Caitlin's Birth

If I had one word to describe this labor, it would be intense.  Yes, there was pain, but mostly it was just incredibly intense.

At 4:30am, I woke up with what I figured was probably just gas.  After two weeks of thinking gas pains were contractions, I had finally given up and figured everything was gas.  I tried to go back to sleep but lying down made it worse.  So I got up to watch TV.  I watched a few shows (I believe it was “The Middle” and “Modern Family” in case you were curious), and by 5:30, I was pretty sure these were actually contractions.  At 6, I woke Collin and told him it was time to set up the birthing tub.  I was watching SNL, when Caedmon woke up.  He came into the living room and sat on the couch with me where he soon fell back asleep.  By 7, the contractions were getting so intense that I stopped being interested in the show and could only concentrate on what was going on within my body.  So I got out my handy iPhone because there’s an app for that!  But seriously, the free contraction timer was nice because all I had to do was hit a button with the contraction, and it told me everything I needed to know (Well, at least as far as timing contractions.). 

It was around 7:15 that I told Collin is might be time to call my midwife.  At this point, my contractions were between three and five minutes apart, but were lasting less than a minute, so my midwife said to time them for an hour and let her know what they were like for that hour.  By 7:30, my contractions had increased to less than three minutes apart and they were lasting for a minute or longer.  I had moved to the birthing ball and couldn’t do anything but deal with labor.  I think it was Collin that decided we should call my midwife again.  This time she said she was heading our way.  Once I knew she was coming, I stopped timing contractions, and from then on I didn’t look at a clock again.

I moved to the bedroom.  I think at that point I decided that with no one to direct my labor (unlike last time) that I would follow the advice of Ina May and let my monkey do it.  In other words, I simply followed my instincts.  I was pacing around my bedroom making goodness only knows what kind of noises.  I kept trying to sit or lie down but that made it hurt worse.  I had to be able to move.  I kept thinking about those women who used to be tied down during labor, and I could not imagine what kind of hell they went through.

All this time Collin was filling the birthing tub which meant draining the hot water heater into the tub, waiting for the heater to fill and reheat, then draining it again.  Once the tub was full and the water reheated, I moved to the shower where I felt some relief.  That’s when I started dry heaving.  I never experienced actual transition with Caedmon so this was new.  I think I knelt down in the shower and my water didn’t just break, it exploded – it was like opening a shaken soda can.  Things were starting to get pretty intense (as if they weren’t already), and I felt the need to get out of the shower and move around. 

I moved back into the bedroom and got down on all fours.  I was beginning to feel a very slight urge to push, and I began to think, “Okay, if it’s time for this baby to be born then it’s happening, and it will be okay.”  I moved back to sitting on the bed, and the doorbell rang.  In came my sweet midwife who asked if I wanted to be checked.  Yes, I did, and I was 9 cm!  So I moved to the tub.  Not long after I got in the tub, Caedmon woke up.  We had read him a book about birth where the mom “roared like a lion.”  So of course, Caedmon comes in and says, “Mom, are you roaring like a lion?”  “Yes, Caedmon.”  “Mom, are you swimming like a lion?”  “Of course.”  And that was that as far as Caedmon was concerned.

The water was a bit of a relief, and I soon felt the need to start pushing.  I think the nice thing about the water is that it really allowed me to relax between the contractions.  I thought it was taking a while.  Caedmon was born after twenty minutes of directed pushing.  But when my midwife told me it had been an hour, I couldn’t believe it.  She asked if I wanted her to check me to see if she could help.  I was feeling pretty ready to be done, so I did.  She gave me a homeopathic to help the stubborn cervical lip that was getting in the way.  Not long after that I needed to get out of the tub to use the potty.  While in the potty, I felt the baby’s head start to crown. 

(I have to make a side note here.  One of the things that makes this experience so amazing is how involved I was – yeah, I know that sounds funny since in both situations I was birthing a baby.  At the hospital, they had to practically force me to touch the baby’s head, and even so, I don’t remember much of anything about it.  I think I’ll remember what Caitlin’s squishy little head felt like for the rest of my life.)

I called in my midwife, who told me there was still time to get to the tub if I wanted to have her in the water.  So I quickly waddled back to the tub.  In one big push, her head came out.  The cord was wrapped around her neck and it was too tight to unwrap, so I pushed like a mad woman to get the rest of her (ahem, ginormous and somewhat stuck) body out.  After one or two more big pushes, she was born into the water, my midwife handed her to me, and it was amazing.  I feel like there should be better words to describe something so awesome, but I’m not the writer I used to be, and those words just aren’t there.  She was beautiful, Collin was right there, and Caedmon came in almost immediately to meet his new little sister.

Next blog, I’ll tell you what a great day that was after she was born because the benefits of home birth don’t stop with the birth!

