midwives

My crazy pregnant brain

| thedarwinsgirl

I have lost my rational mind.  I have convinced myself that this pregnancy is ectopic.

Let me explain.  When I was ovulating last month, I could feel (for the first time I could recollect), which side I was ovulating from (right).  Then, a few times this week, whenever I get up quickly, or move fast–the right side of my abdomen hurts.  It feels like a tearing or ripping feeling inside my body.  It feels like a round or broad ligament pain would, if I were farther along.  So, when I consulted Dr. Google, the first thing to return is Ectopic Pregnancy.

Apparently, somewhere between 1 in 40 to 1 in 100 pregnancies are Ectopic.  And, if you have had a D&C, you are more likely.  Most are discovered somewhere between 5 and 7 weeks-either via Ultrasound or because they rupture.

I have been holding off on making my Midwife appt. out of some sort of denial and/or fear of eminent loss.  But, it seems that I can hold off no longer.  I need to put my mind to rest.

Update:
After letting this consume me and ruin my weekend, I reached out to a logical friend.  She reassured me that everything was fine.  And that it was likely to be ligament pain.  Nonetheless, I made my first pre-nantal appointment for Aug 20th.

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28 weeks and counting

| thedarwinsgirl

To add to my current list of anxiety and worry, I can now add a breech baby to my list.  Thank you Anon commenter–I know I should relax and enjoy and stress less — you advice is well received and much appreciated!  I am doing much better at taking things in stride the last couple of weeks.  


I went to my 28 week Midwife appointment yesterday. On my list of things to discuss with her were my 2nd trimester bout of the blues, constipation, and when babies get into the head down position (34 weeks or so).


You see, I had a strong feeling in my stomach (pun intended) that this little guy was facing the wrong way.  She checked him, and he indeed is head up.  Of course, there is PLENTY of time for him to turn and face down.  But, from my day to day experiences with him–he seems to like being head up.  


This is one active baby though, and most days he is alert and moving like crazy from 4-11pm.  The midwife thought that perhaps the placental positioning was causing me to feel more movement that usual.  But, alas–its anterior which typically allows you to feel less movement.  


I am grateful that the wee one allows me to sleep very well, most nights I only wake to pee once.  My overall comfort level lately is good.  I attribute the additional comfort to the wide variety of yoga pants that I have recently acquired and wear on a daily basis without shame.  And the ever growing pillow palace I sleep with.  My back is starting to feel the pressure of the added weight, but I am hoping to continue to do Yoga and Stroller Strides to help alleviate my aches and pains.


I passed both of my glucose tests, so I can rest easy that I won’t have to struggle with gestational diabetes.  The only test left is the Beta-Strep.  And now we move onto appointments every 2 weeks with the midwife.  

BF Follow up

| thedarwinsgirl

Motherhood makes me feel stupid. At least that is often how I feel lately. There are so many new things to learn. So many times where you have to be vulnerable, and ask for help or advice. So many times you have to throw your hands up in the air, and say you just dont know the answer or what to do. So many times where more than your maternal instinct is required.

My experience at the Midwife yesterday was no exception. The first not so pleasant experience was making the appointment. The admin when I told her my reason for wanting to come in, said, something to the affect, Oh, did you see Eve? I said that I had, and she proceeded to say that Eve had referred several people to the Clinic with the same diagnosis, which she (the admin) was surprised about since the condition was so rare. I shrugged it off. But, it really bothered me. What business does an admin have telling me about other peoples diagnosis, planting a seed of doubt about the lactation consultant’s abilities, as well as my own diagnosis. Plus, she is an ADMIN, she is not a midwife, a LC, or a doctor… She isnt even a nurse.

I was very excited about seeing the Midwife. I saw another Midwife I havent meet. I think I have almost seen every one (Linda, Jennifer, Rebecca, Jazmine, Beth, Rita…), except for Steve. Who I suspect might be in clinic next week when I go to my follow up appointment. When the Midwife came in, I explained my story (the let down issue, the clamping, the extreme pain during and long after a feeding, my visit to the LC and the diagnosis).

She listened attentively, and then proceeded to say that she has never heard of the condition, and even conducted some on-line research prior to my visit. She proceeded to say that she would be uncomfortable prescribing meds to me, etc. etc.

