Thursday, June 12, 2014

Baby 4 Week 13: Confidence Pie Chart

Week 13

Since I wrote last I've had a prenatal appointment with Dr. Chandler and interviewed 2 more (so 3 total) midwives for our home birth that I had just about given up on. Before we dig into all that...

I'm feeling good. Last week was super busy. I taught birth classes Monday and Wednesday, On Tuesday I went to a professional round table discussion on gestational diabetes and on Thursday I went to a talk on pelvic floor health... all after working 10 hour days and somehow trying to squeeze runs in between work and whatever birthy thing was happening that night. This week I focused on resting and working out, fit in some longer runs and tried to get to bed earlier. I was pretty successful! I'm not sure what the association is but I notice that when I work out really consistently, I don't get heartburn, which is reason enough to lace up my running shoes. Other pregnancy feels... pretty awful congestion, sometimes when I sneeze I somehow blow snot into my throat, it's disgusting. I've been a little more nauseated the last few days after not feeling much of any nausea at all for a while. That's it! Really, very little to complain about.

My prenatal with Dr. Chandler was interesting. Thirty minutes before my appointment, about when I should be walking out the door, Eric called to tell me that he couldn't leave work. All three kids were dead asleep, mostly naked, taking their naps. So I had to wake, dress, and load them all in the car in less than 15 minutes. I somehow managed but they were bouncing off the walls in the office. Dr. C just looked at me and said "I feel like I'm really getting to see inside your life." Ha... thanks.

We couldn't get baby's heart beat on the doppler, which I was anxious to hear since my pregnancy symptoms were so mild, so we went over to ultrasound. There was a little active baby in there... it was hard to get good pictures, but baby did face me, kinda waved... we weren't planning on any ultrasounds until 20 weeks but I can't say I don't love sneak peeks at baby.

little hand by face
profile, measuring baby

We mostly talked about medication and my blood sugar. So this is one of the many ways in which medicine is a - not an exact science, b - fucking confusing. The first midwife I interviewed with said my fastings should be 90 or lower and if I have any high readings I'll need to transfer care... well considering that my normals have been 89-95, and occasionally 97... I'm risked out before I'm even in. Then Dr. C said his cut off is 92 and below. Any higher and he wants to put me on a medication called Glyburide. I have also been under the care of a provider who said 95 was her max. Well... what is ACTUALLY safe? By the way, for a nonpregnant person a normal fasting is 100 and below. So what if my normal IS around 95? By getting pregnant I have to somehow get my body is lower its normal? And we are taking about a few points difference here.

I didn't really dig into any of this because in the moment I'm just taking in everything as gospel which is so incredibly easy to slip into when you are sitting in an exam room... I was also trying to keep kids from climbing in the biohazard can. I asked if I could take Metformin instead of Glyburide which I have a long history with and has been very effective for me. I researched adverse affects and currently there aren't really any for mom or baby, it actually has been really effective in helping moms gain less weight (important for me at least because increased weight exasperates the diabetes), and control their numbers. The concern is that it passes freely through the placenta to baby, but there haven't been any negative effects to baby. Glyburide has been shown to increase weight gain and works like insulin which has been totally ineffective for me in the past, but less of it passes through the placenta. Ultimately I want to avoid medication in the first place, but during that conversation it felt unavoidable.

My blood pressure reading was really high, 148/90something. I was physically struggling with a 15 month old at the moment and had just ordered Ash to not lick anything. So I'm going back in on Monday to discuss my blood sugar again and check my blood pressure... without kids. However, I am less concerned with what Dr. C is going to say about my blood sugar, because he is no longer going to be my primary provider and I'm not going to take medications for such a small variation in my fasting numbers unless he has a fantastic argument for it on Monday.

After interviewing three midwives, two that I count as friends and one I had never met before... I believe we will be signing a contract next week. In all we talked to Jamie Meyerhoff, CNM, Caroline Cusenza, LM, and Jacqueline Little, LM, CPM. Jamie and Caroline I have known for a long time, we have relationships, I didn't think it was really necessary to interview someone that I didn't know. However, neither Jamie or Caroline were completely comfortable taking me on, though both were willing. Our local midwives, and the midwives in most areas, only take on very low risk moms... so even though they might be (and in this case, totally ARE) fantastic midwives, they just might not work with a lot of women at my level of risk. I really didn't want to find someone who would take me on because they were irresponsible and opposed to the medical community... and they exist! Just not locally... thank God! But I wanted a provider who was completely within THEIR comfort zone, then I could really relax too.

I had said to several people that whatever is supposed to happen will feel right, it'll feel perfect. Jacqueline moved here last week from Los Angeles. I think it was when I posted a interview on youtube with one my favorite birth advocates and obstetricians, Dr. Fischbein, that a friend, Candice Garrett (prenatal yoga instructor and pelvic floor health... expert... I don't know her title... she's just my friend!) posted "hey my friend who is a midwife is moving here works with him." and I said something cool like "OMG OMG OMG INTRODUCE ME!!!!" And then I think Candice tagged her... and I friended her... this was in like... February. I don't know why I didn't set up an interview, I guess I was just really preoccupied with all the other appointments.

Candice took care of that, she group messaged Jacqueline and I last week and we set something up. Everything just clicked. She had dealt with women of moderate risk a lot more because she trained and worked alongside an OB... this OB by the way, exclusively does home births and he is the only OB who works in a free standing birth center. So... she was totally comfortable with me, very experienced, and didn't have any hesitation in saying that I should be able to have a home birth. Everything that was important to me was there, along with additional personal things that might not go on a resume, but really resonated with me. This, my friends, is what it's like when you find "the one" whether it's your provider, or your doula, or educator...

Eric was able to attend the interview and totally agreed. Here's her page from Sanctuary Birth Center, so you can meet her to :)

click to enlarge image

We meet again next week to go over my medical history and hopefully sign a contract and make this happen! There is still a good part of my confidence pie chart... I'm going to go with a... 16th... that is like... there's no fucking way this is going to happen. That must be my skeptical slice. We'll see how I feel as this sinks in.

Next week I will be writing to you from my second trimester... that's insane.

What this week was like with my other pregnancies:

- Cori

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