Caedmon's Birth Story, Part Four

Let’s see.  When we left off, we were on our way to the hospital.  I should also point out that I was fairly convinced that I was pretty far along.  I don’t think I could have thought I was in transition yet, but I definitely thought my contractions were five minutes apart, although it was hard to tell.  From the time we walked out the front door, it felt like a downward spiral.  At home, I was calm and relatively comfortable.  On the way to the hospital, I was really uncomfortable.  There was conflict in my mind over feeling totally wrong to get in a car and change locations during labor and relief that we were on our way to the hospital.  You see, as nice as it sounds when they tell you to labor as long as possible at home or that you don’t have to even come in until you feel the need to push, my biological response didn’t work that way.  Once I realized that this is it, and I don’t know when this baby is actually coming out, I started looking for my cardboard box in a closet.  I wanted to find a place, settle down, and go about the business of giving birth.  I didn’t want to get comfortable, nor could I get comfortable, knowing that I would have to relocate at the critical moment.  But I digress…

Once we got to the hospital, it got worse.  I went to triage (or whatever they call it).  First, they checked me and told me I was only three centimeters.  I felt like someone had deflated my labor balloon.  I looked across the room and saw the diagram of dilation; I saw those seven centimeters that I still had to go.  Then they told me they had to do a test to make sure my water had broken.  To this day, I do not understand why they did this.  I had been gushing water for five hours.  I could understand in a for-profit hospital where they can charge you an extra twenty or two hundred (if my recent ER bills are any indication) dollars for the test, but this was a military hospital.  They don’t have anything to gain from running unnecessary tests and procedures.  When they put me on my back to do the test, I felt like I was going to break in half.  This was the point where I turned to Collin, and said, “I can’t do this.”  And as the words came out of my mouth, I’m thinking I’m not supposed to feel this way until transition.  When I sat back up it was better, but I think at this point, the damage is done.  I’m entering into panic mode, and panic mode is what causes pain in labor.

The guy comes back and tells me (surprise, surprise) my water has broken.  So I wrap a sheet around my waste, and I walk half-dressed down the hall to my room.  I change into a hospital gown, which immediately makes me feel like I’m sick and possibly dying because that’s what I think of when I think of hospital gowns.    I go to the bathroom and feel like I’m going to throw up.   And I think again This is not supposed to happen until transition.  Then the doctor comes in and tells me they have to do an ultrasound to check the position of the baby, even though my midwife has checked this at my last two appointments.  So back on my back again I go.  And once again, I feel like I’m splitting in half. 

With that over, I’m handed over to the labor and delivery nurse.  This nurse was a blessing and a curse.  I’m forever grateful that I had a nurse that was supportive of natural labor; however, she decided to take over as my labor coach.  Unfortunately, she knew nothing about Hypnobirthing.  I spent the rest of my labor being told I needed to open my eyes and focus.  Not at all what I practiced.  Poor Collin got pushed to the sidelines.  And I was in such a state that I didn’t know what to do except to listen to her.  I was in constant pain.  There was never any down time in between contractions for me to collect myself and regroup.  They started the intermittent monitoring.  People would come in wanting me to check things or sign things.  I would basically try to ignore them, and they would look at the machine that goes ping and say, “Oh, we’ll just wait until the contraction is over.”  I’m sorry, what part of back labor do you not understand?  If you work in labor and delivery, then you need to understand that a woman who is having back labor doesn’t have an "in between contractions." She is in constant pain.  In fact, a woman who is in labor with no drugs is not in a mental state to take care of business.  Leave her alone.

Other than that, the labor was pretty uneventful.  My friend brought us bagels, but they made her leave them outside since I wasn’t allowed to eat (it’s not like you need fuel when your working that hard, right???).  Towards the end, the nurse thought having an oxygen mask might help me “concentrate” during contractions (Once again, not what I was supposed to be doing, but it’s hard to go to your happy place when every time you close your eyes, you’re nurse tells you to “open your eyes.  You can sleep after the baby comes.”  What planet was she from?  I didn’t sleep again for a month!).  So here I am hooked up to the stupid fetal monitor and breathing through an oxygen mask.  I kept asking for ice chips because my mouth felt drier than the desert (I later found out that Collin didn’t know I wasn’t allowed to have water.  He just thought I really liked ice chips!).  I start feeling the need to push, and the nurse tells me I need to breath the baby down.  This is the point in my mind that I see myself turn into a dragon and breath fire into the face of the nurse.  Maybe if I had been doing my Hypnobirthing techniques, I could have tried to override the intense urge to push, but with the stuff she had me doing, I felt like I had reached the top of the mountain and now I was hurtling down like an out of control train.

