We had our 30 week (or, to be exact, 29 weeks and 5 days) appointment this afternoon! It went quite well. My blood tests from our 28 week appointment came back with some interesting results:
1) I have no issue processing sugars. This was surprising to me! I ate some white flour a few days before the test and felt horrible. I’ve also been having some flora imbalance issues that are taking a rather long time to completely work out. THUS, the pessimist in me felt 78% certain that I must have gestational diabetes. Alas, this is not the case at all. My sugar was on the very lowest end of what one’s normal glycemic range should be after consuming sugar, sugar, and more sugar for breakfast.
2) My Hematocrit levels were EXCELLENT. My iron is off the hook with badassary! One would think that I paid more than what I feel to be a minimal effort to eat well! I suppose that it’s a very good thing that I don’t really crave horrible foods. All this good iron indicates that I will have a much smaller chance of hemorrhaging during our home birth. If pregnant woman’s Hematocrit is lower than 30%, she has to deliver in a hospital. I am at 38%.
3) I have gained 22 pounds. Frankly, I find this a little excessive. This is because I very suddenly gained a few extra pounds during the month before I got pregnant, so I technically feel as if I am up 27 extra pounds. She says that my 22 pound gain is perfect for my 5′10″ height. What she says goes; I guess I’ll chalk these pounds all up to baby fat and pat myself on the back for all of the really really hard work I’m doing on keeping pregnancy so healthy. Yeah? Ok, just kidding.
I am serious when I confess that I am a lazy lazy pregnant lady who does exactly as her will tells her to do. I just now had lunch at Chipotle and then stopped at the Cinnamon Works counter on my way home for a blueberry bar. And, no, blueberries are NOT local right now! But my will made me do it! Granted, Cinnamon Works bakes with far less sugar a whole lot of nuts- it is definitely the healthiest cookie option in town! But still! Who needs a blueberry bar after a 790 calorie lunch at Chipolte? Surely, no single Wednesday evening yoga class could heal this type of gluttony?
Milton did say when we stopped into Chipolte that I was sure to gain 3 more pounds by tomorrow. But hey! I have an idea! Why not just not weigh myself again until next week? Yeah, perfect.
4) The baby, though still a mover and a shaker who is not necessarily staying head down, seems to have progressed normally according to all the listening, poking, and measuring. He’s still very playful in his movement, and has always been pretty active. Go, little Benson, go!
With all of this good news, I have to tell you that the pessimist in me is waiting for the other shoe to drop. The chubby-cheeked optimist in me is healthy enough to handle 10 pairs of shoes that are really really cute.
Thanks to my girl Kathy T for these!
Had our 28 week midwife appointment today. Esther got to drink sugary orange juice plus sugary white bread plus a spoonful of sugary honey and get her blood drawn in order to test for gestational diabetes. I got to be coached yet again on how to feel for our baby’s head, and butt, and legs, etc. We all think he’s upside down already (I felt a hard little head way down there, it was cool), and it would be great if he just stayed right there. Though maybe he needs the exercise and should do a few more warm-up laps around her uterus so he comes out extra strong and ready to go. That’s up to him I guess.
Today I voiced my somewhat irrational fear of him getting too tangled up in umbilical cords before he comes out. You know, after reading 3 bazillion birth stories certain fears lodge themselves. For me it has been the tangling. Not sure why. But I guess because I so much enjoy to rock him back and forth in Esther’s belly to try and figure out where he is, what he’s doing, etc and the thought has crossed my mind that I may be making him move more and get tangled more than he otherwise would.
Luckily, Beth reassured me that almost all of those horror stories of hospitalized births “failing to progress” where the doctor later says, “Oh, it was because he was all a tangled up and had his umbilical cord around his head 25 times and that’s why he wasn’t coming down” are really usually confabulated stories where, yeah, there might have been some tangling, but that wasn’t what was causing the labor to halt. Drugs, anxiety, impatience, etc, much more likely to be the cause. Yeah, sometimes the cord is in the way, but only once in a blue moon (Beth said once every 10 years even) does the chord actually inhibit the birth from progressing as normal. Yeah, sometimes it’s around the neck, even twice or three times, but a little looping around and pushing the cord and all is well. Very rarely they’ll clamp the cord and cut it if the baby is really close to being born, but even that almost never happens.
