Questions and Answers.

I thought I'd take a few minutes to go over some questions I've received (some fairly common, others sort of unusual) lately. Seems like a good way to kill time (otherwise known as wait impatiently for a baby to arrive).

Question:
How do you keep the water in the birth tub warm?
Answer:
I'm not really sure how this will work in real life, but in my imagination, it's not so hard. I do not plan to fill and get into the birth tub until I am sure I am in active labor (my MW suggests about 5 cm, but does not demand I get checked to prove I am 5 cm first or anything). Our water heater will be turned up so the tub fills very hot. I'll get in and relax.

The water is actually NOT intended to be 'hot' when baby is born in it. It should be close to mom's normal body temperature of 98.6, so ideally by the time baby is born into the water, it will have cooled down to about that temperature. And many moms who've birthed in water say you won't WANT it really hot anyhow, since labor raises your core body temp and too-hot water = too-hot mom. Now, should the water need heating, we can boil some on the stove and add it in, or siphon some out and add more in straight from the tap.

Question:
What do you do with the water when you're done birthing and the pool needs to be emptied?
Answer:
You siphon the water out. You can use a hose to siphon it into the yard, sink, or tub.

Question:
Does the birth pool have stirrups?
Answer:
No. Stirrups are not needed, as mom pushes in whatever position is comfortable for her. Stirrups are only used in labor to get mom in a position that's convenient for the OB or MW attending, and that position can lead to worse tearing or...episiotomies. Which leads ME to....

Question:
What if you need an episiotomy?
Answer:
Episiotomies are very rare, if not non-existent, in home births. I am not even sure if my MW brings the right....tools....to do one. I never asked, as I don't plan on needing one done. She tells me very few of her moms tear at all because they direct the pushing themselves and, in water, the tissues have time to soften enough that there's usually no tearing. What tears she DOES see usually don't even need stitches.

Question:
What about the mess?
Answer:
Most of the 'mess' will be contained in the birth pool. We also have 'drop cloths' of sorts to lay on the floor and bed, and the MW and her apprentice do a cleaning of the house after baby is born, including throwing soiled linens in the wash.

Question:
So about this 'mess' in the pool...isn't it kind of gross and unsanitary to float around with your placenta?
Answer:
I don't plan on bobbing for placenta, if that's what you mean. There will probably be some amniotic fluid and blood (and possible 'debris'...please see fish net post below) in the pool at some point. But the fact is...this is all stuff (ok...maybe not the 'debris') baby is being exposed to in the womb, and is no less safe for baby to be exposed to OUTSIDE the womb. I don't expect it to be a lot, and usually the blood comes after the baby, so it's not like I'll be swimming in it for 10 hours of labor. Also, the placenta is typically delivered outside of the pool, on dry land, so there will be no floating with that either.

Question:
What if baby needs oxygen or CPR? What if mom needs oxygen or bleeds too much? Can the MW handle this?
Answer:
We bought this jar of stuff called Rainbow Puppy Unicorn Magic. You just open the lid, and out comes a magical fairy to sprinkle Rainbow Puppy Unicorn Magic around the room, and all is better. And the bonus is, labor doesn't hurt and AIDS is cured and there is world peace.

Ok, but seriously, people. I do appreciate the concern and curiosity, but we didn't get out MW out of the back of the New Times. We didn't pick her just because she has horses and Luca likes going to see them (though she does, and Luca does). We interviewed 3 potential MWs and asked a ton of questions. Naturally we asked about emergency medical situations and how they are handled. My MW carries oxygen for both baby and mom (maybe even for panicked dads?). She knows First Aid and CPR. She brings pitocin to births in case mom bleeds too much or needs help getting her uterus to clamp down and expel the placenta after baby is born. She is a qualified professional with a LOT of training and experience, and a part of that includes knowing when she needs to call for help. We live less than a mile from the hospital where Luca was born, and an ambulance could be to us in about 2 minutes if need be. About the only thing my MW cannot do that the OBs at the hospital CAN is perform a c-section or give me drugs for the pain.

Question:
What about all the normal things the hospital does? Eye ointment, shots, health checks, etc. Can your MW do those?
Answer:
I've sort of touched on this a few times before, but the answer is yes, if we wish. The big difference here between a home and a hospital birth is that we as the parents can decide what things to have done and what to decline, with full knowledge of the pros and cons, no on-the-spot pressure, and no judgment on our decisions. So, we won't get the eye ointment, we will get the Vitamin K injection and the newborn screening (required by the state anyhow), baby will be weighed and measured....and all this will be done (I hope!) while I lounge in a robe at home in bed.

