, and tell your doctor or nurse right away.
  • Remember that as painful as contractions can be, that are only temporary and will pass. Each one increases in intensity until it reaches a peak, then tapers off.
  • Rest as much as you can in between contractions. Focus on relaxing rather than waiting for the next one.
  • During active labor, try to change positions every 30-60 minutes (unless you can’t move because you had an epidural). This will keep encouraging your body and your baby to progress.
  • Urinate as often as you can, this not only alleviates pressure but will provide your baby with more room as it drops down further.
  • Try to stay as relaxed and comfortable as possible at all times.
  • If you decide you want an epidural or a shot of narcotics for pain management, it may take awhile to actually receive it. The doctor will usually check your cervix first, then call in the order or call the anesthesiologist. Then papers need to be signed and you will need to be prepped. Keep this in mind if you are considering pain medicine.
She also had this chart of positions to try during labor. I tried to get a better picture, but the lights in the room keep causing a glare. This is the best pic I could get:

I really like the squatting and sitting positions, especially with the ball. She recommend we try these positions now, that way we can get used to them and see what we like. Some of these are yoga poses that I happen to do almost every night anyways. I really suggest everyone do Cat/Cow pose, it feels so good to stretch out your back and alleviate the pressure from your baby while your belly hangs.

We have the hospital tour, a newborn care class, and an infant CPR class in the next weeks. I am looking forward to the hospital tour the most. Even though I have been to Labor and Delivery twice now, I only went to the Triage area. I have questions about what happens when you are actually admitted. Then I will be able to finalize my birth plan too.

Anyways, here is a bump shot I took a week and half ago. Another H&M top that I am so in love with.

29 weeks.

Here are some links for more info on labor: 
Signs of Labor, American Pregnancy Association
10 Ways to Relieve Labor Pain, Fit Pregnancy
Water Breaking During Pregnancy, What to Expect
Labor Positions, Mayo Clinic

Why I Got A Flu Shot And Things to Consider Before You Get One

There is a lot of controversy when it comes to vaccines. I don’t want to get into the whole debate, but I wanted to put some information out there so you can make your own informed decision about how to prevent the flu.

I never got the flu shot until I was 22-years-old and I was a pretty healthy kid. I did get sick a lot in college, but not with the flu. I had a lot of tonsil/sinus/ear infections (and yes all the thee at the same time) starting my sophomore year at Oregon. After 2 years of some horrible infection every 3 months, I had to get my tonsils out. A few months after I got a very bad cold. The doctor told me I most likely got sick again because all these infections slightly damaged my immune system. He recommended I get the flu shot every year from now on.
After that I started to take more preventive measures to avoid getting sick and it worked pretty well for awhile (which proves to me that your body can fight off germs if you give it a chance). Then I started dating my now husband, and the week before finals our last term at UHH, he caught the flu….and gave it to me. I did get the flu shot that year, but that particular shot did not inoculate against the strand we caught. It was a strand effecting Japan and they did not think it was hit America that flu season (or so the urgent care doctor told me)….guess they didn’t realize that Hawaii is not really near the mainland and would get the virus sooner…
The flu was awful. Ten days of us both squished in front the AC in my apartment trying to keep our fevers down. Coughing all over each other and barely being able to move. Needless to say, I NEVER want the flu again. EVER. It was the worse sickness I have had in my life. I honestly think childbirth will be more pleasant.

So, I have been trying to not take unnecessary medications since I found out I was pregnant. I took a few Tylenol (for aches and pains) and Benedryl (for sleep and nausea) on occasion, but only when I really really needed it. When it came time to get the flu shot, I had to think about it. I did not want to get the flu again, especially when there can be a lot more serve complications when pregnant (including death of the mother and fetus). But I did not want to harm my baby and there is some nasty junk in flu shots.

Then one day my mom called me one day to say that Dr. Oz says all pregnant women should get preservative-free flu shots. My response, “Do you have to do everything Dr. Oz tells you?” She told me it’s my choice, but to think of how awful the flu was last time. So I did some research first (I linked the articles I read below). Then I talked to my doctor. She said they did have preservative-free shots and it was safe. I also asked my husband, who agreed I should get one because I get sick so easily.
I was still not convinced I should get it right away since I had got the shot year I got the flu—what if I inject all this stuff into my baby and I still ended up getting very sick? But then I remembered I live on the mainland now, and odds are the shot will be for the correct virus this time. Then I read the CDC’s criteria for who should definitely get the flu shot and realized I fit into 3 of them: pregnant, compromised immune system, and blood disorders (Anemia). I realized, for me personally, the benefits outweighed the risks.

I am glad I got the flu shot now. As of this morning, 15 deaths and 13 hospitalizations in the Bay Area alone for the flu. Three of them in my county. And yeah, I know the media hypes things—I did go to a very good Journalism School and know how the news works—but those are still 15 innocent people who lost their lives.

Like I said, it is your personal choice on whether to get a flu shot or not. You need to do what is right for yourself and your baby. But please make an informed decision above all else.
Articles I read about the flu shot:

Key Facts, Center for Disease Control

Pregnancy and the Flu, March of Dimes
Five Reasons Why I’ll Never Get A Flu Shot, The Organic Prepper (Blogger)

Low Blood Pressure: So That’s Why I Keep Almost Fainting….

source

I went to my nutritionist the day after my whole embarrassing Labor & Delivery ordeal. I had a much better experience this time, no crying in my car afterwards!

I explained how I got dizzy during my counseling appointment and that was not the first time that has happened. I explained how my doctor thought it was low blood sugar, and the doctor at L&D thinks my anemia was a factor too. She took the time to actually listen to me and look over all my lab work. Yes, my blood sugar was lower when I felt dizzy, but not actually out of the normal range. And yes, my blood work from my glucose screening 3 weeks ago said I had anemic iron levels, but the ones taken the at the hospital yesterday were within normal (meaning my iron supplements are working). So she was not convinced either one was the reason for feeling so faint.

Then she say my blood pressure readings and asked if I had naturally low blood pressure. The last pre-pregnancy blood pressure I can remember was from last May, and it was something like 104/75. It’s normal but on the lower side (here to learn how to read blood pressure). At the appointment to confirm my pregnancy, it was something like 102/80, still lower but normal. I couldn’t see the rest of the numbers on my chart, but the one from almost fainting was 91/71 and at L&D it went up to 94/75.

It’s normal for your blood pressure to drop in the first and second trimester, which is normally not a that big of a deal, just some minor dizziness. However, since I have blood pressure naturally, dropping 10+ points in just a few weeks makes it’s worse. I am do not have hypotension because I am still in the normal range though. And since my baby is doing fine and I have no other complaints, she does not think I have an underlying condition causing it.

She loved my diet and said there is no reason why I cannot continue being vegan. My weight gain is perfect, she said I could have one more snack a day if I wanted actually. She loved that my husband and I go for walks daily on our break. Her only suggest was maybe a few extra walks a week to help increase my blood pressure. She made a note for my doctor to follow up on it at my appointment on Friday too.

So I am going to keep doing what I am doing, take a few extra walks, and be grateful that I do not have hypertension or preeclampsia. Between high blood pressure that runs the risk of needing an emergency c-section before I have a stroke and low blood pressure that makes me almost faint, I’ll take the slight inconvenience of being faint.

Anyways, here is a recent pic of my bump. Twenty-six weeks and 2 days here.

Go Niners!