So, that was all good to hear. Nature wasn’t silly enough to put a noose in the womb. It’s stretchy, and easy to move around, and not a problem at all. After I voiced this fear, Esther also confessed to having the fear, so it was good for us both to talk about it and then move on.
Weird how fear works like that, sometimes. It’s a full-time job to worry less.
Walking through the doors of pregnancy and all of it’s unknown factors, Milton and I have had lots of questions and lots of aha moments to answer them. At first, we weren’t even totally comfortable talking about a home birth. At first glance, it didn’t seem like the safe option. One book in the right direction and suddenly we found ourselves on the path of home birth research. This has led to us meeting some pretty amazing people in the Seattle Midwifery community. We feel very cosy at our monthly midwife appointments and like we can call their office with any questions or concerns that we have.
It was at Rainy City Midwifery that we were approached about possibly hiring a doula. At first, it really didn’t feel necessary. Between the 20 books we’ve already read, the 40 books we’re bound to read, the class we’re going to take with The Mother of all Doulas, and the 1,394 people we talk to who give us advice (unsolicited or otherwise), it seems like we could lasso in this whole laboring experience and take it to the moon, right?
Well. Sort of.
The more we started to visualize our birthing experience, and the more we talked to the midwifes at Rainy City, the more we started to think that we should look for someone else to help us on our journey. It’s not that we don’t trust ourselves. It’s certainly not that I don’t trust my body. It’s not that I don’t trust my midwifes to act in my favor and do everything they can to support and protect my family. I have trust in all of these things! It’s more that I am fairly certain that much of what my husband and I learn about pregnancy and labor will fly out the window without a good mediator who has a whole lot of experience with the process of saying hello to babies. I could be in labor for 3 days, after all! No matter how much my husband and I adore each other, he is going to need a break. I am going to need a break. We are going to need encouragement and knowledge to help us along so that fear doesn’t take over the experience of bringing life. There is potentially a long stretch of time between when labor begins and when my midwife arrives when I am going to need a woman who knows what she’s doing to help me out with crazy things that I have never really thought about… like calming to heck down when I feel as if I’m about to break in two, or like breast feeding after the labor is all said and done and the actual taking care of a newborn begins.
I met Cheryl Murfin while I was working at my salon. I was tending to another lady when Cheryl marched right up to my chair and asked which one of us was pregnant. Since both my client and I are pregnant, all we could do was laugh and say “Me!” Turns out, Cheryl is a doula who had heard through salon scuttlebutt that I was a pregnant lady and decided to come around with her card. I immediately took to her direct approach! I love Seattle, but am not native to the Pacific NorthWest and am often a little turned off by the typical north-westerner’s politely standoffish way. This woman came over and told me what she did in 20 words or less! She was practically New York in my book. I made a mental note to ask my midwife if she had any more information on this lady. As it turns out, Lynn at Rainy City knew Cheryl very well. Cheryl was the director of the Seattle Midwifery School and is very tied in to the community here. I decided to call her for an appointment…
We met today and it all felt so comfortable! I feel like she’s the other hand on deck we need for this delivery, which will make the total of people in the house during the birthing a whopping 6 (Milton, me, 1 midwife, 2 midwife students, and our doula)! 7 if you count our baby! Practically a party for our small loft (if it doesn’t sell by the end of February, we’re staying right here, folks). I can’t imagine that this baby will feel anything but love and support when he gets here.
Just in case you haven’t heard, our 20-week ultrasound went smoothly and our very friendly nurse played along with our request to have her write the gender in a card that we could open at our leisure (away from the sterile confines of the hospital).
