reconsidering birth location — The Bump
Natural Birth

reconsidering birth location

I'm so torn.  I toyed around with the idea of home birth early in my pregnancy, but in the end decided to go to a CNM and use a hosptial associated birth center.  I was in both the birth center and the main hospital during DS's birth.  The birth center is a nicer facility, but it's really just a hospital.  There's even a surgical suite in it if you need a c-section. 

The reasons I chose not to pursue home birth were

1) I delivered DS at 36w4d according to my ovulation date.  I'm worried that I may deliver prior to 37 weeks again

2) I had borderline high blood pressure and severe swelling during my pregnancy with DS.  They actually transferred me out of the birth center because of this because I was considered "high risk" even though my lab work did not indicate pre-e. 

Mainly, I'm afraid of risking out of home birth at the very end.  I don't handle change very well, so I wanted to go into this knowing that I was preparing for a hospital birth.  I'm also so afraid of the "what ifs."  After reading Ina May's book and some of the stories about the pyschological part of labor, I'm afraid that my fear could actually stall my labor. 

Last night, I stayed up waaaaay too late watching that live birth posted below.  It was AMAZING.  Everyone was calm and patient.  The husband was able to be in bed with his wife and massage her during contractions and support her when she pushed.  When I think about those horribly uncomfortable and tiny hospital beds in a room full of medical equipment, it makes me so sad to think about delivering there.  Also, I eventually caved and got an epi with DS after a whole host of other interventions.  It would be nice to be somewhere where an epi wasn't even an option.  Thinking about recovery is also very depressing.  I just think about how wonderful it would be to already be home instead of trapped in the hospital for 24-48 hours after birth.  I hated being bugged constantly throughout the day and night.  I couldn't wait to escape out of there. 

Besides home birth, there's also a very new birth center (open less than 2 years) in town run by a CPM.  It is literally across the street from the hospital, which might help my "what if" fears.  While the birth center is new, I know that the CPM has been practicing for over 20 years.  However, I've read her blog, and I don't know that I would click very well with her.  

Ugh, I'm just so torn on what to do.  Has anyone else struggled with this decision?  What finally made up your mind?

Hilary
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Re: reconsidering birth location

  • Could you meet with the CPM and see if you click with her in person?  Are there any other hospitals near you that you might feel more comfortable in?  Maybe you could also meet with a MW who does HBs and see how you feel after that.  I think the reason you are so torn is because you don't have all the information yet :) 

    I love the idea of a HB, but chose not to do that because a) I knew I wouldn't be supported by my DH or anyone else for that matter and b) because I too was scared of the 'what ifs.'  In the state I live in BC have to be attached to hospitals, so that left me with only one option, the hospital.  I was fortunate that one of the closest hospitals to us was very pro-natural childbirth and I had a very nice, calm birth.  I remember my CNM sitting at the edge of the bed as I pushed, the lights were dim, I remember feeling safe and protected.  Nobody told me when to push or how, I just did what came naturally to me and they supported me.

    Next time around I might want look into a BC if that means I can leave soon after the baby is born.  While I really liked the L & D hospital experience, being in postpartum drove me nuts.   

    This probably doesn't help you much, sorry :( I would dive a little deeper into your options and maybe consider hiring a doula.   

  • Just curious- what did you do when you had the high b/p and swelling?  I had the same starting around 28 weeks and my MW put me on a very high protein diet (minumum of 80 grams a day) and my b/p came down in two weeks...and stayed that way until I delivered at home at 43 weeks. My MW actually had a patient who had borderline pre-e and by eating 120 grams of protein a day was able to keep her health in check and have a spontaneous birth at home.

     I still had swelling which was annoying, but it was July in New England- there was not much I could do that I was not already doing.

    Here are some other things my MW recommended in addition to the high protein diet:

    Avoid processed foods and other similar foods that are high in bad sodium and only salt your food to taste with a high quality salt like sea salt.

