Sunday, July 1, 2007

Pregnancy update

  • I'm still pregnant. 17 weeks now. I had a midwife appointment the other day, and there is still a heartbeat present. I used to scoff at people who bought home doppler ultrasounds. I know the American Institute of Ultrasound in Medicine is not a big fan of ultrasounds for other than indicated medical reasons, and I thought that people who disregarded such advice for their own reassurance were foolhardy at worst, merely silly at best. I'm not running out to buy a Doppler, but I now have much more sympathy for the people who do. Four weeks is a long time to wait between live-fetus checks. Especially when one is a big research-slut, aware of many of the things that can go wrong in a pregnancy at any point. But next week is the screening ultrasound, and fairly soon I expect to start feeling fetal movement on a regular basis. So this four weeks might just be the longest period I've had to go not being quite sure if there's a real live fetus in there.
  • I'm not showing. I bought my first baby item last week: a Maya Wrap sling. I found it on craigslist. Plain black, my size (but not A.'s), with instructional DVD, and within short biking distance. Perfect. The couple I bought it from have a six-week old daughter who hates the sling. The father said to me "I hope... whoever you're buying this for... enjoys it!" So I guess, even when my behaviour indicates I could be pregnant, I don't look it. The midwife also mentioned me not showing. I told her A. can tell, when I'm naked. Apparently having one's husband think one looks pregnant while naked does not officially count as "showing."
  • I have a definite case of white coat syndrome. Except that it's not doctors (or midwives) who necessarily freak me out. It's receptionists and nurses. I've always had a pretty significant social anxiety disorder (yes, professionally diagnosed), and it tends to be worse with "counter people" (retail workers, receptionists) and low-level authorities like nurses. I breathe deeply in the elevator while A. pats my arm, check in with the receptionists (whom I hate, for a combination of rational and irrational reasons), fiddle clumsily with the label for the urine sample I brought along, try to calm myself while flipping through a magazine in the waiting room, quickly get called by a nurse (since my midwife seems to do her appointments on time, and I refuse to show up any time either than exactly 5 minutes before my appointment), follow the (feared, but not hated) nurse into the exam room, and immediately get my blood pressure taken. High, of course. This time I got the midwife to take it at the end of the exam as well, at which point it was comfortably in the normal range. I'm worried that they'll want to induce me later for PIH, which will really just be social anxiety. Maybe I can convince them to let me take my own readings over 24 hours before they make any decisions.
  • I'm gaining weight like crazy. It worries me. If I continue gaining at this rate, I will gain 50 lbs over the course of the pregnancy.
  • We asked the midwife if she knew any Bradley instructors. She mentioned a couple of names, that A. had already found in his research. She also said that she liked them because they didn't make their clients "hostile." She described the "hostility" as "vestigial." A. was impressed with her choice of vocabulary. I was slightly disturbed by her dismissal of the consumer-education portion of the classes. It seems she measures an instructor by their tendency to have complacent students. I guess I shouldn't expect any differently, since she would be on the receiving end of the "hostility." I think she thinks it's no longer needed since she and her colleagues no longer routinely shave their patients, give enemas, separate the parents, etc. But I'm still worried about other decisions: to not have an IV, to eat and drink, to delay cord cutting, and to have the baby never ever leave the room.
  • A. finds me extra-sexy when I'm pregnant. He told me he's even finding himself attracted to other pregnant women, which hasn't been a factor for him before. I'm enjoying the attention, since I have the typical worries about how pregnancy is changing my body.
  • I still haven't told my boss I'm pregnant, and only one labmate knows. I figure the boss should be first. She's been out of town for a few weeks. I may have to tell her at a workshop we have out-of-town in about a week. I'm nervous. She does not like children. She's always felt, I think, that I've been one of the few people she can confide in about her dislike of children, and her annoyance when events she has to attend turn out to be child-centred. On the other hand, I know she strongly identifies as a feminist, and I don't think she's going to try to make my life hell for choosing motherhood. She knows that it's much easier for men to choose fatherhood at this stage (or any) in their careers, and I know that her sense of fairness will win out in the end.


emjaybee said...

Wow, this is reminding me so much of my first trimester with Nathan. The anxiety, the confusion, the general weirdness of being pregnant...phew. Oddly, I sometimes miss it.

If you are worried about your midwives respecting your wishes at all (or the hospital) Google EMTALA and also check online for patient rights. Basically, once you are in active labor (4cm) you cannot be refused admission...nor can you be forced to undergo any procedure, up to and including monitors, IVs, hep locks, cervical checks, temp checks, sonograms, etc. etc.