I started to cry. Through my tears, I explained how I considered myself an intelligent woman, resourceful, and up for a challenge. But, that I was at the end of my rope. I saw a LC in the hospital, I meet with my Doula for a post-partum visit to assist with BF. I have the Sears book on BF, I have conducted a ton of on-line research. I have consulted friends who have successfully BF, I attended the hospital sponsored BF support group, I have called La Leche League (they didnt call back-twice), I called the hospitals BF Program-2x’s (no call back). I saw a Midwife again (on Wednesday past) who said my nipples looked great! I finally decided to shell out the $60 and see a LC in person. I cried harder, explaining how hard BF was, and how everyone touts that the Breast is Best, but that there wasnt enough support out there…waaaaahhhhhhhhh.

When I was able to regroup, and hold back the tears…I realized that I probably startled the poor gal. She was now more sympathetic. I asked her for any other alternative solutions she had, as I was willing to try anything to ensure that my BF relationship was not jeopardized. She didnt have any solutions. But, offered to discuss it with the OB on staff.

She returned after discussing it with the OB, asked me a few more questions and then wrote me the prescription. She also said the OB had never heard of the conditions either, but they were able to find a 2004 study published in Pediatrics. So, with a heavy warning to call should I develop any side effects I left feeling very successful, if not a tad bit depressed with the sucky–ness of the system.

I filled the prescription, and took my first pill this morning. And ever since I have had a horrible migraine (I have taken 1200 ml of Motrin). Headache of course is the first side effect listed on the pharmacy printout. I will need to analyze the cost/benefit of the headache versus the nipple pain. Again, more to follow.

Which brings me back to feeling stupid. All of that fretting, crying, pain, etc. and now the medicine may not even be tolerable. Boy…dont I feel stupid.

38 week appointment

| thedarwinsgirl

Yesterday Hubby and I attended our 38 week appointment. We met yet another midwife in the clan o’midwives. There are 12 or so, and they all rotate on clinical duty and with being on call. I think so far I have met 4 of them during my 4 month tenure at the birth center. My regular appointment was moved from Friday AM to Wednesday PM, and the gal I was seeing on Friday mornings is now out on maternity leave. And then next week due to the holiday, we move to Tuesday and will likely meet yet another (a fifth) midwife. In a way I wish I didn’t meet them in advance, since any one of them could catch Elliott when he is born-depending on their on call rotation. Meeting them in advance has allowed me to form opinions about each one, and being as judgemental and opinionated as I am…. in my head I have already made my like and dislike list. Had I not met them, I wouldn’t have any pre-existing biases or preferences towards them.

The appointment was kinda odd, as this midwife offered unsolicited advice, and it was kinda out of left field. Luckily, I had a couple of questions based on random paranoia of my own for her.

  • I wanted to know if she could judge his size at this stage. I am starting to worry that he is going to be to big, and I am not going to be able to birth him. She said she could, but never told me and I forgot to ask, as I got caught up with the other questions.
  • I also wanted to know if he was going to keep on growing, as I don’t feel like I can get any bigger and still move around. She said yes, he would continue to grow…and yes, so would I. Damn it.
  • I have been getting sharp shooting pains in my breasts, and assumed that it was a sure fire sign that something was starting to brew. She confirmed that yes, that was likely a sign that my milk or pre-milk at this stage was beginning. And assured my all was well.
  • Lastly, I wanted to confirm that I had enough amniotic fluid. For some reason, I am all of a sudden paranoid about this. I think that it stems from several things. The first is that the birth class gives you all of these random things to look out for, and one of them is when you water breaks at the top, and just slowly trickles out. A lot of women don’t realize their bag of waters has broken…and infection, etc. can occur. They give you some acronym to check for…but I forgot what it was-COAT I think (color, odor, appearance and time…?) The second wave of paranoia is that I am excessively thirsty (I asked last week if this was common, and the midwife said yes) and don’t feel like I have to pee as much as I consume. So, I was all wrapped up in the idea that maybe I was so thirsty because I was loosing amniotic fluid, and needed all the liquid I was drinking to replace and replenish Elliott’s supply. The last reason I started to get worried is that when I move into certain positions, I can actually hear and feel the fluid displace in my upper torso. Imagine you are in the bath tub leaning back, and you go to move or sit up, and then water moves from the back side of you to the front. It kinda feels like that. Phew, after all of that worry-everything is fine there too. She prodded my belly, and squished him around and confirmed that he had plenty of fluid.

