A very reassuring midwife appointment with Sharon

Tomorrow marks week 20 of my pregnancy – I can’t believe I’m halfway done already!  Wow, the time sure is flying by. 

Today, I had another midwife appointment.  I went in prepared to leave disappointed, to be honest.  After reading Ina May Gaskin’s book on natural childbirth (which I posted about here), I put together a list of about 8 new questions for the midwife that would give me a better indication of the type of environment I might encounter while attempting natural childbirth in the hospital.  I was nervous that, despite the great things I’ve heard about the group of midwives I’m working with, they might still subscribe to more of a “hospital” mentality than I was hoping for, or that hospital policy would prevent them from having the same flexibility in their practices that midwives working outside of hospital might enjoy. 

Luckily, I did not leave disappointed.  Quite the opposite, actually! 

I met with midwife Sharon Hammond.  She is the oldest and most experienced midwife in the group, and I had been eager to meet with her from the beginning.  I LOVED her.  She was fantastic. 

Dear Lord, please let Sharon be on duty when I go into labor. 🙂

Sharon was lovingly direct, clear and honest.  Here are the questions I asked her:

 

1. Will I be able to eat and drink during labor, assuming I am able to attempt natural childbirth? 

Answer I thought I would get: You may drink but not eat. 

Answer I got: Yes, you may do both, but within reason (meaning I shouldn’t have a McDonald’s Extra Value Meal or something), but rather I may have light and easily digestible food, such as yogurt, etc. 

My response: That’ll work!  If she had said I would be restricted from eating, I would have come prepared to hide food in the bathroom anyway, so this is better (although I didn’t tell her that…).

 

2. Will there be strangers or hospital staff besides the expected nurse, midwife, etc. coming in and out of the room during labor/delivery?

Answer I thought I would get: I actually kind of doubted a lot of strangers would be floating into the room but I just wanted to just be sure.  I want maximum privacy.

Answer I got: There may be an additional nurse to come in to assist immediately before the baby is born, but other than that, no – not without my consent.

My response: Fine.

 

3. For many patients, including VBAC patients, the baby must be continuously monitored via a wireless belt that straps around the abdomen, which can be somewhat annoying, particularly for women moving around and laboring if various positions, which is ideal in natural childbirth.  I asked Sharon if alternatives to this fetal monitor strap were available – so in other words, can I take it off it it prevents me from moving into an particular labor position, and use other methods (Doppler, etc) of intermittent fetal monitoring instead?

Answer I thought I’d get: No, you must keep the monitor on at all times, per policy.

Answer I got:  In non-VBAC births, alternative fetal monitoring methods are used quite a bit, but in VBAC cases we do need to be particularly vigilant of the baby’s condition; however, if we see that you need or want to be in a particular position and the monitor belt isn’t working, we will work around it, even if that means someone has to manually hold the monitor in place. 

My thoughts: Okay, not ideal, but at least there is some flexibility. 

 

4. From doing my research, I understand that even though a woman may be fully dilated and ready to push, she may not feel the urge to push yet – meaning her uterus has not taken control and may not be quite ready for that stage of labor.  Some doctors/midwives encourage women to push regardless in order to speed things along.  Do the midwives in this group encourage pushing when the urge to push is not there, even with full dilation?

Answer I thought I’d get: Actually, I wasn’t sure what she’d say to this one… but I was hoping she would say no.

Answer I got: No.  She was pretty direct about that.

My thoughts: YAY, great.

 

5. Will I be allowed to push the baby out in a position other than lying on my back if that’s what feels best?

Answer I thought I’d get: I was pretty sure she’d say yes, but I was worried that there might be some kooky hospital policy that prevents women from being out of the bed or something, lol.  I know women can’t have the baby in the bathtub at the hospital…

Answer I got: Oh yes, women deliver in all sorts of positions – squatting, on hands and knees, etc. 

My thoughts: Yippeeeee!  On hands and knees while moo’ing like a cow, that’ll be me.  (kidding… I think… 😉 )

 

6. How soon is the baby’s cord clamped?

Answer I thought I’d get: Immediately.

Answer I got: Usually, as long as there is no distress, we wait until the cord stops pulsing.

My thoughts: Whew, that’s great, that’s exactly what I want.

 

7. Could you explain the timing the when the baby’s examination takes places after the birth?

Answer I thought I’d get: We place the baby on your chest for a few moments and then try to do the exam right away.

Answer I got: We place the baby on your chest and the nurse wipes the baby off.  As long as the baby is breathing normally and all appears okay, you may have your baby with you for 30 minutes or so before an exam is conducted, in order to benefit from that initial bonding time.  When the baby is examined, the exam table is right next to the mother, so that baby isn’t taken far at all and is given right back to you.  If the baby’s breathing doesn’t sound just right, the exam may happen sooner.

My thoughts: Perfecto.

 

8. (and this is when all the pregnancy hormones kick in and I lose it right there in the midwife’s office) I understand that a c-section will be scheduled for me at week 41 in case I don’t go into labor on my own, but is there any leniency at all on that policy?  I just really don’t want another c-section that early, if possible…

Answer I thought I’d get: No, 41 weeks is the policy and given liability there isn’t much flexibility.

Answer I got: Depending on how things are going in your pregnancy, there may be a possibility to go a bit longer, such as 41 1/2 weeks.  We will be observing you and the baby around that time to make the best possible decision and try to let you go as long as possible without putting your/baby’s  health at risk.

My thoughts: 42 weeks would be better, but I’ll take whatever I can get. 🙂

 

Next, Sharon asked me about my prior induction, particularly regarding the timing of it.  It happened at 41 weeks exactly last time, which makes me cringe now that I know what I know… and I told her that.  From her line of questioning, I got the impression that she was a bit puzzled/annoyed by the fact that I wasn’t encouraged to go until 42 weeks, but she didn’t really let on much about this, probably to avoid upsetting me further.  Sharon could see that I was really worried about not going into labor on my own again this time.  She told me that the women in my situation who tend to have the best outcomes are those who do not stress about it too much and just let nature take its course.  If you stress about it, adrenaline may build up in the system, and adrenaline stalls and sometimes can completely stop or reverse labor (Ina May talks about this in her book, too). 

So, my goal will be not to be overly worried and overly determined once week 37 hits. 

Sharon also gave me another piece of advice.  She said the best thing I can do to help myself and the baby from this point forward is to be pretty strict about my weight gain.  So far, I’ve only gained 9 pounds, which is good, but she said I should not go beyond a total of 25 pounds gained in order to increase the odds of having a successful VBAC.  And the best way to watch my weight, she said, was to follow a diabetic diet.  Babies born of mothers with gestational diabetes automatically grow an extra layer of fat, which makes things a bit more complicated in some cases.  And since I was borderline gestational diabetic last time, it might not be a bad idea to go ahead and follow a diabetic diet.

Okay.  Diabetic diet it is.  That does not scare me. 

 

Prenatal Stats:

Appointment date: April 14, 2009 (19 weeks, 6 days pregnant)

Weight:  135 – ergh, a pound higher than expected, but right on given that I’m supposed to gain a pound a week. 

Blood pressure: 118/64

Baby’s heart rate: Somewhere between 150-160.  Sharon said he/she was an active little thing today. 🙂

 

Oh, and I had another baby dream last night.  This time it was a girl.  Time will tell…