Hospitals will seldom own up to this--sometimes they will even LIE about it--but it is the law. They cannot force you to do anything or do anything to you, nor can they kick you out until after the last stage (placenta delivery), at which point there's nothing left to fight over. Oh, and if you don't follow their advice, they also can't get your insurance to penalize you for that. I know women who have been told that lie, also.

good link on your rights here:

If you are considering using a doula, it could be good to get one who is well-versed in all of this and willing to help you advocate for yourself. (I say this because mine was nice but not nearly well informed enough, so she wasn't much help).

Which was something I didn't know
in my labor, and so wished I had.

I'm sorry if I'm blathering on, but one more thing; you posted at my blog that your insurance won't cover homebirth. (Not surprising). Have you considered having one anyway and paying out of pocket? It's not hugely expensive, necessarily--many midwives do installment plans--and it can relieve you of the need to fight so hard to have the birth you want.

You might even use your current midwives as "shadow care" up to your due date, and then just..not go in to the hospital until after the birth. Women have accidental homebirths all the time, after all. You can still visit the hospital and get a birth certificate, etc., and a certified professional midwife (CPM) can do all the inital weighing, checking Apgars etc. herself.

Depending on the laws of your state, you have the right to birth with with a CPM who will do a homebirth. Some states do not recognize CPMs, however, and that would require you to use her "under the table" should you be able to find one. Or if you live close to the state line, go to a friendlier state to birth. Some women rent hotel rooms, use the homes of friends or relatives, or even find midwives who will let them birth at their homes or clinics, in order to get a non-hospital birth (usually women who've already have one and say NEVER again).

you can go here to find the laws on midwives for your state:

You will only have this child's birth once. Whatever happens, even if it's sideways breech or other rare event that makes a c/section your only option, it is so so important not to go into your labor already defeated and withdrawn (says someone who did just that).

The system is not set up for your convenience, and in some ways, not even for your safety, and that can have enormous repercussions for you and the baby. Be well armed with your rights, and ready to fight for them, however you proceed. Even if it is a necessary c/section, there are ways of having a good one, and it not being traumatic. But only if you insist on your rights in no uncertain terms.

(/climbs off of soapbox)

Dr. Confused said...


I'm so glad that you and I have found one another's blogs. I went all the way back through your archives and I've read your birth story and its aftermath, as well as many of your pregnancy posts. It's scary, because I almost feel like I am you, just a little bit delayed in time. Like you did, I'm seeing CNMs affiliated with a particular hospital. I think I'm going in with a similar birth philosophy to the one you had (and not far from the one you have now, without the grounding in experience). Your birth story is one that concerns me, because I think it's an example of a woman doing everything right and still being treated like crap. I would probably have made the same decisions you did... avoid pitocin if possible, but relent when postdates, take the epidural along with the pitocin, and then consent to a c-section when things aren't moving along at all. I'm not even against any decision you made, and I totally see where each comes from. The problems with your birth weren't any of the medical decisions you and your HCPs made, they were you being treated inhumanely, and then with them taking your son away from you for so long. The first bonding moments are just so important to me, and your story really gets me listening.

I do know that legally they can't do anything to my body without my consent (well, except for in extreme instances, cf. Angela Carder). But I also know that I don't want everything to be a battle, and that I want to maintain a good relationship with my midwife and the L&D nurses.

I do think my hospital may be slightly better than the one you delivered in. Its c-section rate is somewhat (not hugely) below the national average, its induction and augmentation rates are low, and its episiotomy rate is extremely low. Breastfeeding rates on release are very high. They don't have a regular nursery, instead insisting on rooming in for all well babies. I'm hoping this means that even if the CNM is no longer primarily responsible for my care, I'll get the majority of what I want.

I've considered a homebirth midwife. I might even still be considering one. But we're seriously poor right now, and there's other priorities for our money. This state is good for CPMs, and there are many that advertise homebirths, even right in my area, so if I really wanted to go that route and were willing to pay for it, I could do so.

I fantasize sometimes about an "accidental" unassisted homebirth. That will most likely not happen, as I'm sure I (and A., whose vote counts too) will have the standard first-time-parent fears. What I'm hoping for is showing up at the hospital pretty much crowning. That probably won't happen either, but I can do what I can to plan to stay at home as long as possible.

As long as I don't go too postdates that is. As long as everything goes smoothly. It's too bad I can't count on that.

Thank you so much for all your advice. I really appreciate you taking an interest in me.

Anonymous said...

Buy two of the baby carrying device, one to fit each parent. We had "Sara's Ride," two of them, one to fit each of us.. Worth the trouble.