Julia's Birth Story: Part 3 (Jai's Version)

For weeks I'd been frustrated that nothing was happening. I came home from work on Monday, the 8th and Tara looked a bit more tired than usual. She expressed some concerns over the contractions but I didn't think much about it since we'd been dealing with Braxton-Hicks for awhile. I asked her if they were more intense, she said not really. I asked if they were more frequent, she said she hadn't noticed. I pulled out one of my dad-to-be books and asked Tara to time them...the book said something about 5 min apart. She said they weren't and we continued our night. I fixed dinner, we watched a little TV and Tara decided to go to bed.

An hour or so later she says she can't go to sleep b/c of the contractions which were only a minute or so more frequent than before. She told me I needed to come to bed earlier than my usual time b/c who knows how much longer I would be able to get sleep, I didn't listen. I crawled in bed about 12midnight and we spooned and I rubbed her back as I dozed off. Within 15 minutes, Tara exclaims something. I ask and she says her water just broke. She carefully walked to the bathroom, I got the phone, Tara gave me the midwife office phone. Soyehl was on call and asked me what color was the fluid; just as I asked Tara she says "Oh, gross, that's nasty." I tell Soheyl that its greenish and tells me that is meconium and we should go straight to the hospital. She doesn't explain, I don't ask. I call Bonnie and tell her what's going on.

We were both hurried but I felt surprisingly calm and focused. Nervously, I let Johnders out. It was the middle of the night and I didn't know when we would be back. He thought it was a game. I got my bag, filled with a change of clothes, a book, Tara's laptop, my iPod, a comb and toothbrush. As we left, it was obvious that Johnders knew something was going on.

As I think about it, I knew something was going on too, it had only been a day or two earlier that I sent an email to my desk replacements to make sure I had proper contact info. It had been only a day or two that I filled a giant plastic bag with Johnders' food. It was earlier in the evening that I first asked Tara which route she preferred to get to the hospital. I asked b/c invariably I take the highway and Tara asks why I went that way and I didn't want to be on the way to the hospital and have THAT conversation.

We calmly make it to the hospital. Along the way Tara had couple of contractions but she was far more worried about getting messy...amniotic fluid continued to flow...more than the pain she was feeling. Her calmness allowed me to be calm. We made it to Vandy's Emergency Room and the valet was about to take the car, I had the bags and the car wouldn't start. I went back to see what was going on - the battery had died. Let me repeat.

We ARRIVED at Vanderbilt Hospital and the battery died.

The universe conspiring to move my life forward (I'll tell you about the night my dad died at some other point). Tara proceeded to check in and have contractions but finally the valet said he would figure it out, which he did and I finally got inside with Tara.

Midwife visit # 5

Susie came with me this time since she was in town. All is going well. I gained 4 pounds since last visit 5 weeks ago. Overall I've gained 24 pounds so I'm happy and the nurse guesstimated I might gain about 10-12 more pounds in the remaining 10 weeks. As I say to Jai, "as long as I don't weigh more than you!" :)

It was fun for Susie to hear the baby's heartbeat; the midwife (Emma, another full-timer, I think I have 2 more to meet) said it is good and strong. They are all wicked nice and enthusiastic and they love that we're not finding out the gender. She had me sign the release about declining the gestational diabetes test. Actually Soheyl called me a few weeks ago to check in with me and discuss the pros and cons of doing the test and encourage me to keep eating healthy and watch carbs; Emma talked with me about that also.

Ironically Susie and I then got something to eat, quite a few carbs, not too many veggies. To top it off we went to Gigi's Cupcakes - yummalicious! If you haven't gone there and you live in Nashville, you must. I love cake, especially the frosting. These cupcakes are creative and artistic and also made daily so they are moist and the frosting is AWESOME!

Back to the midwife, I had a few questions for her ... of course. : )

• The baby makes these strange (to me) flutter movements - probably hiccups.
  
• Leg cramps - probably related to potassium and magnesium intake so banana-a-day.
  
• Heartburn - she commiserated & supported the natural remedies, but also mentioned OTC options like Tums & Pepto-Bismal; I'll see what happens.
  
• Discharge - UGH! You don't want to know. Though it's normal and common.
  

I mentioned to Emma that Jai & I went on the L&D tour at Vanderbilt and how reassuring it was to see the facilities. The people were really friendly and about 1/4 of the women in our tour are using a midwife so I didn't feel so alone. Even though I'd like for Soheyl to deliver our baby, if that's not possible, I feel certain that we will be comfortable with one of the other providers.

Why Midwifery?

