Tag-Archive for » decisions «

Sep
16

Last night, we toured Evergreen Hospital in Kirkland (~20 min away), and did a meet-and-greet with the nurse-midwives who practice there today. Let’s just say that making this decision won’t be easy.

The guide who did the tour of Evergreen was a short, older lady with… the most annoying habit of talking in short sentences, making the last two words sound crucial, and talking slowly. And the way she talked to the little two or three year old that was with us… UGH! It made it a little hard to focus on the tour, but as Jason said – over time, you kinda warmed to her, or at least uncooled towards her. It was the first maternity ward I liked the layout of, oddly enough. The rooms were nice enough, had a decent amount of space, various supplemental birthing supplies (ball, squat bar, jacuzzi tub, rocking chair, even birthing stool, I think). She talked a fair amount about the support for natural childbirths, one-on-one nursing (they try to keep you with one single nurse during each shift), their openness to avoiding interventions if not warranted, and even talked about the vaccination waiver process. (I’m not planning on not vaccinating this kid; don’t worry. I’m not so fond of giving a DPT, Hep B, and Hep A vaccine all at once withing 24 hours of the stress of birth. While I have much more research to do on this front, I’m of a mind to try to space the three out over the first month or so. We’ll see.)

This morning, we met with one of the five nurse-midwives at the Center for Women’s Health at Evergreen (not to be confused with the Evergreen Women’s Health Center, aside from the fact I confuse them every single time). She was an interesting combination of very patient (we were there for 40 minutes, asking questions, after all), and medically efficient. It’s a combination that I think I like. I was disappointed to hear they don’t do vaginal breech delivery, as I’m a little annoyed at the reduced care available because people aren’t trained. (Seriously, lack of training and experience is the biggest reason breeches aren’t delivered vaginally. In *some* breech presentations, it’s not more risky to do a vaginal birth, if the provider is trained. But, no one trains them anymore. Sigh!) But I was pleased about the discussion over various methods of version in the case of a breech. And I was pleased with her response to my question on episiotomies, which was somewhat vague in the “depends significantly on the woman” but she discussed the other methods they use to avoid them focusing on giving the baby’s head plenty of time to do the stretching naturally, and finished by saying that in her 15 years of midwifery practice, she’s probably done about that many ‘routine’ episiotomies.

As an final irony, the assistant at the chiropractor’s office I go to mentioned that she used to work in the birth center that we’ll be interviewing at next week, and she thinks I would really like two of the midwives in the group of three I’m interviewing with. She doesn’t know the third, because she left before the new midwife came in, who also happens to be the person we’ll be interviewing with. And, she knew the midwife at the birth center we already interviewed, and suspects I’ll take to the other midwives better. Definitely a small world!

So, this all leaves me very uncertain where I want to give birth and who I want for a provider. Evergreen falls into the “acceptable” category, and Jason does like the immediate proximity to emergency facilities (though I’d add that the other birth center is literally two blocks from the maternity center). The main differences are the environment – can I find myself just as relaxed in a hospital? – and only the birth centers offer water birth. And when it comes down to these two relatively small differences (as far as I know now, without having given birth, anyway), I suspect it will strongly come down to who do I mesh the best with.

The decision has gotten difficult!

Sep
13

We toured Valley Medical Center today. It was difficult to navigate, for one (we ended up in the pediatric area first, only to head upstairs to the birth center). The tour was ok, the rooms were ok, but neither of us felt it lived up the expectations we had. The rooms were a little bigger, but felt a little more cluttered. They didn’t move people from a delivery room to a mom&baby room, but they didn’t appear to have telemetry for monitoring. The person giving the tour we had couldn’t really say much about policy mandated interventions, other than they usually go with the doctor’s preference, and that people coming in should probably have something written up if there are fairly standard things that they don’t want.

So, still leaning towards the birthing center.

Sep
12

I admit, I went into the tour of Overlake with a significant bias – they don’t have CNM’s, they don’t always get the best reviews, and they just seemed unfriendly to a non-allopathic approach. I further admit, however, that my biases were not entirely met.