Question:
Will Luca be there for the birth?
Answer:
It depends. If I go into labor while she's sleeping at night, we'll leave her in bed. If she's awake or wakes up, we'll play it by ear. It's really dependent upon whether I am comfortable with her there, whether H can help me while keeping an eye on her, and what her reaction is to the whole thing. We don't want to exclude her, but we also don't want to scare her, so if we think she'd be better off playing with one of her Grandmas or uncles or a friend, we've got backups on call.

Question:
Who 'catches' the baby?
Answer:
We plan to play it by ear. My MW is more than happy to step back and let Darrick or me do it if all is going well with the birth. I can't predict who will actually end up doing it.

Question:
Who will announce Andre's sex?
Answer:
My MW has told us she doesn't even look unless we ask her to. I'm hoping Darrick will announce it, but this is another thing we can't actually predict for sure in advance.


That's it for now! If you have other questions you want to see answered, feel free to comment here.

Holy Hell.

I had a scary realization today.

I am pregnant. And due in about 17 weeks.

I am going to have a baby. At home. With no drugs. And too much of a 'rule-follower' mentality to even take a shot of whiskey to dull the pain. Just a birth tub, my husband, and a midwife.

Holy hell. What did I get myself into?!?!?!

Why I Love My Midwife.

On Thursday, I was supposed to go straight from my ultrasound to my Midwife's office for a prenatal and some bloodwork. However, the ultrasound took much longer than anticipated, mostly because baby was not super cooperative, so by the time I got out I was already 15 minutes late and still 15 minutes away. I called MW and asked her what she wanted me to do and she asked me to come Friday instead. I agreed, and we set an appointment time for the afternoon. It was at 1:30, so Darrick wouldn't be able to be there, but that was no big deal.

Let me set up the scene for an appointment with my MW. Her office is in her home, in a back entrance. She lives about 15 minutes from us, in a pretty rural area where the norm is still to have horses and goats and other farm animals. To get to her house, you drive down a narrow gravel and dirt lane, and look for 'the house with the green roof'. It's a large ranch home with a huge backyard that houses 3 horses, 2 turkeys, some chickens, 3 (I think...maybe 4?) dogs, and an undetermined amount of cats. The cats all look exactly alike, so while I know there are at least 2, there could be JUST 2 or 14 for all I can tell.

Anyhow, when I pull up, I park in the dirt and walk to her office door. Next to the door is their oldest dog, a female who is blind and deaf and, MW reports, so sedate they often walk by and have to stop to make sure she's still breathing. Her office has dark wood floors, a comfy couch, a bathroom with a large tub (fun fact: her daughter's first child was born in that room, in the same bed in which her Grandmother was born), tons of books, and an exam table.

All these details are not the reason I love my midwife, but I will admit the feeling I get at her office helps my overall sense of calm when I'm with her. Luca and I got there early on Friday and she was with another patient, so we went out and looked at the horses and turkeys....who DOES that??? It's definitely NOT something I've ever done while waiting to see an OB.

After MW was done with her other patient, Luca and I went in and took a seat. Her apprentice was there, and we all talked for a bit about how things were going. As we were talking, the fax from the ultrasound place came through, so she grabbed it and sat next to me so I could read it as well. Most OBs wouldn't let you read the file, so that was pretty refreshing as well. The info was all stuff the Dr and genetic counselor at the ultrasound place had reviewed with me, but we talked about what it meant and what the next steps were. She then drew some blood for a regular panel, to be sure all my organs are functioning ok and I have no anemia. She let me refuse the HIV, gonorrhea, and chlamydia tests, since I've had them before and am in a monogomous relationship...who wants to pay for tests you don't really need? AND she was able to get my vein and get the blood in one shot, without having to stick me multiple times, dig around, and blow veins like most people do to me.

She also took my BP (normal) and had me get on the scale (2 pounds up, but this was after lunch so who counts that?). After that, we listened to the baby's heart beat. This was cool: she had me lie back a bit and she felt my belly for a few seconds, stopping and saying, "There's baby!". She grabbed the doppler, put it right where she'd felt baby, and got the HB right away. I was pretty amazed she was that accurate.

After all that was done, we sat for a bit and talked about random things: waterbirth (she loaned me a DVD to watch), dads and homebirth (a DVD on that, too), nutrition (I forgot my journal, so I'm bringing it next time), and what other tests she'll do in pregnancy. It's just so easy to talk to her, and her apprentice, and I adore them both. Keep in mind, while this is happening, Luca is running around the office playing with the toys, sitting in the kid chairs at the kid table, talking up a storm, etc....and no one bats an eye. They think it's important for kids to be there for these things, and the whole family to be involved as much as possible, which I also think is awesome.

When Luca and I left, both MW and Apprentice gave us hugs, and as we got in the car, I checked my clock. It had been over an hour. That's right: I'd spent over an hour with them, getting checked, talking, discussing my options for care (not what she insists I do, but what my choices are), and just generally discussing childbirth and kids and family. What's NOT to like about that?