Sans-Octopus

We have a running joke in our family where we refer to the Mirena as "the octopus."  As my CNM (Certified Nurse Midwife) appointment approached earlier today, this evolved in to Aunt K referring to the midwife we were seeing as "Dr. Octopus."  Hilarious, if you ask me! 

See the resemblance??

So, I am sans-octopus, as Aunt K put it.  I got to the the Nurse-Midwife group office around 9:45am.  My appointment was at 10am and I figured this gave Daddy B and I enough time to do any paperwork that maybe required and be ready to go at 10am.  The drive took about 30 minutes and the right parking lot was a little difficult for me to find, but we got there eventually and got checked in and started on the small amount of paper work.  We waited for over 30 minutes after that and we regretted not getting something to eat first!  Once in the exam room, we waited another 20 or so.

I'm not going to lie, I was freaking out. 

It felt so impersonal, just like the OB office in San Antonio with the last birth.  I didn't really love the assistant's reaction when I told her I didn't want to know my weight (personal reasons), I was freaking out about the reality of having another baby and getting PREGNANT again, I was worried I would choose the wrong provider...  I was sweating up a storm and had some pretty impressive pit stains to boot.  (LOL) And to top it off, I was anxious about the pain that I might experience when they removed the IUD.

After the nurses assistant left and we waited a bit more (while Daddy B tried to make me laugh by playing with all of the instruments and calm me down by praying with me, glad he was there!), a midwife student came in that was helping out my CNM.  She was super friendly and had me talk to her about why I was there today.  I told her my back story with Baby C's birth and what I hoped for this next time around and told her I wanted my IUD removed.  She went to get my CNM and once they were both back in the room, that's when the questions really began.  We waited for a good while, but they were both in there for over an hour talking to us!  So worth the wait!  Baby C's pediatrician is the same way and after you wait so long you are very thankful your health professional has such great bedside manner.  It makes you forget about the waiting!

So after all my research, here are the questions we prepared and the answers we got:

Insurance coverage as it pertains to the midwife group - (Brian's main question haha)  They cover the prenatal care and birth just like any OB office.  This is all based on our health care coverage, which is through United HealthCare.  We asked this because with everything last time, we paid over $7,000 out of pocket and it really hurt!

How is the breastfeeding support in the hospital? The hospital the midwife group delivers at is one of the few baby-friendly hospitals in the state of Texas and are so adamant about breastfeeding that we were told it borders on obnoxious.  I'll have a doula with me as well to help establish good habits. 

I heard you have a "40 week rule" as a group, is this true? I was told that this is false.  The reason some women may have felt that is because at some point during your pregnancy you see the physician that is tied to the midwife group.  He tells you the risks of going past your due date for you and the baby, but does not encourage induction.  In fact, his wife is a VBAC mother that delivered well after her due date with no pain medication.  My CNM said because he is a man, his was of communicating to pregnant women sometimes isn't the most sensitive.  haha

Do you allow intermittent monitoring? Yes.  They said that because I would be a VBAC patient, they may want to monitor a little more often than normal towards the end of labor to ensure the baby is doing okay, but they are fine with intermittent monitoring.

Do you allow non-traditional pushing and laboring? Yes.  They want me to do whatever works for my labor and delivery and is comfortable. 

I've heard other midwives in the practice aren't as VBAC friendly, is this true? I was told "Absolutely NOT!"  All the midwives have different bedside manners and some of these rumors may be because of personality clashes between patients and midwives.  Also, the CNM I went to see was the most recommended through my ICAN ladies, but she actually has the lowest VBAC rate in the practice! 

I've also heard the physicians that back you at the hospital aren't all VBAC friendly, is that true? Yes and no.  Not all of the doctors in the practice will be comfortable with VBAC hopeful patients who have had MORE than one c-section, but the midwives all are and I don't fall in to that category anyway so I shouldn't worry about it.

One thing that led to my c/s with my son was that I wasn't following the "Curve of Labor."  Do you go off of that too?  They think the curve of labor can be useful in some birthing situations, but it is based on a study of like 50 births, so it is not accurate for every woman and every birth.


Those were my main questions, but I also got 6 recommendations for doulas and recommendations for homeopathic remedies for things like mood stabilization and varicose veins!  Loved that!

I was given a list of things that increase your likelihood of a successful VBAC, I thought you'd be interested. 

1. Greater maternal height and BMI less than 30  - check and check (I'm 5'7.5" and am normal size)
2. History of previous vaginal delivery - obviously don't fit this one
3. Indication for previous cesarean for something other than failure to progress - My CNM said in her opinion, my c/s was due to physician intolerance, not my failure to progress or fetal intolerance so CHECK!
4. Women who previously delivered infants weighing less than 4000 gms - 4000 gms equals about 9lbs, so Baby C just barely makes the cut at 8lbs 9oz!  Check!
5. Earlier gestational age, spontaneous labor and smaller babies - CNM said we will work on this together with diet, exercise and and an active pregnancy to encourage spontaneous labor and lower birth weight
6. More favorable Bishops score on admission - another thing the CNM said we would work on during my pregnancy (need to research this.  I have no idea what it is!)

So it looks like I'm a good candidate for a VBAC.  Woohoo!

Overall, it was a great visit.  It hurt a little to get the octopus out, but since I been having regular cycles since the Mirena was placed, I was given the green light to get pregnant after a month or so to let my body get back to normal. 

Daddy B and I talked it over and I think we are planning to give the midwife group a shot.  I feel such a weight lifted off of me knowing I have found my care provider!  One thing I loved that my CNM said is that a VBAC is 80% mental and emotional.  She said we will have LOTS of conversations about how I am just a normal, healthy woman carrying a normal, healthy baby who will have normal, healthy birth and that I can't get too caught up in having a VBAC but need to just let my body do what it was made to do.  As I get more and more pregnant, we will have to talk about this again and again.  I was glad she recognized that about VBAC mamas!

Now all the ducks are in a row and once I give my body a chance to remember how to ovulate, we just need to get to baby-makin'!  :)