We got to see a labor room, and then a mom&baby room, though in the middle of our discussion in the labor room, a nurse came in to say they needed the room asap. 🙂 It was reasonably nice – the lights were adjustable (presumably during stage 1 labor, not so up-to-your-control during stage 2), the bed had lots of configurations (including being able to add a squat bar), they had birthing balls, and had telemetry on monitoring if necessary (but they do an awful lot of monitoring). But it was most definitely a hospital, with rooms that weren’t cramped but were definitely not spacious, a door in front of the tub (which was in the bathroom), and a bunch of machinery to watch you. I have to admit, the stack of twenty widescreens mounted to the wall displaying fetal monitors with two nurses behind the desk there to watch them… a little impersonal, and a little “metrics” heavy.

But they seemed open to all kinds of delivery choices (even non-medically necessary elective cesarean, which I might be of the opinion is a little too open minded), roomed mom and baby together, tried starting nursing immediately after birth, and other friendly options. They don’t limit both food and liquid after starting active labor, but do generally limit to liquids only, and definitely do limit to liquids only if induced.

So, all in all, not the place I would choose to deliver off hand, but I don’t feel worried about ending up there in an emergency transfer either.

Though, I have to admit, I felt really strange being the only woman not showing. I’m at seven weeks, and … well… don’t really look pregnant. Everyone else was at least 32 weeks. Weird!

Sep
11

We had our first “interview” with a prospective provider. It was at a birth center nearby. We came in with a list of 39 questions, spent an hour there, and came out with a DVD of births they’ve done. One of the two midwives in the practice was our contact for the day, and she showed up around the birth suite, which is attached to her husband’s chiropractic clinic. It was nice, if a bit hotel-y. (Definitely not hospital-y, however, and had lots of room for moving around. It also answered one question I had always had about tub births – there was a shower immediately on the other side of the shower for cleaning up.)

We chatted for a while, asked about what they tend to do for coping mechanisms (movement, tub, herbs, willing to use TENS), if the same person would be with me the whole time (yes), what the do for transfers (non-emergency to one hospital, emergency to the other), got a feel for what those transfers tend to be like, how they avoid conflicts (careful planning and a bit of luck), and got an idea of how they do prenatal care and postnatal care (all regular tests offered, but not required). And how much it tends to cost (not cheap at nearly $5k, but cheaper than hospital, and totally covered by insurance).

The woman we talked to was nice, but I haven’t figured out if it’s a good personality fit. The only thing that I really noticed is that she talked a lot, rapidly. Heavens knows I do that too, and more so when I’m nervous, so I’m not saying it was all bad, but I think that’s the only reason it wasn’t a quick “meeting of the minds”.

We stopped by Whole Foods afterwards, and picked up some food so that I could have the oddity I decided would be tolerated well by my stomach – a BLT. It was gluten-free bread, nitrate/nitrite-free bacon, and organic tomatoes and lettuce, even healthy mayo. And it was good. 🙂 I might make another one tomorrow.

Sep
03

It still doesn’t quite feel like I’m pregnant. Don’t get me wrong, I still have the bloating/tenderness, and whooboy is there a lot of fatigue. But it just mostly feels like being tired, not like being pregnant.

I am incredibly happy that I have the luxury of taking a nap in the afternoon when I am feeling tired, and can sleep for 8 to 10 hours at night. Housekeeping is taking a back seat at the moment, but it’s hard to describe how exhausted I have been feeling. It’s not too horridly impacting, but only because I’ve got the time for it.

My doctor appointment was yesterday, and it was nothing more than blood draws, urine samples, and a couple of questions. I asked about providers and she noted that an OB or a midwife would be just fine. Nothing in my medical history makes me a high risk, so find where I want to deliver, and find a provider who has privileges there. I’m very much in favor of a midwife, and open to a birth center, but Jason is not so down on the idea of going somewhere that doesn’t offer the option of an epidural or other pain killers. (He quoted Susan in Coupling: “GET. ME. A FUCKING EPIDURAL!” :P)

It’s also horridly weird to not be able to tell anyone. I have told my health providers and my yoga teacher (because I was doing things a lot differently in class this past week, and realized that it’d be a lot easier to just let her know). But I’m not really sure when I want to tell anyone else. I’m thinking that I want to wait until I see a heartbeat (and, of course, I don’t really want repeat ultrasounds), because it still doesn’t entirely seem real to me, and I worry about telling people and then bad things happening, but who doesn’t.