Some people might wonder why we're using a midwife instead of a traditional OB/GYN. One reason is I'm not very traditional. I'm a simple person when it comes to health care. Other than managing my asthma which is fairly mild at this point in my life, I lead a healthy life (eat organic "whole foods" as much as possible, exercise frequently, don't smoke) and usually go to my primary care physician once a year. I rarely use over-the-counter and prescription medications (as needed for my asthma). A drug-free kind of child birth fits my model of health care and midwifery seems like a natural fit. I could go "natural" with an OB/GYN, but the traditional medical model is potentially a lot more intrusive than I want. "You could have complications so let's check on everything rather than seeing me as a normal pregnant person."

Having said all that, it has been fascinating working with the West End Women's Health Center because it seems like a compromise of traditional midwifery and traditional obsterics practices. Throughout June and July I read Ina May Gaskin's Guide to Childbirth which basically tells the story of midwifery. Ina May is famously known from the midwifery practice at The Farm in Summertown, TN. I heard about The Farm often as a child of the 70's & 80's because one of my mom's good friends was a resident and currently is a midwife/instructor in Knoxville, TN. I have always had a positive association with The Farm and its values/tenets of living in community.

However, I didn't know much more about midwifery and this book is very informative and confirms my beliefs about how I want my child birth experience to be. Even at my AMA (advanced maternal age) I am not interested in having many of the diagnostic tests performed and that has been somewhat in conflict with SOP (standard operating procedure) even at WEWHC which surprises me. These tests used to be done for a specific medically driven concern - older age of mother, family history of genetic disorder, or some other genuine reason. With technological and medical developments as well as fear of malpractice, it seems like these tests have become standard and expected for all rather than rare and only truly necessary for a few.

Pregnancy and child birth are a normal part of life; women have been having children for centuries with the assistance of midwives. Actually outside of the United States, midwifery is much more common - something like 90% of women in the world use a midwife, only 5-10% use a different model. In the US, it is the opposite - only about 5-10% of American women use a midwife and most of those are affiliated with a hospital. Ironically that reminds me of the issue of last names when a WOMAN gets married. About 8% of women retain her "maiden" last name or hyphenate - 92% change to her husband's (in a heterosexual model). Once again I'm a non-traditionalist!

There is the convenience of insurance connected with using the WEWHC versus giving birth at The Farm or at home. It is still significantly cheaper to give birth using a midwife, even at the hospital - so I'm told by the WEWHC office manager. However, these lab tests cost money (someone pays for it) as well as being intrusive, possibly painful and potentially harmful to the fetus in addition to any emotional and mental anguish depending on the results.

At the end of my most recent visit to the midwife (not Soheyl again), she mentioned that at my next visit (28 weeks) I would have the test done for gestational diabetes. I said that I wasn't going to do the test and she looked up, seemingly surprised and said "not at all." I didn't understand that comment because I thought you have it or you don't. I said "not at all." Then she said she'd leave a note for my primary midwife who would prepare something for me to sign stating that I was declining the test. Interestingly enough it wasn't presented as a possible test to take and here's some information about why or why not to do it. It was presented as a standard test to have done.

I've read about the test - I don't have any of the symptoms. I haven't had fast weight gain, I don't eat much processed foods, I exercise, I don't have a family history of diabetes, and I eat because I'm hungry. Also I don't want to drink some sugary gunk, wait for an hour for them to take some blood and see if my blood sugar is high. That isn't natural!

I am happy with the WEWHC in general. When I asked the midwife about Labor & Delivery at Vanderbilt - can you move around, what kind of fetal monitoring is used, can you eat & drink, what about bath/showers, limits on labor time before induction, how do they feel about a birth plan, having people at the delivery, etc. - I received pleasing and comforting answers. The number of C-sections performed is low and there isn't pressure to get an epidural; it sounds like a more relaxed attitude about natural child birth which I would expect with midwifery.

First Trimester

During most of April and May, pregnancy exhaustion has been the norm for me. Ironically the week I discovered I was pregnant, the spring tennis league (3.0) started - weekly matches for 7 weeks. I signed up in March, before I was even pregnant! Luckily I felt great once I was playing tennis - wish I could have played tennis all the time. Another positive is that I had another winning season!

Yesterday I went for my first prenatal visit at the West End Women's Health Center affliated with Vanderbilt Hospital which is where I will Labor & Deliver. I researched my OB/GYN options last year and knew that a midwifery practice is a good match for my personality and values about health care. My primary midwife is really cool, a woman named Soheyl who is of Persian descent and has lived in the United States for the past 20+ years. I enjoyed conversing with her about my outlook and questions about the pregnancy/birth process as well as her philsophy. I plan to go natural child birth yet know that the connection to a hospital gives us options in case an alternative is necessary.

I am learning that flexibility is key to this process as well as future parenthood. Also daily naps are a must!