We tried to play it cool the rest of the day, running errands, watching a movie (Avatar was great), and walking around. Around 7pm we started getting fidgety, and I asked Esther if she had any new guesses for the gender. She admitted to having a pretty confident guess about it, as she think she spied some balls in one of the ultrasound shots inadvertently. I asked Esther if she wanted to swap her bet and go for a girl at 10/1 odds (so that she’d get 10 pizzas if it was a girl and I’d get one pizza if it was a boy) and she declined. I sighed and admitted that I too thought I spied something on the screen. (It was pretty funny at the time, and I think we were probably giggling a little.)
We decided to open the card while she sat on the pig in Pike Place Market.
Our suspicions were correct! We are going to have a son!
And to prove I’m good for my word, here’s the pizza:
We spent the rest of dinner (and a good part of the last couple weeks) talking excitedly about what this means for us, and how much more tangible it all feels now. A son. A little man. Amazing.
Today was the momentous occasion we’ve been looking towards for some months: The 20 Week Ultrasound!
This means that we are OFFICIALLY at the half-way point. I also officially have a baby bump and officially know the sex of my baby (though I won’t be sharing that quite yet!).
Things are looking pretty sweet. I have a great heart rate, have gained the perfect amount of weight and have a uterus that has grown right where it should have grown.
As far as our baby is concerned, (s)he is doing very well. Good heart rate, good skull shape, no signs of the dreaded spina bifida, no sign of a cleft palate, skull in good condition. 10 fingers, 10 toes…
Speaking of toes, the baby has my husband’s feet. My big toe is considerably longer than my second toe, while my husband’s second toe is longer than his first. While we both have long toes, Milton sports tingers, which simply means that his toes are freakishly long. We can see in the ultrasound that our baby also has tingers. I am also convinced that the baby has my husband’s leg proportions, which means another family runner. This is all good stuff.
I did have a moment of nervousness after the ultrasound tech left the room and returned with (dum dum dum) The Doctor. It was obvious from the start that The Doctor was summoned into the room to give us Potential Bad News. First, he confirmed my age, “You’ll be having the baby when you’re 34 and a half,” he says, and suddenly I am filled with fear. My brain immediately starts telling me that this will be my only child, that the risks are too great as I approach my dreaded (and absolutely youthful) 35th birthday. The Doctor goes on to tell me that the baby’s heart is showing a sign of Echogenic Intracardiac Foci, as told by bright spots on the heart. This increases my chances of having a baby with Downs Syndrome by 2. Broken down, this means that while my age and history indicated a 1 in 350 chance of having a baby with an extra chromosome when I woke up this morning, appearance of EIF ups my chances to 1 in 200, or .5%. SPECIFICALLY, babies with the EIF marker have a 1 in 188 chance of T-21 (Downs).
Of course, there is no indication of a chromosomal problem as far as the bone structure of the baby’s face is concerned. The ridge of the baby’s nose and cheekbones appears to be strong and “normal”. AND, further investigation (thanks to an immediate iPhone google search) indicates that a full 30% of Asians have EIF. Further race investigation indicates 11% of caucasians and 6% of black babies show symptoms of EIF. Thus, I don’t think that there is anything to worry about… and if there is, it’s out of my control to do anything but love whatever baby we have. I do find it odd that it’s required for a doctor to put extra fear in you, but not required for them to say, “But, hey, your baby is Asian, so there was a 30% chance the baby would have EIF anyhow.” I mean, really? I would hate to be a doctor who gets called into examination rooms to only deliver red flag news. I was thinking the whole time about how awesome the job of the ultrasound technician was… and later I thought about how the stony-faced-bearer-of-bad-news doctor ’s job was NOT awesome. Also, WAY TO MAKE A GIRL FEEL OLD, doctor. 34 and a half. Geez louise.
All that EIF business aside, it was AMAZING to see our baby moving around in there! S(he) is far more active than I even imagined! Lots of times there is whole moving around that I can’t even feel. I didn’t realize that! The baby flips and flops into all sorts of different positions without my even knowing, all of the time! I need to really be punched and kicked to know that something is going on in there… which means that I’m being punched and kicked all the time, too, because I feel it plenty! So great!!