So she goes to get the doctor.  The general consensus is that I still have a cervical lip, but since I’m going all natural, I should be able to do it.  I’m so glad they all got together and decided it was time to do what my body had already decided on.  This is where things really fall apart (at least for me and the birth I had imagined and wanted – and once again, there was no reason I couldn’t have had).  Suddenly there is this flurry of activity.  Carts with trays full of equipment are pushed in.  Bassinets and baby warmers appear out of the wall like magic.  Half of the bed is pulled out from under me – stirrups appear at my feet, handles appear at my side.  I don’t know the exact number but somewhere between ten and fifteen people show up in the room.  Next thing I know, everyone is looking between me, my crotch, and the machine that goes ping, and yelling at me to “Push!” and counting, and then yelling at me to “Breath!  Breath for the baby!”

Twenty minutes later (and seven hours from the start of labor), Caedmon was out.  He was supposed to go straight on my tummy.  Here’s what happened instead…They lifted him up, and I saw him.  He wasn’t crying, which is perfectly normal.  Then they took him over to the bassinet/warmer thingy.  At that point, I panicked.  The only reason I could think of that they would take him away instead of giving him to me like they were supposed to is if something were wrong.  Over the clattering of the giant crowd in my room, I finally got Collin’s attention to ask him if everything was okay.  It was the longest probably less than a minute of my life, and I was practically in tears by the time he responded, “He’s perfect.”  By the time they gave him to me, they had been quite successful at getting him to cry.  They had also wiped him off (against my wishes) and covered his poor little feet in ink for the footprint.  He looked like he had been beat up.

I guess it’s at this point that they inform me that I’ve torn (Hmm…I can’t imagine how that happened.  Maybe all that crowd directed pushing?), and I’ll need to keep my feet in the stirrups until the OB on call can get there to check the tear.  Now the actual birth didn’t hurt, but having to lay there with my feet in stirrups for forty-five minutes while waiting for the OB was extremely uncomfortable, not to mention wondering that whole time if my vagina had been torn beyond repair.

Oh, but wait…this may be my “favorite” part of my birth story.  You see once they got Caedmon to cry, he didn’t seem to really want to stop.  I couldn’t get him to nurse, and holding a baby when your feet are in stirrups and you’ve got a freaking IV needle stuck in one hand is probably hard enough for the experienced, but for someone who hasn’t held a baby in ten years, it’s a bit confusing to figure out.  So what does my nurse tell me?  “The reason he’s crying is because you’re hurting him.  See that bruise on his head?  That’s from hitting your pelvic bone.  You’re pressing on that bruise.”  I can’t even begin to tell you what that did to what little confidence I had.  Simply readjusting him would have been enough.  She didn’t have to tell me I was hurting my new baby or that I had already inadvertently hurt him with my pelvic bone during labor.  At that point, I handed him to Collin, and I really think it was that moment that started a lot of our bonding issues, which then led to breastfeeding issues. 

Eventually, the OB showed up.  I was stitched up.  I was allowed to eat my bagel.  And I eventually headed to my room in the postpartum unit. And that was that.

 

This is me after the birth.  Notice the broken capillaries in my face.  That's not supposed to happen. That is from crowd-directed Valsalva pushing.

Now that the birth story is done, I’m going to try to start my breastfeeding story.  Stay tuned.

Caedmon's Birth Story, Part Three

Before I start the actual story, I feel that I should tell you that this story isn’t easy for me to tell.  Even though I’ve told long and short versions of it over and over, it’s never easy.  I still have a lot of regrets that I didn’t have the birth I wanted, and I couldn’t give Caedmon the start that he deserved.  For a long time, I felt like I had failed him.  I still feel that way sometimes.  While at the same time, I feel guilty because I have friends who have worse birth stories.  Mine is not that bad.  But there was no reason that it couldn’t have been what I wanted, couldn’t have been better, and couldn’t have been my best birth.

He made it home.  So after weeks of lying on the couch drinking water and praying this baby didn’t try to beat daddy, it was time to switch gears.  At my forty-week check up, my nurse midwife reminded me that if I made it to my forty-one week appointment, we would have to talk about scheduling an induction.  I love that with two weeks to go before I was “post term” we still had to talk about induction.  So we started taking long walks, eating spicy food, all those good things you do when you’re trying to get a baby out.  First my “official” due date passed.  Then my due date passed (My nurse midwife chose to go with the due date according to my last menstrual cycle; my due date was based on the day of conception.).  Then the day I had told him to be born (6-7-08…don’t you think that would be a cool birthday?). 

My sister-in-law had said that he would be born on June 8 because it’s her anniversary, and I had already stolen her birthday (I was born first, but I guess that’s a minor detail.).  So on June 7, even as we sat around with some good friends joking about stealing dates, I thought I felt some different sensations.  We went to bed after midnight that night.  And stupid me had eaten this huge meal knowing that it would come back to kick me in the bum through heartburn and acid reflux.  Around 2am, I gave up on trying to get comfortable in bed, so I got up to watch “Frasier” on TiVo.  A minute or two after I sat down I felt a pop, and thought Did my water just break?  Then I felt the “water.”

