Wednesday, June 2, 2010

First Pre-Conception Visit with a Midwife

Matt and I had our first pre-conception visit with a midwife this week. I feel fortunate that she's already volunteered so much of her time. A few weeks ago, she spent about half an hour on the phone with me talking about her practice, and this time she spent about an hour with us.

I'd like for us to decide on our care giver before we get pregnant because it's quite stressful reading about the American birthing industry and sifting through the various options. I don't mean to put the cart before the horse, but it makes sense for us to have our plan in place when/if we get pregnant.

After the conversation with her, we're definitely leaning toward a home birth. She talked us through the risks of delivering at home but also talked through the benefits of laboring in the home environment. She's helped deliver more than 1,600 babies and has lost 9 of them--many of them due to congenital defects that the families knew about in advance but decided to birth at home anyway. She said there were 2-3 cases that may have gone differently if the mother had labored at the hospital. Her hospital transfer rate is around 10% and 3-4% (of the 10%) end up requiring a c-section). She has had to call for an ambulance 20 times, and the mother's life has been in danger 7 times.

She's a certified nurse midwife, and she brings the same equipment to a home birth that would be available in the delivery room (electronic fetal monitoring, IV, antibiotics, infant resuscitation, etc.). She also brings a labor and delivery nurse with her and requires that we hire a doula.

She also humored us as we asked a wide variety of questions, ranging from "How do we prepare our relationship for pregnancy and birth?" to "Should I work full-time while pregnant?" She talked about the importance of putting systems in place for communicating our needs to each other and embracing the fact that we're going to have to put our needs on hold for 1-2 years (although she thinks couples start to get their life back after six months). As for working full time, she's seen mothers make lots of different choices for themselves. Her one worry is that a lot of full-time mothers can't listen to their bodies, like taking naps when they need to.

I also brought along my Rainbow Light prenatal vitamins and had her look at them. She said they were fine but they weren't as good as the Opti-Natal vitamins from the Eclectic Institute that she recommends, since the latter has more vitamins, minerals, and herbs.

I asked about other birthing options in Houston, since a birthing center attached to a hospital seems like the ideal way to balance the risks and the benefits. However, the landscape is not very appealing. She says there aren't very many certified nurse midwives in Houston, and most of the birthing centers are not attached to hospitals or are far out of town.

I was surprised that Matt left with such a favorable impression of home birth and midwifery. He appreciated her honesty, warmth, knowledge, and humor.

Since she's downsizing her practice as she nears retirement, she won't be available to deliver babies next summer. That means we have would need to get pregnant in the next few months if we want to use her (or stop trying for September, October, and November) and then try again after that. We'll see what happens.

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Chayah & Mike said...

Thanks for this record of your experience. My brother and I were both homebirthed in the early 80's, as were some of our best friends. Our bodies know how to do it!!

Also, a wonderful midwife friend of mine is pregnant right now, and takes children's vitamins! She says that they are much cheaper than prenatals, and have equally high concentrations of certain vitamins and minerals. The only catch is to supplement with iron (Floradix is terribly yummy!) which children's vitamins don't contain. Check it out!

Thanks, Sara for this great site. I am planning a wedding right now, and though it is much more elaborate in many ways than yours, I've been really inspired by your approach.

Stacy Marie said...

I'm really glad it went so well! Good to hear that couples get their lives back so soon...I was at at BBQ Sunday and one couple had their 4 month old there. There were plenty of hands to hold the baby while Mom/Dad ate or played in a bags tournament, and the little one ended up passed out in someone's arms for most of the afternoon. It made me hopeful that you can still have a life and a baby at the same time! And I feel terribly selfish even saying this at all, but my parents always put their kids first and never put any work into their marriage, and now they are really struggling. I don't want that for my partner and I. I think you have to put your relationship first so that you can be the best parent possible.

Oh and I love prenatals....we aren't trying to conceive but I've been taking the Trader Joe's brand for almost a year now, and it's really helped my energy levels.

Amber Morrisey (@BirthRoutes) said...

It is amazing how awesome most midwives are, the time they take to answer all your questions.

One thing that stuck out to me (being a doula) is that she requires you to hire a doula? Did you mean suggests?
While I think my role as a doula is pretty important to many, blanket requiring an outsider to attend a birth in my mind isn't the safest idea. You should only be hiring one if YOU want one and can afford one (on top of the cost of midwife assisted birth).

I'm not saying don't, just the words 'required' made me pause and I thought I'd share that with you.

Robin Norgren-Well of Creations said...

very interesting to read this process. I noticed your "to do" list on the sidebar-is this as a result of Flying Lessons? I too want to learn spanish-I have the CDs but no motivation. Maybe we could partner up somehow?

Avid Reader said...

My sister (28 years old) has had all three of her kids at home, with a midwife. She had the first in Colorado and the other two in Indian. She loved it so much that she became a doula after the first birth. I was there for the third one (I was in London and missed the others) and it was amazing, so peaceful. The midwife and doula had all of the knowledge, without putting pressure on my sister to get the baby out NOW so they could open the room up for another person.

Elsa said...

Let's try this again :-)

I'm really enjoying reading about your whole process, especially now that we're also ttc.

When we started researching birthing centers in Houston we also realized how far away they are. I can't imagine having to sit in a car while in labor to get to a center. Everything we looked at was a minimum of 30 minutes away. That was one of the reasons I began leaning more towards having a home birth, if possible.

Did she explain why she requires a doula be present? I know many midwives say it's optional.

Again, thanks for sharing with us! I'm excited about our meeting this weekend!

Roxanne said...

Hey Sarah, have you looked into this program at Texas Children's Hospital?

They are midwives, but associated with a hospital. I read a book once, and I believe it was called something to the effect of "Home Birth in The Hospital" and it seems like this may be similar.

I know whatever ends up happening, things will work out.

Sara E. Cotner said...

@ Roxanne: I feel so lucky to have a fellow Houston-ite looking after me. Thank you, Roxanne!

From what I've read in a couple different places, the problem with midwife-assisted birth in U.S. hospitals is that the physician is still the one who is ultimately in charge. Being under the care of a physician (who is trained to respond to pathology) can lead to increased interventions.

It's definitely hard to get my hands on unbiased information regarding this topic!

Justine said...

You know we all wish you the best of luck...but it sounds like you're playing with fire. Why risk something so important as your life and the life of your child?

Again, I just speak from experience of seeing home-births gone horribly wrong that come to the NICU in which I work.

I guess not everyone sees it that way...but I wish all those considering home births could see the severe anxiety and fear that I see in the faces of these mothers to see these end results because that is a real danger that can be avoided... *shrug*

In any case, again, I do wish you a healthy pregnancy and baby : )

Sara E. Cotner said...

@ Justine: I appreciate your insight so much! I really do.

[Actually, as I sit here and think about how to respond, I'm realizing I should just write a whole post in response to your points!]

Stay tuned...should appear next week.

lisa said...

While it is much nicer to labor at home, and most deliveries are indeed without incident, the comparison I often use is this: Since most of the time you aren't in an accident, why does your car have airbags and seatbelts? Why would you put your infant in a carseat when it is so much nicer to hold her in your arms?

Hospital birth is the seat belt of obstetrics. An awful lot of things go wrong very very quickly and very very thoroughly.

Birth is like a wedding: only the beginning of the whole experience.

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