I read Jenny McCarthy’s Belly Laughs book a couple days ago. Wow. It’s scary to think that she’s encouraging women to act like her, in my opinion.
On the other side of the spectrum, we watched the Business of Being Born last night. That’s a pretty great documentary. I think it was meant to be controversial, and to show the worst of hospitals, and I don’t think all hospitals are as ignorant and backwards as the ones depicted (Seattle’s Swedish, for instance). However, I think the fact that more light should be brought to the midwifery traditions and practices is definitely called for.
According to our midwife, that documentary and the book Pushed have both contributed to a surge in business for midwives in the last few years.
Only 1% of births in the United States are done via midwives, and only a fraction of those are home births. Seattle’s a little different, and actually has between 4-7% of births through midwives. I think it might be because of the better insurance policies that allow them to be covered. So hopefully this number will grow.
One of the great and unexpected things about The Business of Being Born is that the film-maker is pregnant during the making of the movie. Of course, after all this talk about home births and everything, she ends up having pre-term labor and a C-section at a hospital, and had to keep her baby in NICU for 3 weeks.
The reason I think that’s great (in the documentary’s sense, not in the sense that the baby had such a scary beginning) is because every doctor in the movie is like “what if something scary happens?” and this is the answer… you go to the hospital. Hospitals aren’t inherently bad, it’s just that they are designed to deal with emergencies and dangerous medical conditions. Most births, however, are not in this category, and could just as easily (and some argue more safely and nicely) be handled outside of the hospital system. For the 10-15% of births that have complications, it’s awesome that hospitals are there to help, and this fact has a lot to do with the lowering maternal mortality and baby mortality in the last 100 years.
Anyway, it’s just so interesting to think about all of this. I keep trying to remember how we first started down this midwife/home birth track–I remember being just as pro-epidural as the next person before Esther got pregnant. We are trained to be afraid of birth. And, as the non-participatory husband, of course fear is even more justified because all of this is happening to Esther, not me, and therefore the lack of control is scary.
This is merely how I feel now, and reserve the right to change my mind at any point along this pregnancy.
I think today we went from being pretty certain about having our baby in a hospital with a doctor and all that that implies to going to the complete opposite end of the spectrum and deciding to do a home birth with a midwife.
I totally think it’s the right thing for us to do.
We met with a midwife group called Rainy City Midwifery and the difference between what we learned in the 60 minutes there versus the 3 visits and many hours of being at the Polyclinic was stark, to say the least.
Beth Coyote (great name, right?) at Rainy City Midwifery was amazing. Right away she talked about how this is not simply a medical procedure involving a uterus and a baby, but something that is happening to our family. The creation of a family even. Imagine that.
3% Cesarean rates, with 85% of the births taking place without transferring to a hospital. That’s a stark contrast to the 30% Cesarean rates at Polyclinic (even though even that’s lower than the national average).
They have 3 midwives and 2 students, with one midwife always on call, while all 3 are always up to date on everything happening with every mother. The 2 students attend every birth. So there are at least 3 people with their full attention on you at all times. If things end up going to the hospital, they come with you and stay through the end.
Listen to this. They visit your home 1 day after the birth and 3 days after the birth, and also continue to help out for the following 6 weeks. That alone was a huge deal to me, and illustrated the difference between getting the baby out and starting a family.
They are cheaper than a hospital. Mostly because they don’t bother running up every single bill that they can. When we explained our insurance situation Beth even suggested that some potential payment plans were available. We might need those.
On every visit (about the same number of visits as you would for a doctor) they spend most of the time talking with you, answering questions, etc. Contrast that to our 10 minutes of doctor time that we’ve had during our first 3 visits, and however many minutes waiting in waiting rooms and little rooms.
I was ready to sign up right then and there this afternoon. Esther wanted to talk about it, so we left, talked 10 minutes, and then made our next appointment and canceled our future appointments at the Polyclinic.
We’re gonna try to do a home birth. 1% of births in the US are through midwives, and only a fraction of those are done outside of a hospital. So we’re going a pretty radically different route than most people do. But, outside the US, plenty of other countries do it this way. We both strongly feel that this is the right decision for us.