I asked what the next couple of weeks held as far as setting expectations for my appointments. I asked if I would be having any vaginal exams (I haven’t had one since I have been with the birth center-my only one was my initial exam at 9-10 weeks with my previous OB) or other tests. She said that they will continue with weekly appointments for the next 2 weeks, weight, BP, make sure the baby is head down and his heart rate is normal. Then on week 41 if I am still pregnant, they will want to see me 2 times a week to perform the non-stress tests. Then at 42 weeks, we can start discussing other options. She said that they do not perform any vaginal exams until after 41 weeks because they are invasive and unless there is worry-unnecessary. She also said that they are also uncomfortable for the mother, and tend to get a women’s hopes up with out being based on any definitive data. She said that regardless of how effaced or dilated you are-that at any time you can go into labor…so it instills a false sense of hope.

For me, all is well. The appointment was fine-BP is normal, a small bit of swelling but nothing major, Elliott’s HR is good, he is still head down and in position. I stopped looking at the scale, partly because I cant see it from my vantage point, partly because if there was an issue I am sure I would have heard about it, and mostly because it just serves to depress me (and why would I want to stress over my weight, when there will be plenty of time for scrutiny and self doubt after the delivery!). *Laugh*

Mobility is limited and energy levels are low. But, my attitude is good and I am 90% ready to have this baby. I still have a few more things to get settled (make sure my disability paperwork was completed and sent, finish packing my bag for the hospital, and do a final pass at cleaning the house), but if I went into labor right now, I would be happy.

In 18 weeks I’ve learned

| thedarwinsgirl

I have learned a lot in the past 18 weeks, about a variety of topics related to motherhood, parenting and the HMO system. Beware bitching and sarcasm ahead.
I learned how to research and locate a hospital, medical group, doctor and midwife.
I also learned that pregnancy prepares you in weird ways for what I think some parts of motherhood will be like.
Lastly, I had the displeasure of learning that there are too many options available to us as consumers. A perspective that leads to indecision and uncertainty when making a choice.

How to research and locate a hospital, medical group, doctor and midwife that your insurance plan accepts, and is in line with your ethics and values:
1. When you first find out your are pregnant, if you know you are keeping the baby-don’t hesitate! (if you aren’t sure about keeping the baby-then do not read further, as you have other more critical decisions to make) Otherwise, get to work. There is no time to get adjusted, or find your groove. And forget the fact that you have morning sickness, can’t eat, and haven’t had a cup of coffee for longer than you can ever remember going in your previous life. You need to start researching and making decisions about the next 9 months (10 really, but lets not rock the boat of social norms yet (that is going to be discussed in topic #3)).
2. If you have insurance, consider yourself lucky, and get on the phone. Yes, you may wait for 10 minutes on hold, with an operator who doesn’t know jack…but do it anyway. If you are using an HMO like most of us, find out what your plan covers and what hospital and medical groups you can chose from.
3. Find out what hospitals are in your area. You can do a quick search on the Internet for hospital in your city.
4. Go to each hospitals website, find out about their birth centers or maternity departments. Do they have a Midwife option, or can you only select an OB in the provider finder list. Also find out what medical groups they are associated with, and if your selected OB or midwife is affiliated with them. Get as much info as you can and use that to help you make a decision about the type of hospital environment you want to deliver in. There is also the home delivery and free standing birth center option, but since that isn’t an option for me, I am going to leave these out.
5. Call you insurance company back, and make the switch if possible. You can only change medical groups while you are in your first trimester, so don’t hesitate.
6. Make your first appointment with your new OB/midwife. Take the appointment seriously. They typically will want you to wait until you are 10 plus weeks along, but you can force a sooner appointment by saying you have concerns about the viability of the pregnancy or feel at risk. This is critical to get the appointment as soon as possible, because as mentioned in #5, you only have until your 12th week to change medical groups, and if you don’t like the doctor, you may be limited to similar types of doctors (doctors who all share the same ideas) within that group.
7. The other thing to remember is that the first appointment is typically not even with the OB, its with the Nurse Practitioner. She is there to field the questions you want to know about the delivery, the common practices of the doctor and the medical group, your freedom in the delivery room and with your baby after delivery. This appointment is not the time to be shy, or coy. You must be direct and prepared.
8. If after your first appointment, you don’t like the doctors views-change immediately. Do not hesitate. While this may seem like an insignificant issue since women all over the world give birth without the assistance of doctors and hospitals (which is what I thought until well into my 14th week)–it is huge. When American women give birth there is a procedure that doctors and midwives are supposed to follow regulated by the hospital, medical group, and their conscious
and experience. They need to follow hospital procedure (e.g. you must have an IV when you check in, you can’t walk around once you reach the labor/delivery room, you cant have music or candles, your husband can/cant spend the night with you, your baby can/cant spend the night with you) and then the opinions or experiences of the OB/Midwife (their quickness to give an episiotimy, their feelings on breach delivery and the use of C-section, and their use of forceps and vacuums, as well as their availability on weekends, holidays, nights, etc., and who they use when they are not on call).
9. Once you have found your niche office, enjoy your appointments! This is a fun and exciting time-and it goes quickly.