So I turned off “Frasier,” went back to bed, and told Collin that my water had broke.  Now right about here is probably where you’re imagining the crazy first time dad jumping out of bed all excited and asking what to do.  Well, at least, that’s more along the lines of what I was expecting.  Instead I got a half asleep, “Umm…okay.”  And I’m pretty sure at that point he rolled over and went back to sleep.  I decided that since I probably had a lot of work ahead of me, I should try to get some sleep.  So I lay down and slept until contractions stated around 5:30am.

It didn’t take long after contractions started for me to decide that a warm bath was the best place to be, so I moved to the bathtub.  Every once in a while, we would try to time the contractions, but I honestly couldn’t tell when they began and when they ended (I would later find out that that’s because I was having back labor.).  My plan was to stay at home as long as possible.  In fact, my nurse midwife had told me I could stay home until I felt the urge to push if I wanted.  Well, the problem with that is that when you don’t know what the urge to push is or feels like, it’s really hard to know if you’re feeling it.  And when you can’t get a handle on timing your contractions, you have no way of knowing where you are in labor.   As far as I could tell there was no end to the contractions.  There was never any relief, and I wasn’t prepared to have my baby in the bathtub (although, sometimes I wish that’s what I had done…okay, I’m half joking.). So around 7am, I decided it was time to start making our way to the hospital.

I’ll leave off here.  Sorry this story seems to drag on, but it wouldn’t do it justice to give you the quick and dirty version.  I’ve told that version a million times.  This is for those who want all the nitty gritty details and to make sure I don’t forget them!

Caedmon's Birth Story, Part Two

The only way to deal with my experience with the Jacksonville Naval Hospital is to split it into two different experiences, because that is essentially what I had.  My prenatal experience was completely different from the birth and postpartum experience.  So in this blog, I’ll tell you about my prenatal experience. 

I really think the Naval Hospital is on the right track.  They still have some kinks to work out (at least they did two and a half years ago), which we’ll discuss in the actual birth story.   So here’s how it works at the Naval Hospital…you can choose to either go to the OB clinic where, unless you are high risk, you will be seen by a nurse midwife or you can choose to go to a Family Practice doctor.  Generally, those who want a natural birth go to the OB clinic, and those who want a medicated birth go to Family Practice.  I know this seems backwards to a lot of people in the natural childbirth community, but the OB clinic is where the nurse midwives are.  Thankfully, they recognize that OBs are specialists and if you have a low-risk, normal pregnancy then you don’t need to see them.

One of the nice things about the Naval Hospital (and really the point of this part of the blog, I guess) is that they offer childbirth classes.  Not the typical “we’re going  to show you all your scary options for intervention” hospital classes (at least I’m assuming that’s what they’re like after seeing some of my friends reactions to them), but actual worthwhile classes for mamas wanting a natural birth (Heck, even if you don’t want a natural birth, it might be worth taking the class to find out that you have options, that childbirth is not as scary as everyone has told you it is, and that you can do it.  But that’s just my opinion.).

So the options are Hypnobirthing or Bradley Method classes.  I shied away from the Bradley Method because of the emphasis on husband-coached childbirth.  I’m sure there’s more to it than that, but since my husband wasn’t home to take the classes, and we didn’t know whether he would actually be home for the birth, it just didn’t appeal.  So I chose Hypnobirthing. 

I absolutely loved the Hypnobirthing classes.  They were so encouraging and informative.  I will admit, when it came time to watch the birthing videos, I was nervous.  All I could think of was the childbirth video they showed us in seventh grade.  It turns out watching women who have prepared for a natural birth have a baby is a completely different thing than watching a crotch shot of a screaming woman meant to scare the sex drive out of thirteen year olds.  (I know I’m stating the obvious here, right?)  In fact, some of these women actually seemed to be experiencing some pleasure from birth.  It was a real eye opener.

Everyone in the class, including the people who worked for the hospital, we’re supportive of home birth.  Unfortunately, we had all resigned ourselves to the fact that our insurance (Tricare) doesn’t cover homebirth, so we would go ahead with the hospital birth.  We were reassured that the nurses and doctors at the Naval Hospital were not only supportive of natural birth, they knew about Hypnobirthing and would allow you to have the birth you wanted (i.e. leave you alone to use the hypnosis and relaxation techniques that you’ve been practicing for months).  The only thing on my birth plan that was a nonnegotiable was not wanting a heplock.  The funny thing is that at the time it didn’t seem like that big of a deal.  It was annoying that they were insisting I have something that I didn’t need, but whatever.  Now that I’ve spent over twenty-four hours trying to hold and nurse a newborn with a needle sticking into my hand, I feel a little differently.  But I’ll save that gripe for the postpartum story.

