Tuesday, December 11, 2012

Baby III Week 30: The Decision Week

30 Weeks

By 30 weeks I was supposed to contact the nurse-midwife at Dominican that I used for Ash to arrange a transfer of care. I had begun to waver a bit on whether I wanted to go to Natividad instead of Dominican because not being allowed to video the birth was a for sure deal breaker for us, as was a mandatory 48 hour stay without medical cause. I needed to talk to the OB at Natividad, Dr. Chandler, one more time before making a decision, and fortunately he had given me his cell.

I called Chandler a little freaked out about calling a doctor's cell. Am I supposed to help him remember me or just fire off the questions... no idea... I started, "Hi, I'm Cori, I saw you once 2 months ago..."


"I'm looking to transfer from my midwife."


"um.... I had 2 crazy boys that I was shoveling candy corn at and I have pink hair..."


*feels stupid*

I just continued that before I could make a decision I needed more information on some of the hospital policies. I brought up the video first because if there was no wiggle room there nothing else mattered. I asked if there was any way we could compromise and not video any part of that actual birth... like... vagina stuff (though I worded it more eloquently than that) and record from a position where it was just our reaction meeting the baby. Finally there was life on the other end of the phone and he said that was fine, everyone in the room just has to agree. So that's great news.

As for the mandatory 48-72 hour stay after an uncomplicated delivery, he said that is not the policy and asked who told me that. I gave her name and he said it was likely she was thinking just on average because obviously women have to stay longer after cesareans. What matters is when the OB is willing to release you and he seemed fine with 24 hours.

I also asked about the policies on Group B Strep. GBS is a bacteria that lives in about 25% of women's intestinal tracts and can sometimes travel to the vagina. If you are GBS positive during delivery it can potentially cause an infection in the baby that can be life threatening. Women are routinely screened around 35 weeks and the policies of most hospitals are to require the mother is on intravenous antibiotics while in labor to prevent infection to the baby, and that has been quite effective. Easy decision right?

Yeah those don't exist for me.

I've never been GBS positive but it is always a possibility. Even if you test negative today, you might be positive next week. So, I could be positive. Here's my problem: I don't want antibiotics. If I'm on antibiotics I always, every time, without exception will get a yeast infection. Annoying but whatever... right? Well antibiotics can also cause a type of painful yeast infection in the baby's mouth and mom's breast called thrush. So baby may not want to eat, I will be in more pain than neccessary, and this lasts for weeks. I feel like because of my history with yeast infections and antibiotics, antibiotics are just not a viable option especially when there are other treatment options available, just not preferred by hospitals in the US.

After researching and obsessing, I decided my GBS testing options were:

Don't test for GBS
-Pro: what the doctor doesn't know about he can't treat.
-Con: some hospitals will require mom and baby get antibiotics just in case and if you refuse they will call child protective services... no joke.

Test and refuse treatment if I'm positive
-Pro: if I'm negative, no worries! positive, at least I will know and we can be extra watchful of baby.
-Con: cps issue again, may refuse to to treat me, may hold baby for observation... or give me dirty looks.

I talked this over with Chandler and got a fairly shocking response. He listened and replied... totally not condescendingly, "those are very valid concerns."


So after discussing the options I decided to test and if I'm positive we will not use antibiotics, but we will stay and let baby be observed for infection for 48 hours after birth, which I feel like is reasonable. Chances are I will not have to worry about all this, but I always feel better having a thoroughly thought out plan.

And that's it, I see Chandler December 28th and will likely only see him a couple times before the birth. I suppose this is not a technical transfer of care because I will continue with my midwife. I feel like this is a homebirth with a planned hospital transfer, it's like the best of both worlds for me.

I'm feeling good about the belly. It's big, I like it, I don't feel uncomfortable.

When baby kicks, or whatever it does... it feels like it's vibrating, it's weird.

I've given up on trying to cook meat, but have become a big fan of the rotisserie chickens at costco, so convenient and I'm getting some meat in my diet. I've been waking up at night starving sometimes too, growth spurt?

I think baby may have flipped, not sure, we will see what my midwife says.

Total of 33lbs gained so far.

Tanking baby out to a Christmas party.
Cucumber this week, about 3lbs and 15 3/4 inches.

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