    Avoid caffeine and sugar

    Eat lots of fruits and veggies

    Avoid stress (this was another big one for me as stress really affects my b/p

    Swimming can help with swelling (and just feels good). 

     

     


    Lilypie - (ZESJ)Lilypie - (QAi1)

  • Personally, I don't think the risks you listed would preclude you from a homebirth as long as you have a good MW.  Of course you should give birth where you feel most comfortable and for many that is not at home.  

    It's just that, IMO, what you listed above does not make you "high risk."  I think that therm is thrown around way to much and is many times just an excuse to use more interventions. 

    A lot of the late pregnancy conditions are easily preventable through proper diet and exercise.   Unfortunately this is not common knowledge in our society where we sit around waiting for problems to arise and then treat them after the fact with drugs and procedures.

    GL to you


    Lilypie - (ZESJ)Lilypie - (QAi1)

  • Well, my BP wasn't really a concern with my OB until I was in labor.  It had been running 130s/80s in the office.  She gave me the speech about looking out for headaches, blurry vision, and upper right quadrant pain, but didn't manage it further.  I had one super high reading of 160/100 when I was admitted (I think due to nerves), and then stabilized to 140s/90s throughout my labor. 

    My swelling was a concern to me and my OB because I gained 20 pounds in 3 weeks.  I gained the first 10 over 2 weeks, and then an additional 10 just 1 week later. 

    Last time, I was already aiming for 100g/day of protein.  I didn't think about increasing it further, but will remember that for this time.  Do you have any tips for getting in extra protein?  With 100g/day, I felt like I couldn't choke down one more bite.  I drank only water and milk, and cut back on processed foods. 

    I don't think I'm necessarily "high risk," I'm just afraid of becoming high risk in late pregnancy.  For example, doesn't a birth prior to 37 weeks necessitate transfer to hospital care?

    Anyway, I'm still struggling with my decision.  My DH is deployed right now, but will be back fairly soon.  I think I may consider interviewing some home birth midwives when he gets back so we can make a decision we're both comfortable with. 

    Hilary
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  • It is hard some days...especially on the days when I am just not in the mood for meat.  On those days I add protein powder to some of my food.  If I really want oatmeal instead of eggs in the morning, I add protein powder. 

    Meat is really the easiest way.  I also eat a lot of greek yogurt- at nearly 20 gr per serving (1 cup) it is just too easy.  I also add nuts to a lot of my meals and we eat a lot of eggs- not just in the morning, but hard boiled for snacks or on salad and deviled eggs for dinner.

    I find that I really don't have room at most meals for anything but meat, fruit and veggies.  All the other stuff just fills me up too much and doesn't help the cause. 

    Last year I went on a diet called the paleo diet where you cut out bread, dairy, grains and corn and basically just eat meat, veggies, fruit, nuts and seeds.  I haven't been able to maintain it perfectly while pregnant, but I still use a lot of the recipes I acquired over the last year.  

    This blog is full of yummy recipes:

    http://everydaypaleo.com/category/food/

    Here are a couple of my favorite recipes from the blog:

    http://everydaypaleo.com/2010/09/22/puerto-rican-beef/

    http://everydaypaleo.com/2010/08/11/better-butter-chicken/

    I made this recipe last night and it was awesome:

    http://paleoblocks.blogspot.com/2011/05/real-simples-pork-chops-and-peaches.html

    this blog is a compilation of a lot of paleo recipe sites:

    http://www.thefoodee.com/blog/category/uncategorized/meal-of-the-day/

     

    I totally understand how you are feeling right now.  Although I would love to have 100 percent faith in my body, I still fear that something is going to go wrong and that I am not going to be able to have this LO at home like I did with Lily.  I feel like I sort of got lucky with Lily (see my story in my bio if you are interested) and am wondering if I will be so lucky twice. 

    HTHs!

     


    Lilypie - (ZESJ)Lilypie - (QAi1)

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