So at this point, I’m beginning to realize that a hospital birth is not what I want.  A tour of the hospital was part of the class.  It was the first time I felt any fear about what I was doing.  I came home and my stomach was in knots the rest of the day.  There’s just nothing they can do to cover up the fact that it’s a hospital.  There was nothing in me that said, “Yes, this is a good and safe place to have a baby.”  In fact, every instinct in my body was telling me the opposite.

But I felt that at this point it was too late.  I know now that it really wasn’t.  But I didn’t have the support group or the information that I have now.  I didn’t even have a husband home to encourage me one way or the other.  I was alone.  And I didn’t think we could afford it.  If the Naval Hospital was really as great as it seemed during my pregnancy, then what did I have to worry about?  Sure, it wouldn’t be ideal, but it would be okay, and we were saving thousands of dollars.  Plus, I liked the nurse midwife I was seeing.  I felt comfortable with her.  I felt bad thinking about transferring care.  These are the only reasons I can come up with that I didn’t at least seek out a midwife for a consultation.  It was for similar reasons that I didn’t hire a doula.  It seemed like so much money.  And my husband would be there.  I had sent him books and copies of my birth plan.  He would know the deal, right?  Oh, ho.  If I knew then, what I know now.  

Join me next blog for the actual (yes, we’re finally there) birth story.

Caedmon's Birth Story, Part One

I think most birth stories start at least as early as the pregnancy.  And I think it’s a good place to start this one.  When I was eight weeks pregnant, my husband left for a seven month deployment.  One day before my twenty-seventh birthday and four days before my first prenatal appointment.  My due date and his date of return were pretty much one in the same.

The only thing I knew about pregnancy and childbirth was what I had been told by my mom and grandmother.  This mostly consisted of foggy birth stories.  In a lot of ways, I was a blank slate.  So the first thing I asked myself was Do I want an epidural?  I went to Google, found a pregnancy website, and read how they do the procedure.  I didn’t even get to the side effects and risks.  A giant needle in my spine?!  Nope.  I knew there had to be a better way than that.  Thus began my adventures into learning about natural childbirth.  I checked out The Thinking Woman’s Guide to a Better Birth by Henci Goer.  I began to learn about “the machine that goes ping” and all the unnecessary interventions that I might be offered.  I learned about doulas (a lesson I should have taken more to heart, but we’ll get to that later).

Other than the obligatory What to Expect When You’re Expecting (Oh, how I wish someone had given me The Pregnancy Book by Dr. Sears.),  I think that might have been all that I read until I started Hypnobirthing classes about halfway through my pregnancy.  Natural childbirth just seemed like the obvious choice to me.  And it also seemed fairly simple.  It’s the way God made it, right? 

This is how I started on my path to natural childbirth.  In my next blog, I’ll tell you about my experience with the Naval Hospital Jacksonville during my pregnancy.

At this point, I think I need to put out a disclaimer.  I have nothing against doctors or medicine.  I think we are so blessed to have good doctors who use their tools appropriately and when needed.  But I think maternity care in the United States is sorely lacking.  And it’s going to take the good doctors, midwives, and women to stand up and demand that the situation be put right.

And now for your viewing pleasure...

It Happened on the Way to the Midwife, Part 4.

 As promised, here is Collin's letter to Dr. Miller.  He's much more subtle than I am.

***

I understand that you no longer act as a contingency physician for home births, as you have in the past.  I have no qualms with your decision to provide care in the best manner you see fit; that is wholly within your purview and I commend you for your carefully considered philosophy of care.  That being said, my wife clearly communicated to your staff that she intended to have a homebirth, and rather than inform her of your recent change in policy, they nevertheless scheduled an appointment with you, a needless appointment for which she waited one and a half hours.  I hope that your staff was ill informed rather than deceptive by omission.

The decision to have a non-hospital birth is one that we have made with deliberate risk management, weighing with great gravity the risks and benefits of both hospital and non-hospital births.  The extremely high rate of caesarian births at Ridgecrest – at 22% for a low-risk pregnancy, versus 10% for Bakersfield Memorial, per the Census Bureau  – gave both of us pause.  Hearing that Ridgecrest categorically does not conduct VBACs, contrary to the recently revised (August 2010) guidelines issued by the American College of Obstetricians and Gynecologists, makes me think that the OB/GYN standard of care in Ridgecrest is less than what it should be.  If we lived in a city with a birthing center affiliated with a hospital, we would have preferred that, but given the option between a well-briefed home birth with a certified professional midwife versus a birth in a hospital in which one in five women with a normal, healthy pregnancy leave having had a c-section, I am compelled to think that the two options are at worst equal in terms of risk, to say nothing of other factors.  I am supported in my opinion by the paper “Outcomes of planned home births with certified professional midwives” from the British Journal of Medicine, volume 330, which I commend to your reading.

