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Birth Preferences…Revision 1

Jos
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I’m sure this will keep evolving, but for those who are interested (and for my own records), here is the first revision of my thoughts!
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FYI for my readers, this will be a hospital birth, but that birth will be attended by my midwife – not an OB – unless an emergency c-section is necessary.
My midwife’s responses are in color (Erin)… generally she said no problem… I’ve included text if she elaborated. 🙂 

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During Labor
-This will be a midwife assisted hypnobabies birth – please keep lights and voice low. Minimal coached pushing.
-I do not want any meds offered to me or pain scale questions asked of me. If any medical interventions become necessary, I want to be fully consulted first.
-I would like to be assigned a nurse that is partial to natural birthing. They can’t guarantee this, though my midwife said that most of the nurses at our hospital are very supportive of natural labor patients. I will be making it clear that I want only positive, supportive people around me! 🙂
-I want to be able to walk, move, or change positions as desired during labor. No problem, though they require a 20 minute time period every “couple of hours” where I lay down and get monitoring to ensure all is well with the baby. Other than that I’m free to walk around, get in the tub, etc.
-I want to have the option of eating/drinking during labor. She recommends staying home as long as possible so that I can eat/drink/move without any hassle. She agrees with the importance of nourishing a laboring body, but “the nurses are very strict about not eating,” she said… so I pushed and asked who gets final say – the nurses or the midwives? She sort of stammered… “well, we do.” Then extrapolated that I should definitely bring snacks, and when the nurses leave the room feel free to eat something light and high protein. Hm. Weird. Obviously I need to get on the nurses’ good side or make sure my midwife on call asserts her ability to make the final call.
-I do not want a routine episiotomy. No problem – their practice has the lowest episiotomy rate in the state.


Post Birth

-No cord traction for placenta removal / No Pitocin (though after delivery to assist with placenta expulsion is okay – please consult first) No problem, barring any complications with the baby of course (regarding pitocin necessity). 
-Delay cord clamping until pulsation has ceased Again, no problem, as long as the baby is doing fine. Cords usually quit pulsating within a couple of minutes. 
-Immediate skin-to-skin contact between mother and baby, please delay any cleaning or rubbing. No problem.
-No Vitamin K shot (look into oral options?)… or is this necessary for blood clotting reasons if it’s a boy and circumcision is being done? She highly recommends this shot, especially if it’s a boy b/c of the circumcision. What do y’all think about this shot? ETA –  we ended up giving Stella this shot because she had a bruise on her head when she came out. Either way I think we would have done it.
-No Antibiotic Eye Ointment (NO silver nitrate, and I am allergic to the alternative option of erythromycin so could baby be?) I can do a STD test pre-delivery to rule out any chance of passing on gonorrhea or chlamydia if that’s the only concern. If there are other concerns, what are they? She recommends getting the STD tests pre-delivery if I want to not do the ointment. That’s fine by me. 
-No Hep B shot – delay to at least the 2 month immunization schedule. Pretty sure this is fine – just communicate with the nurses, b/c they will routinely do it otherwise.


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After all of my questions, she said – “remember, this is your body, you baby, your birth. you can decline anything you want.” That’s good to remember! (though as you’ll see 2 paragraphs from now, I need to stand up for myself more strongly)


At this point, she said I should be feeling movement about 10x every 2hrs… if I’m not, I’m supposed to drink some sugary juice, lay down, and “tune into my baby and my body.” She said I would then often feel 10 kicks in the first 15 minutes (and if so, don’t bother laying around the full 2 hrs unless I need to *grin*)… basically, stay hydrated and rest whenever I feel the need. Not enough movement or 5+ braxton hicks contractions in an hour = call them.

They also did the glucose challenge test on me yesterday (I’ll get the results Monday – no news is good news *fingers crossed*)…. and they also drew my blood to confirm I was A- and RH- to confirm I needed the RhoGAM shot. I didn’t realize that shot was scheduled to happen so early so I hadn’t researched and wasn’t prepared to ask questions about it. I just read this (http://www.vaccinetruth.org/rhogam.htm) and am fairly frustrated that when I asked my midwife why I needed this shot during pregnancy, she sort of blew me off and said it was important. Everything I’ve read this morning basically says the same thing – the important one is POST-delivery. UGH. I hate feeling like I should have taken the time to research something sooner… praying now that I’m not in that percentage whose babies are affected by this shot. *sigh*

On a happy note, I’m also at the point where I start going back for appointments every 2 weeks. HFS!!! I remember how LONG it was between appointments in the beginning, and now we’re already at the every other week point. Eek!!

Stats at 28w appointment:
BP: 115/74
Fundal Height: 27 (they want to see within 2+/- of the week I’m at)
Baby HR: 130s

I asked if it was normal that the heart rate keeps getting slower (160s/160s/150s/140s/130s), and she said yes, that she would be more concerned if it was still in the 160s. She said the baby is more comfortable and not in a constant state of flight or fight anymore, and it’s common to have the HR get slower throughout pregnancy. Okie dokie…

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