Thursday, October 9, 2014

Getting Good Medical Care

If you have been with me for awhile you know that my preference when it comes to childbirth is for things to be as natural as possible.   I have found birth to be a very empowering and spiritual experience, and for me that is best created in a calm, peaceful environment with minimal medical staff and few tubes, wires, and beeping machines.  Thus far, I have had three natural hospital births with nurse midwives, two home births with lay midwives, and one birth at a freestanding birth center (also with a lay midwife).  

At the beginning of this pregnancy, the first person I called was the nearest home birth midwife that I could find.  She serviced my area, but she lived more than two hours away, and we determined that given my history of fast labors and the fact that I was due in December when the weather can be iffy she wasn't the best choice for me.  But home birth midwives always have good advice on the best hospitals and doctors in the area to go to if you are seeking a more evidence-based experience.  

Not that I had a lot of options in the boonies.  My town had one group of OBs that delivered at the local hospital and that was it.  If you were pregnant, you saw them.  Period.  And I had heard a lot of mixed things about them.  However, there was one other town within reasonable driving distance that had a hospital.  It was even smaller, but the midwife told me that I would get more flexible and personal care there.  

So that's where I started out, with one of the family practitioners there who had delivery privileges.  It was a woman (I vastly prefer women practitioners for childbirth) and she was really wonderful.  She felt almost midwife-y and I was happy.  

But then the whole twins thing came up and that changed everything.  She was happy to deliver twins, but her lack of resources in the small town plus the low volume of twins she had delivered in her rural career meant I was much more likely to end up with a c-section.  

Now, I am all for c-sections when they are truly needed, and I accept the fact that with twins this is a big possibility, but if at all possible I would really like to adjust to life with two newborns without also having to recover from major abdominal surgery.  

The biggest thing was that she was not willing to deliver the second baby breech.  I had several friends in larger cities who had delivered twins with the second one breech, so I knew it was an acceptable scenario in many larger hospitals, and given that I have given birth to 9 and 10 lb babies I have confidence in my body's ability to deliver a breech baby safely under appropriate circumstances.  
I called the OB office in my town and talked to one of the docs there.  She said that a breech delivery for Baby B was a possibility with them.  So I switched providers after my 20 week appointment.  

I only had 2 appointments there before we moved, both with one of the male doctors.  I liked him better than I thought I would, but it was still not as good of a scenario as I was hoping for.  ("If you come in during Thanksgiving weekend we will probably give you a c-section because we won't have enough staff on hand."  Blah.)  

I was just praying that things would work out for the babies' and my best good, whatever that was.  

Then, this move.  One of the wonderful things about coming to Utah is that boy, do I ever have choices when it comes to childbirth!  I have my pick of several different hospitals and dozens of doctors.  And, if we need it, we can get top-quality care without having to be airlifted to the big city far away.

But first I called a nearby practice of nurse-midwives and asked if, by chance, they could possibly take on a client with twins.  The nurse asked me a little bit about my history and then said yes, in my case, they could.  I was pretty excited to have an appointment with a midwife.  

However, when I saw her, it turned out that the nurse I had talked to was wrong.  The nurse midwives in my area do not have delivery privileges for twins.  I was disappointed, but not really surprised (it had seemed too good to be true).  We talked about my desires for low-intervention and she told me that she knew the OBs in her practice would work with me on keeping things as natural as possible.  She got me set up to see one of the women OBs and assured me that she's fabulous and I will really like her.  That will be next week.  I am looking forward to it.

Meanwhile, she set me up with another ultrasound at the perinatology office associated with the nearest big hospital.  (It's pretty standard procedure with twins to do a thorough ultrasound every month to check growth.)  I had that appointment yesterday and it went really well.  They looked at everything on both babies very carefully (and this is an office that is used to seeing abnormalities so they really know what to look for.)  Everything looks great: in fact, the babies are both measuring ahead of schedule.  My girls are both currently head down (in fact, they are facing each other, so they must be having some deep conversations about life after birth.)  Baby B is curled up in a ball and Baby A is wrapped around her.  

I really liked the perinatologist.  He was great.  I hope I don't need to see him again but if something goes wrong and I do, I will feel comfortable with him (which is one of the reasons they sent me to perinatology for the ultrasound in the first place.)  

I hit 30 weeks a couple days ago, which means 10 weeks left of a normal pregnancy.  That sounded SO long and far away.  I kept hearing "twins come early" but I couldn't wrap my brain around that idea because I have always gone full term.  So I had been hanging on to my due date in my mind to prepare myself psychologically for the longest possible wait.  But when every day is a struggle even 3/4 of the way done just sounds like a very long stretch left to go.  

Well, the perinatologist told me that most women with twins truly do go into spontaneous labor between 35 and 37 weeks.  I guess just hearing that from a specialist made me believe it more.  He said that 38 weeks was considered full-term with twins and that the doctors weren't going to want to let me go past that.  (I might, under certain conditions, fight them on that, but without going into all the details I will just say that even slightly crunchy hands-off-my-birth Birrd will probably accept an induction at 38 weeks.)  

38 weeks is December 1st.  That means these are very likely going to be November babies.  And November is NEXT MONTH.  

Also, with twins they start you on non-stress tests weekly at 32 weeks.  That means you're in the home stretch.  My first appointment for that is less that 2 weeks away.  

All of the sudden this feels like we're getting really close.  It's exciting!  It won't be very long before we're meeting these little people!  It's going to be so wonderful!

1 comment:

Melissa said...

I'm so happy that things are going smoothly! The next 5-8 weeks will be over before you know it! I'm hoping my little guy comes home within that time frame too! :) By the way, IMC is a fabulous hospital. Hopefully, you get the intervention-free delivery you hope for, but IMC has an OR in L&D that is staffed and ready 24/7, and one of the best nicu's in the state. Again, not that you'll need it!! :)