Although she may not have presented her reasons for non-hospital births so succinctly, my wife nevertheless articulated her decision to have a home birth, a decision that you should have respected.  Rather than politely informing her of your disinclination to provide care under the circumstances, you continued with what was in essence a sales pitch in an attempt to change her mind.  Clearly, what transpired was a mutual waste of time, a waste that certainly could have been obviated by early, clear communication in what you do and do not provide and a respect for her articulated wishes.

Your comparison between appendicitis and pregnancy summarizes the gulf between our respective views of pregnancy and childbirth – pregnancy as a malady to be cured rather than a process to be observed and in most cases allowed to follow its natural course to fruition.  I wish you well in your practice, and that you may better inform your staff of the care you have elected not to provide.

It Happened on the Way to the Midwife, Part 3.

Since this is the part where Dr. Miller gives me a sales pitch for himself (who is one of only three OBs in Ridgecrest) and the hospital, I think I should give you a few stats about the hospital.  They do not do VBACs.  Even though this isn’t a concern for me, it tells me they are seriously behind the times.  As of 2007, their overall c-section rate was 40%.  Their c-section rate for normal, low-risk pregnancies is 22%.  Compare that to 10% just two hours down the road in Bakersfield.  I have other reasons for being suspect of this hospital, but I think the statistics are enough to give one pause.

At this point, I’m pretty well shocked.  I had no indication that the meeting would wind up like this.  I wasn’t really sure what to say.  If he’s already made his decision, what point is there to arguing.  I’m hungry, tired, and ready to leave, but that wasn’t going to happen any time soon.  So I mostly tried to stay quiet and listen to his spiel until I could get out of there.

He starts giving me reasons he doesn’t do this.  He says (and I quote) “1 in 100 babies died before hospitals.”  I don’t have internet right now so I can’t check the accuracy of this statement.  But I do know that a statistic like that doesn’t apply to modern home births attended by professional midwives.  I also know that some of the darkest days of maternity care were the early maternity wards that were unsanitary.  Doctors didn’t even wash their hands and antibiotics hadn’t been discovered to treat infections.  But I digress.

He tells me he can’t be sure about some of the midwives “around here.”  He says that there are a lot of midwives in the area practicing without licenses or even any training.  In case you were wondering, my midwife is licensed by the state of California.  Since he has worked with her before, he should know this.  However, it’s fairly easy to check that kind of thing.  We do live in the information age, after all.

I think it was around this time that I finally interjected and told him that I wish he would have told me this over the phone so that I wouldn’t have had to spend an hour and a half waiting to find this out.  He says, “Well, we didn’t know what you wanted.”  Liar, liar, pants on fire.  I said, “Yes, you did.  I told the nurse on the phone that I was having a home birth and looking for a back-up physician.”  He didn’t really have anything to say to that.  Now, I know there’s a chance that this was a miscommunication among his staff, but if you have a hard and fast policy regarding home births, I would think you would communicate that to your staff.  But I would have to remind you that I left a message telling them what I was looking for.  I reminded them twice on the phone when I made the appointment.  And when the nurse brought me to the exam room, she knew what I was there for even though I hadn’t mentioned it that morning.  I never asked for a consultation on home births versus hospital births.  If I had known he wasn’t going to accept me as a patient, I wouldn’t have made the appointment.

I mentioned that I have a friend who had a home birth in May with my midwife, and he was her back-up physician.  He didn’t really have much to say to that either.  It seemed like he really wanted to pretend that this is always the line he’s walked, and he can’t remember ever doing anything differently, even if it was only four months ago.  He continued to act like he doesn’t know anything about my midwife. 

He says he doesn’t like backing-up home births because then he “misses out on all the fun.”  He says he likes to develop relationships with his patients.  He would meet my husband, and we would do ultrasounds together.  First, I never declined having a relationship with him.  In fact, I think it would be great to have a relationship with my back-up.  That’s part of the point, right?  So that if your care has to be transferred or you do have an emergency, it’s not a stranger working on you.  Second, I don’t want a bunch of ultrasounds, thank you very much.  They’re unnecessary and haven’t been proven to be completely safe.  Once again, the fact that he sees this as central to my care shows me that he is not be on the same page as me.

I mentioned that in Jacksonville, the midwives and the OBs work together so that you have a relationship with both (I could be totally off on that, but it seemed like it worked that way from what I saw).  He told me that Jacksonville is a big city, and they do things differently.  Thanks, I needed another reminder of why I hate Ridgecrest and miss Jacksonville.  I don’t really think I should have to sacrifice standard of care because I live in a small town.