Exciting.
Before our first visit with Dr. Atwood last week, we had made a list of questions that we wanted to ask.
I ended up asking them from memory, since I felt awkward reading from a list, but the answers I did get were pretty good.
- Midwives – no, no midwives at the Swedish we’re at. So, we’ll be interviewing a couple that we’ve been recommended.
- Induction rate – I didn’t ask for the explicit number, but she reassured us that they don’t induce if they can at all avoid it. That’s a good starting point… I’d still like to know the exact induction rate though.
- Epidural rate – Usually only upon request, unless you’re doing a Cesarean.
- Non-office hour deliveries – She told us that there’s always a doctor on staff, and that they do not pressure to move deliveries along due to time of day or week. She volunteered this information without me asking first, so I’m going to trust her on that one.
- Breech deliveries – They don’t do breech deliveries, even Frank breech. Which is unfortunate. If it comes to that, we will prepare for that possibility when it comes. She did say that they do all kinds of tricks to get the baby to turn, and that they have some success with that. So that’s good.
- Late deliveries – They don’t pressure to induce until 42 weeks. That seems reasonable to me.
- Big babies – Seems like they will occasionally pressure to do C-sections when the labor doesn’t seem to be progressing, and when size of the baby’s head could be an issue.
- Water-breaking – They worry about labor not progressing after water breaking when the mother has tested positive for Group B Strep (about 1/3 of women). If she has tested negative, they’re more likely to allow a labor to progress at its own pace.
- Fetal monitoring – They allow intermittent monitoring to allow the mother to move around. That’s the right answer.
- Movement during labor, alternate positions – Every birthing room has its own tub and shower and all positions are allowed to be explored. This is great news, and one of the main reasons I’m feeling like this doctor and hospital might work for us.
All in all, good answers. Dr. Atwood was kind, was able to listen, answered questions confidently and without getting annoyed at us, and overall gave us a good impression.
Esther’s job this week is to schedule appointments with a few different midwives in the area just so we can have something to compare with. Stay tuned!
Here’s my in-progress list of questions to ask the doctor on Friday. If anyone has any feedback, suggestions, additions, etc, let me know!
- Do you work with any midwives?
- What is your induction rate?
- What percentage of your patients get an epidural?
- What is your Cesarean rate?
- Are you okay with deliveries that happen at night or on weekends without inducing?
- Do you attend breech births? Frank breech?
- What’s your philosophy on going past 40 weeks?
- What’s your philosophy on big babies?
- What is your philosophy on what to do 24 hours after water has broke if there’s no sign of infection and mom and baby are fine?
- What kind of monitoring do you require?
- Do you allow movement during labor, and choice of delivery position, birthing baths, etc?
Went to another ultrasound today (we’re at 10 weeks, 4 days), and confirmed that the little fig-sized being is still alive, still a-wiggling, and seems to be in optimal position to continue to grow into a human.
I must admit that every doctor’s visit makes me put my excitement in a little box in case I am surprised with sad news and have to put the box of excitement back in storage for a while. And, the good news always comes very welcomely.
Heartrate: 169 bpm
Size: 3.4 cm
Adjusted due date: May 8th, 2010 (same as from LMP)
I want to scan in the two little ultrasounds we have, they still don’t look like much (I can barely tell which side is the head) but they’re milestones.
We both feel like we can now be more confident in telling people about the pregnancy as there are no warning signs at all of anything going wrong. We’re trying to tell people in person, as it’s more fun, but there will probably be a group announcement on Oct 23rd (Esther’s birthday party) and shortly thereafter on the internet.
Now, we gotta get serious about figuring out if we’re really going to do this with an OB and a hospital, or if we are going to go the midwife/birthing center/home route. Just have to make a couple appointments. But, we’re meeting with the doctor for the first time on Friday, and I think her answers to the questions I’ve made up will help guide us on whether or not she’s on our side with the non-induced, no-epidural, no-episiotomy, no-cesarean route or if we’ll need to look at the other options.
