Wednesday, March 10, 2010

A Midwife's Care Under Special Circumstances

by Kendra

"Brian and I decided to have more kids about a year ago. We didn't want to get pregnant again while in school, and I'd already tried to get on medicaid and had been denied so financially it didn't seem like a good idea. But the feeling wouldn't go away, it was time.

"I looked into the costs at a traditional hospital, but really I wanted to give birth naturally at home or a birthing center. I'd always wanted a midwife. I'd loved my doctor in Texas, but I wanted someone who sat with me, who knew what was going on every minute of my laboring process, who listened to all my concerns and didn't try to force anything medical on me. I wanted someone who looked at birth as a natural process, not a medical one.

"One problem, my husband REALLY liked hospitals, and really didn't like the idea of having a baby outside of one. I did some research, crunched the numbers, and like all smart women, I convinced him by making him think it was his idea (Ok, not really, but I did get him on my side). First, I got him to agree with me that it was indeed time to have another child, then I showed him the cost of different types of labor and delivery, and last I had him meet with a midwife at a birthing home. She was amazing, the birthing home was beautiful. She answered all our questions and was exactly what I wanted. Brian (after really looking at our finances) agreed!

"I got pregnant very quickly- especially after having dealt with infertility with the first two pregnancies. But I was able to get on Medicaid and my midwife didn't accept Medicaid. I was devastated. Financially I couldn't pay for something that I could get for free. Luckily, I found out about an office that had midwives and accepted Medicaid. I was very excited. I was back on course for finally having the natural birth I'd always wanted. I would only have to give in on one thing, the baby would be born in the hospital. I could deal with that.

"Enter heart problems... I'd always known that something wasn't quite right with my heart. But with each pregnancy I could tell the problem was getting worse. I mentioned this to my midwife and she recommended I see a cardiologist. I did, and I was shocked at the laundry list of problems I was presented with. Once again I thought I was going to loose my chance at a natural birth. But since there are OB's and midwives at the office I was going to, I was able to stay with my midwife as long as the doctors reviewed my charts. The doctors said I also needed to see a perinatologist. I went to see them, and I've decided that they are the worse pregnancy fear-mongers around. I went home from my first appointment thinking I was going to die (seriously.) They had misread my heart charts and thought one of the conditions I had (pulmonary hypertension) was much worse than it actually was. When this is the case, the mortality rate is 56%.

"Fortunately, a few days later I got a call from their office telling me they had talked to my cardiologist and I was not, in fact, dying. Oh, gee, thanks for getting back to me so quickly! Unfortunately, they were recommending I get weekly ultrasounds and non-stress tests. The midwives weren't allowed to go against the recommendations. As time went on I felt like nothing was going like I planned. At this point I made a very serious decision. After much thought and prayer, I decided that I wasn't going to have any more children. I'd always wanted at least four children, but I'd also always wanted to be the one raising my children. So I decided that after I had my son I was going to get a tubal ligation.

"I knew I wasn't going to go full-term, both my other children were born two weeks early. I tend to dilate and have contractions for about 3 months. So it was getting close to when I thought I was going to deliver. Some nights the contractions were so bad I thought for sure I was going into labor, but I'd wait it out and they'd go away. Once I went to the hospital to make sure, and the contractions stopped. A week later, I knew it was the real deal. Right on schedule, exactly two weeks early.

"We headed to the hospital at about 4 am and we were all checked in and hooked up at about 5 am. The thing I hate the most was the IV, but at the hospital they require all women delivering to have one. My midwife came and checked on me, I really did love her! She would come in and unhook things the nurses had done that I didn't want (too bad she couldn't take out the IV). Also, because I was getting a tubal after I delivered, I had an epidural. By this time nothing had really gone how I'd planned, so I had prepared myself to not be disappointed when I didn't deliver without drugs. Then, they decided to give me pitocin! I was not happy about this. I told them it wasn't a good idea because my babies come very fast. But they insisted because after I got the epidural my contraction pretty much stopped. They started the pitocin and then my baby's heart rate started dipping every three minutes- which confused the nurses since I wasn't having contractions... Then I checked the monitors on my stomach, and sure enough the one measuring my contractions was upside down! I fixed it and then the nurses saw that I was indeed having very hard and close together contractions.

"My midwife was with another woman during this (who was pushing). So after she was done with that delivery, she came in and took me off the pitocin. Then she stayed with me. I loved that. She pulled up a chair and talked with me, for about an hour. My dad called and while I was on the phone with him I was taking deep breaths. When I hung up I noticed my midwife getting her gear on and calling in the nurses. She said, "It's time!". I asked her if she was going to check me and she said she didn't need to, that she knew I was ready. When they put me at the end of the bed and lifted the robe, there was a little head, ready to come out. My midwife asked me if I wanted any of the equipment on me, and I said no, so she took off all the monitors. It was very quiet and peaceful. Very different from my other labors. After pushing for about 10 minutes, my sweet little boy was born. He was a bit bruised from coming out so fast, but to me he was perfect. Wesley Owen was born Nov 15th at 9:09am 6lbs 13oz. And even though so many things didn't go the way I'd originally wanted them to, I realized that I didn't care because I was holding my son and he was healthy and safe. That's what mattered."

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