I pointed out that some people who are planning a home birth also go to an OB but don’t tell the OB about their plans.  I told him that I was trying to be honest and upfront with him.  He told me he could tell when someone was planning a home birth.  Of course, you can.  (As a side note, I wouldn’t do that.  Part of the reason I’m going to a midwife is because I want joyful prenatal care that is in line with my beliefs.  But even if I did, I wouldn’t be with him because he’s not the OB that my insurance approved.  I’m certainly not going to pay out-of-pocket to be berated and treated like my pregnancy is a disease that needs to be cured.)

I think it was around this time that I told him I felt like I was wasting his time and keeping him from his actual patients.  That didn’t seem to concern him.

Then he offered to help me with a home birth if I did all my prenatal care with him.  I told him that was ridiculous.  Not that it’s something I would even consider to start with, but what midwife is going to do a home birth with someone who has received all of her prenatal care elsewhere?

He told me he wouldn’t charge me all the extra fees my midwife charges me.  What?  I’m paying my midwife a flat fee that covers all of my prenatal care, the birth, and postpartum care.  Maybe he’s talking about the cost of the birthing kit?  Yeah, that $60 is really going to put us in the hole.  Or the birthing tub rental?  Not required and wouldn’t be an option at the hospital.  I don’t know how much he charges, but I know that between OB appointments and the cost of a hospital birth, a midwife is a bargain.  Of course, why should I worry about that?  Tricare and the tax payers foot the bill for the hospital birth, right?

He told me getting a birth certificate would be easier.  And that’s the rubric by which I measure everything.  Sure, just go ahead and do a c-section.  As long as the birth certificate is easy to get.

He told me he could give me if I had nausea, he could give me a prescription.  Okay, this is another one of those “how different could our philosophies be” moments.  First of all, I already told him my morning sickness was mostly over.  Secondly, I don’t even take Tylenol for my headaches or Zyrtec for my allergies.  I don’t do prescriptions unless it’s a continual quality of life issue and even then, not during pregnancy unless it’s absolutely necessary.

He said he could help me pick out a pediatrician.  I informed him that we have Tricare Prime; my pediatrician is at the base clinic.  “You don’t get to choose?”  Um, no.  That’s how Tricare Prime works.  (Besides that, I have a two year old.  Shouldn’t I already have a pediatrician picked out???)

I think by this time my face was red, and I was shaking.  I was incredibly frustrated with him.  He told me I was just upset because I wasn’t getting what I wanted.  It’s at this point that I started having flashbacks to my pediatrician who used to diagnose my stomach problems and severe allergies as “schoolitis.”  If you want to treat a seven year old like a silly little girl, that’s understandable.  But I’m a twenty-nine year old, college educated, second time mom; I think I deserve a little respect.

Then he told me I should go home and discuss it with my husband.  I informed him that my husband is 100% behind my decision to have a home birth.  He said, “Well, I’d really like to talk to your husband; I respect what he does.”  That was the point where I blew my top and left. 

I know that some of this may seem inconsequential, but it was really upsetting to me.  I was not interested in being sold on the hospital or transferring my care.  I wanted to add him as part of my birthing team.  What really irritates me is that it all could have been avoided.  If he doesn’t back home births, he shouldn’t have made an appointment with me.  I feel that if nothing else, he was deceitful and treated me like I was an idiot.  And maybe because I didn’t really feel like spending my morning chewing the fat with a doctor who just declined me as a patient, he didn’t get the chance for me to prove him wrong.

I still feel that a home birth is the best chance I have for a safe, natural birth, and that’s what I’m doing.  But I am deeply disappointed that I have to do it without a “back-up plan.”  I was already uneasy with of the thought of having anything to do with Ridgecrest Regional Hospital or the OBs associated with it, now I’m terrified.  It is really unnerving to have to spend the next two and a half years of my life in a town where going to the hospital is such a scary prospect.

 

It Happened on the Way to the Midwife, Part 2.

I know some of these things are going to seem nitpicky, and under other circumstances, I wouldn’t bother with them.  But rather than try to make this super interesting by trying to decide what’s important and what mundane, I’m just going to tell you what happened.  So here it is...

I got there.  I filled out paperwork.  I wasn’t sure what to think when the paperwork asked me question like “What is the nature of my problem? How long have I had this problem?  Is there pain associated with this problem?”  I think you get the idea.  I’m filling out paperwork for a pregnancy and nowhere did I answer questions like “When was the date of your last menstrual cycle? When is the estimated date of conception?  When is your projected due date?”  Oh, wait.  I’m not supposed to know these things, right?  Heaven forbid I know what my due date is before the almighty doctor gets out his magical wheel or gives me an ultrasound.  (See what I mean about being nitpicky, but things like this drive me crazy!)

