Tracking Baby #2… and many other thoughts

Posted by Jill

When I was pregnant with Jolie, I neglected to keep a pregnancy journal, which I have come to regret.   I am glad that we now have this blog – I no longer have an excuse not to journal my pregnancy.  So here goes!  Hopefully this won’t turn out to be too boring.  I’ll try to throw in some somewhat humorous anecdotes to make it a bit more lively. 

This first pregnancy post might be kinda boring, though, unless you are interested in hearing about my naturopath, VBACs, our first ultrasound, etc….  See, fun stuff (note the sarcasm)!  But there are some interesting facts thrown in, such as our due date, so see, you do have a reason to at least scan the post if you want to know the due date…

 

Appointment #1:  Meeting my Naturopath, Dr. Lisa Wada, for a “Preg Chat”

So ever since getting those two gloriously positive pregnancy tests, we’ve had a handful of doctors appointments, which are usually always exciting when you’re pregnant (as long as everyone is healthy, of course).  The first with my naturopath, Dr. Lisa Wada of Sound Natural Medicine, who is awesome and serves as my family doc and gynocologist, as well as Jolie’s pediatrician.  I love Dr. Wada.  She talked with me for a whole hour about a week after I got the positive test… which was amazing, because on my way to my appointment with her, I happened to hear a story on NPR about how family practitioners are experiencing increasing job dissatisfaction due an increase in patients (and patients’ demands) but increasingly less time available per patient (then throw HMO bureaucracy in there and things get worse for both patients and docs)… and so, more medical students are opting to specialize rather than go into family practice these days, etc, etc…  So anyway, after listening to this unhappy story, I got to spend a whole hour with my doctor just chatting about my pregnancy, nutrition, my mental state, the kind of birth I wanted, and all sorts of stuff.  I felt very lucky!

 

Appointment #2:  Ultrasound with Radiologist, Dr. Kevin Case

Dr. Wada referred me to a great radiologist, Dr. Kevin Case of Eastside Maternal and Fetal Medicine, to do an early ultrasound to determine what the due date is.  Dr. Wada worked with Dr. Case during her pregnancies and told me that Dr. Case would make us feel like the pregnancy was just the greatest thing in the world.  She was pretty right on!  I think he was perhaps the most lovingly enthusiastic doctor I’ve ever seen. :-)  A great thing about having him (rather than an ultrasound technician) conduct the ultrasound was that he could interpret and deliver the results to us directly and on the spot.  Usually, ultrasound technicians have to give the ultrasound info to the doctor, who then has to interpret it and deliver the results second hand, which is fine, but I just felt good hearing the information straight up. 

Everything appeared healthy in this first ultrasound, and the baby had a heart rate of 169, which DJ and I believe was the same heart rate Jolie had around this time.  We also found out the due date will be September 2.  We’ll be going to Dr. Case for the rest of our ultrasounds, which I am very happy about.  The next one occurs on April 28, and we’ll get to find out the sex of the baby at that time!

 

Appointment #3:  First Prenatal Appointment with Certified Nurse Midwife, Janice Smith

The day after the ultrasound, we went to Evergreen Hospital to meet one of the midwives at the Center for Women’s Health.   During my last pregnancy, I worked with an obstetrician in the Center for Women’s Health and had a good experience (other than the fact that I ended up with a c-section, which I’ll get to later…).  I liked my OB – Dr. Amy Korten – but she moved out of state shortly after Jolie was born.  That’s okay, though… because instead of working with an OB this pregnancy, I am very excited about having a midwife deliver the baby this time around. 

 

Prenatal Stats:

Appointment date: January 21, 2009 (8 weeks pregnant)

Weight: 126 (eek! already 8 pounds heavier than I was at the time of conception, but shhh… don’t tell the midwife)

Baby’s Heartbeat: 169

Blood pressure: Forgot to ask, but I assume normal since the nurse didn’t say otherwise.

 

Huh?  Midwife?

Alright, real quick… before anyone freaks out, let me emphasize that working with a midwife instead of an OB does not mean that I will be having a home birth (at least not this time, heh heh.. )  A couple of people I’ve talked to about midwives have been under the impression that midwives only conduct home births, which is true in some cases but not true for me.   The midwives I’m working with are in the same group of practitioners as my former OB, and they deliver babies in the same hospital where their office is located (and where Jolie was born, of course).

Okay, you ask, what exactly is a midwife?  Well, here is a brief exerpt of the definition provided by Wikipedia:  Midwives are autonomous practitioners who are specialists in a low-risk pregnancy, childbirth, and the postpartum stage. They generally strive to help women have a healthy pregnancy and natural birth experience. Midwives are trained to recognize and deal with deviations from the norm. Obstetricians, in contrast, are specialists in illness related to childbearing and in surgery. The two professions can be complementary, but often are at odds because obstetricians are taught to “actively manage” labor, while midwives are taught not to intervene unless necessary.^[1]

I’d like to emphasize the phrases ”natural birth experience” and “not to intervene when necessary” – two things that will be VASTLY different than my first labor and delivery, assuming that my labor this time progresses as hoped, I don’t break down and demand an epidural (which means yes, I will be trying to have an unmediated delivery.  Yes, I am crazy…), and I don’t have to have another c-section….