Pregnancy prepares you in weird ways for what I think some parts of motherhood will be like:
Now, since this is my first pregnancy and I don’t like kids that much, I can not be responsible for inaccuracies, or mistakes in judgement.
1. You soon realize that your body is no longer yours alone. You no longer have sole control over it. Your hormones are the first indicator of this-they are going nutz’o. No matter what you do, how you sleep, exercise, eat, or try to perk yourself up-they rule. This is a tough realization for some (me!!!) especially those with control issues. The best advise I got was to ‘give it up to the higher power’ (this saying is mostly reserved for conversations about God and religion as support for how to believe in things you cant see, etc. But, I would like to use it here, and have as little association with religion as possible. Indulge me!) The higher power in this case is your body and your hormones.
2. If you are able to ‘give it up’, you will soon thereafter come to the realization that never again will you have control over your time and many of the decisions that follow. This sounds worse than it is (as my wiser friends helped me see). However, when i originally spoke with a (less wise) friend about this idea-I was swiftly informed that I was selfish. Let me clarify that a parent makes choices and sacrifices for their children willingly and with love. However, that doesn’t mean they are any less of a decision or a sacrifice. it just depends on the level of sacrifice and/or resentment in having to make the choice. I welcome the change and look forward to all that is new, but it took some time to get here and didn’t happen over night. Don’t worry about it, it will.
3. Refer to #1, and remember that your body isn’t yours any longer and the fact that you have to get up 2 plus times in the night to pee isn’t so bad. A good night sleep to me used to be when I could sleep 8 plus hours soundly all the way through! That is a thing of the past. The constant bladder disruptions are preparing us for motherhood, and for sleepless nights filled with disruption.
4. Everyone has an opinion about your pregnancy-from what you are eating, to what type of exercise you are doing, to the sex of the child and your birthing methods. Get used to it. This will never stop. After your child is born it will only get worse-with strangers judging your parenting styles from afar, to the pre-school teacher offering suggestions, to your mother giving advice about when she raised you. Figure out how you best handle other peoples unsolicited advice and opinions and use this time as practice.
5. Maternity clothes suck. Now, I have read what all of the pregnancy magazines say about only needing a few ‘key’ pieces to make your wardrobe shine. Bullshit. When you wear a size 12-14 pre-pregnancy, your wardrobe choices are limited to begin with, and maternity clothes are no different. Finding ones that are comfortable for your belly type, your body type and your budget type is a monumental task. Again, another thing to use in your arsenal for motherhood prep. I have 10 pair of maternity pants in my closet and 3 pair fit. A similar thing for tops. Which means i have to do laundry every few days. Yes, I can wear pants twice or more depending on the length of time worn, use, etc. However, I cant do that with the 4 pair of underwear I have that don’t cut my circulation off, and the 1 bra I have (that incidentally is black…a whole separate issue). So, the lesson here is laundry will need to be added to your daily activity list once your bundle of joy arrives. Oh, and what about being environmentally aware… yeah right. You can forget cloth diapers!

There are too many options available to us as consumers:
My husband and I made our inaugural visit to BabiesR’Us over the weekend. Neither of us had been there before, and we wanted to share the experience together. We both left feeling overwhelmed and dumbfounded. Not to mention a little nervous. Now, that isn’t to say we weren’t oohing and ahh’ing all of the cutesy baby items. But, by the time we left we were exhausted. There is too much to chose from. Too many strollers, too many colors, too many car seats.
This is of course our own fault-free markets, supply and demand, capalism and the rise of the middle-class consumer. God Bless America.
Now, for me…when there are too many choices I get frozen with fear and thereby paralyzed. Which is where I am today. I know that I need to start researching car seats and stroller systems…but where do I start? So, instead I will complain about it for a while, and only after I have had my fill of sympathy will I move on to the next step of action.

If you have made it this far in the post…you deserve a cup of coffee! Please comment I would love to hear from someone who can put up with my ramblings for so long.