While I was waiting, I heard the receptionist (Or is it a nurse?  I don’t know.) on the phone with a lady saying, “I know you’re getting big, but the hospital isn’t scheduling any more inductions this week.”  Okay, I know I don’t know the whole story here, but I’m still amazed that people ask for inductions!  I could go on about this, but I won’t.

So after waiting over an hour in the waiting room, I finally get back to the exam room.  They weigh me, but I’m not sure why since they didn’t take any vitals.  The nurse gets out her magical due date wheel and calculates my due date.  Then she says, “So you just want to get Dr. Miller’s opinion on homebirth, and ask him to be  your back up doctor.”  This is where I started to suspect things were not going to go as well as I hoped.  I didn’t get that degree in Literature for nothing; I know foreshadowing when I see it.

By the time Dr. Miller comes in, I have been waiting over an hour and a half.  There are a few pleasantries like “Where does my husband work, What does he do,” etc.  He asks a few medical questions like “Am I taking prenatal vitamins?, Was my last birth full term?, Who’s taking care of me?”  Then he asked me why I want a home birth.  This is the part where I’m kicking myself now, because my answer was total crap.  I don’t know why I was surprised that he asked me that.  I don’t know why I didn’t give him a better answer.  Honestly, I don’t think many people have asked me why.  Most people who have known me more than five minutes can figure it out.  So I told him that my first birth didn’t go the way I wanted.  They didn’t follow my wishes.  And of course he gave me the classic OB line, “But it was a good outcome, right?”  Yes, nobody died.  That’s the rubric by which I measure everything, of course.  Seriously, Dr. Miller should be the poster child for “typical bad OB that you always hear about.”  I also mention that I don’t like hospitals.  So he counters, “What will you do if you get appendicitis?”  A little dumbfounded as to how you can compare having a baby to appendicitis (and I speak from experience here, my mom almost died from a ruptured appendix), I told him that I would of course go to the hospital.

So at this point, I’m feeling like I’ve just been presented with a pop quiz, and I’m failing miserably.  This is when he looks at my chart (not at me) and says, “Well, I’m sorry but if you want me to help you with a home birth, I’m going to have to decline.  I don’t think they’re safe.”

I’m going to leave off here for tonight.  But let me just make a quick commentary on what I’ve written so far.  Even though, I can already tell that this man would not, under any circumstances other than a life or death situation, be the doctor I chose to help me with anything, I respect his right to make his decision.  It is how he handled telling me his decision that I have a problem with.  More in Part 3. 

It Happened on the Way to the Midwife, Part 1.

In order to keep this from being too long, I'm going to assume that you know me.  But if you don't, I would be happy to tell you about my previous pregnancy and birth experience, my strong belief in natural birth, or about how I live in a town where it seems the majority of people (including doctors) don't bother to pick up books and educate themselves or in the rare case that they do, they don't bother to do any research on the credentials of the authors that they are reading.  Where to start?
I am planning a home birth.  In a perfect world, OBs would be willing to work with midwives so that home birthing mothers have a back up OB who is not a complete stranger in the event of an emergency.  But we don't live in a perfect world, we live in a country with a very broken system for maternity care.  Nevertheless, I was advised by my midwife to visit the local OB who has provided unofficial back up for her in the past.

I'll say this right now, I was not excited about having to meet his man.  I'm not excited about anything that takes me onto the property of the local hospital.  Ridgecrest  Regional Hospital scares me.  I was even more apprehensive when I went online to get  Dr. Miller's phone and saw the absolutely terrible reviews of him.  But this was a hoop I had to jump through, so I picked up the phone and dialed.  I left a message with them.  I said, "I am planning a home birth, and I would like Dr. Miller to be my back up physician.  My midwife said that I might be able to just talk to him on the phone."  They called me back a couple of days later and left me a message with their phone number and office hours.  Helpful, aren't they?  I called back and left another message.  The next time they called I was home to answer.  They told me Dr. Miller didn't do phone interviews, and that I would have to make an appointment.  I made the appointment.  The earliest appointment they had was a month from the  day I called.  I reminded them once again that I was having a home birth with a midwife and that I did not want an exam.  They said it would just be an appointment to set me up as a patient and talk to the doctor.  Okay.

I wanted to be prepared for what to expect.  I didn't even see an OB when I was pregnant with my first child.  I saw a nurse-midwife during my pregnancy and a family physician attended his birth (all within the military medical system, so there was no drive for profit - it makes a difference).  So I called my friend who had a home birth with my midwife in May.  She told me he would make you thankful for our midwife.  But he was used to this and would talk to you, offer you a prescription for prenatal vitamins, and an ultrasound.  But overall, he was friendly, and it wasn't that bad.

Since I actually have to leave in a few minutes for an appointment with my midwife, I will go ahead and post this.  I'll get the long story of the actual meeting up as soon as I can.