 

A bit of background on my first pregnancy…

Jolie was born via c-section, and I have a bit of bitterness about that now.  I mainly regret the fact that I did not educate myself much on labor induction, intervention, c-sections, and so forth – basically all the things that I experienced.  Why did I not learn more about these topics before my due date hit?  Because I thought, ha, I won’t need a c-section!  Oh boy, how wrong I was, obviously.  I should have known better, too, especially upon my OB’s suggestion of having my labor induced.  That should have been a red flag. I think I made a big mistake by agreeing to labor induction, because this procedure led from one intervention to another and ultimately to the c-section.  That’s not to say that I wouldn’t have ended up with a c-section anyway, but I firmly believe that my chances of having a vaginal birth would have been much higher had I let nature take its course and let my body do what it was designed to do on its own. 

 

Vaginal Birth After Cesarean (VBAC)

This time around, I would like to try to have what is called a Vaginal Birth After Cesarean (VBAC), and working with a midwife give me the opportunity to attempt a successful VBAC.  VBACs are not incredibly common these days, mainly because it requires that an OB and anesthesiologist be available at a moment’s notice in case an emergency c-section becomes necessary, and this costs money.  Hospitals don’t like to spend money, so some hospitals don’t make VBAC an option for this (and other) reasons.  Luckily, my hospital of choice does make VBAC an option, and even luckier, the Center for Women’s Health staffs midwives that partner closely with the OBs in the practice, all of whom are very supportive and encouraging of VBACs at this point in time.  Yippee!

Why do I want to have a VBAC rather than a planned c-section?  For many reasons.  First of all, if successful, VBAC is considered safer than a planned c-section.  The mother is less likely to get an infection or have serious blood loss.  Recovery time is shorter.  Oh, and then there’s that little thing about allowing my body to do what it was created to do naturally – birth a child vaginally.  I feel that a vaginal birth would be much more emotionally satisfying than a c-section.  As DJ put it, I was “emotionless” after my c-section with Jolie.  I don’t want to be emotionless this time, even if that means experiencing excruciating pain in teh process.  I didn’t get to hold Jolie for almost 45 minutes after her birth.  I was confined to a bed and could not get up to comfort her or even change her diapers for almost 2 days.  I’d rather not go through that again.  I want to hold and nurse my baby right away.  I want to give her her first bath, and I want to be able to get out of bed whenever I need to in order to take care of her. 

Just to be fair, there are risks in attempting a VBAC, just as there are risks to having a repeat c-section.  About 1% of VBAC patients experience uterine rupture, which means the scar on the uterus from the prior c-section opens, which could cause severe blood loss and would require an immediate c-section to avoid a life-threatening emergency (which is why an OB and anesthesiologist would need to be ready to go at a moment’s notice).  Of course, separation of the uterine scar could occur during pregnancy, as well, for any mother who had a prior c-section.  I dont mean to freak out my mother or anyone else with this, but I didn’t think it would be fair to give the VBAC pros without also mentioning the cons.  

Before anyone talks me into changing my mind and volunteering to have a repeat c-section, I’ll give some of the risks of that little procedure, too: increased risk of injury to the pelvic organs due to tscarring from the previous c-section; risk of infection and blood loss higher than that of a successful VBAC; higher risk of internal scarring which can cause future medical or pregnancy complications (and if we’re going to have all those 10 kids DJ wants, lord knows I dont need future pregnancy complications – haha, just kidding ).  And there’s a longer recovery time (this would not make Jolie a happy camper, I can tell you that right now).  Not to mention how crappy it feels lying there on an operating table with your arms strapped down, watching a bunch of strangers man-handle your baby in a cold, noisy, uncomfortable operating room long before the mother herself can barely even catch a glimpse of her own child (LOUD SIGH).

Back in November, I watched a wonderful documentary called The Business of Being Born, which examines maternity care in America.  The film provides insight into the growing trend of labor intervention, as well as women planning their delivery dates via scheduled c-section, and contrasts this against the natural birth process.  I wish I had seen this documentary before Jolie were born – my approach to labor and delivery probably would have been much different.  The good news, though, is that this film has given me a little extra courage to try an unmedicated VBAC this time around.  Even though VBACs specifically are not discussed in the documentary, just getting a glimpse into the possibilities and benefits of natural childbirth is very empowering.  I HIGHLY recommend this film to anyone thinking of having a baby (even if it’s not your first child).  It may shed some light on maternity care issues you otherwise may not have considered.

(By they way, all of the facts about VBAC, c-section risks, etc. came from a document provided by the Center for Women’s Health)