16 & Pregnant

I admit it, I love this show.  I love "Teen Mom" as well.  I think that overall, it sends a really great message to young girls about the realities of having a baby at a young age.  Heck, it isn't easy at ANY age, but I sure wouldn't have wanted to do it when I was 16 or 17!

The episode this week covered a girl who was pregnant after having been treated for anorexia in the past.   Most of the episode was heartbreaking, as her mother was pretty much non-existent as a support system and she was having to wade through the dark waters of being pregnant with an eating disorder on her own.  I know the focus of the episode was covering this aspect of being a young mom, but I have to be honest, what screamed out to me was her birth.  Usually, MTV seems to do a good job at documenting the labor and delivery, noting whether pitocin or an epidural was used and giving a definition of drugs and tools used during the birthing process.

The girl's water broke at home and after telling her mom (and her mom completely blowing her off and not taking her seriously), she headed to the hospital.  We (the viewers) never saw her get out of bed to labor.  She just laid and laid in that bed and after 18 hours, she was 5 centimeters or so and the doctor came in and told her she needed to start thinking about a c-section.  MTV did not document pitocin used to try to further labor, did not document an epidural used to let the mom relax and further labor and definitely no alternative laboring positions than lying down.  They also didn't document any heart decels in the baby and didn't give any indication that they were concerned about infection due to the water breaking earlier in the birth process.

The poor girl looked to her mom for advice and her mom said, "Maybe you should get the c-section because you'll be so tuckered out after having a natural birth."  Really?!?!  Tuckered out?!?!  I thought that was what you were supposed to feel after birth!  And they had another thing coming if they thought the massive amounts of pain pills after a c-section don't "tucker you out" even worse!

So they headed to the OR.  A healthy baby was born.  I just hope this 17 year old mom doesn't look back at her birth some day like so many of us have.  I wouldn't wish that on anyone.

I'm either angry with the doctor or with MTV for doing a horrible job documenting the labor.

Charting after an IUD

I didn't ever look much in to BBT charting or natural family planning.  The most I had heard about it up until recently was that it was something done in the Catholic church, and seeing that we're not Catholic, it wasn't ever something we considered.  After having my IUD removed I wanted a way to figure out when I was ovulating.  I have heard horror stories of IUDs causing infertility and women not ovulating for 4-5 months after removal.  Daddy B and I are wanting to wait long enough to give my body a chance to return to normal (and also aim to have a May 2012 baby!), but we don't want to wait 5 months!!  

I had heard of BBT charting so I thought I'd give it a shot to help me figure out when I was ovulating this time around.  When I was tracking my cycle before we conceived Baby C, I had about a 32 day cycle and seemed to ovulate right in the middle, around day 16.  While I was on the IUD, I had regular periods that were very light and they varied in length from 29-32 days long.  

Here's a good link explaining how BBT charting works.  Anyway, I started taking my temperature on the last day of the period I seemed to get 2 days after removal.  I've been charting ever since every day at 6 am.  I was using one site that said I never ovulated, but then ventured over to Fertility Friend and plugged in my data.  It said I ovulated!  It was the same day I was getting crazy symptoms and Daddy B and I actually decided to take a pregnancy test just to make sure I wasn't.  (I wasn't!) I just wasn't used to having ovulation symptoms after NOT having them for over 2 years!  

Here's what my cycle has looked like over the past three weeks:

See that huge dip that just happened today?  I took that this morning and was shocked my temp went from 97.5 to 96.8.  Then I went to the restroom when I woke up and I was starting another cycle!  It is so cool that my body temperature reflects that!  But now I have no idea how long my cycle is going to be.  I guess we'll just wait another month and find out!

Notes of Insight from Dr. C

I've been meaning to do this post for some time, but just haven't had a chance to sit down and actually do it!  So the ICAN meeting was really cool with Dr. C.  He said a few things that really stuck out to me:

• Let the people around you help you, trust them and trust your body.
• These people include your midwife/doctor, your doula, your husband and your support team
• I plan on my support team being Daddy B, Aunt K, Amiga C and the doula
• This spoke to me because I know a big part of a VBAC is your mindset and having trust in all the things out of your control.  
• 95-96% of babies will come out!
• Your birth plan is usually broken 3 lines down and is simply a list of wishes.
• This one made me think that I will write up a birth plan when the time comes, but I'm not going to focus on it unless I end up in a c/s, which in that case I will want things a lot different than last time, like seeing my baby immediately after they are born and before they are cleaned up, having my baby in recovery with me and being able to start nursing.
• Your husband's bottom line is YOU, his wife, not the baby.
• Dr. C used an analogy saying "Imagine your baby is in the middle of highway 635 and dad is on one side and mom is on the other.  If you both start going for the baby in the traffic, the mom will win every time and the dad will have figured out a way to save both the mom and the baby."  
• This really spoke to Daddy B and I and I think it was one of the things that led Daddy B to feel that Dr. C was the right choice for us.  It honestly warms my soul to hear it put that way because I realize how true it is and how much Daddy B loves and cares for me.  I am his first priority because he knows his children are in my hands and are MY first priority.  (teared up just typing that!) :)
• The risks of a c/s are the same of any major surgery
• Spinal injury
• Anesthesia
• Cutting uterine artery
• infection
• Put that way, it sure sounds like a VBAC is a better choice, doesn't it??
• Labor at home, it keeps people off of you
• As soon as you go to a the hospital while you are in labor, you will be bombarded with questions, poked with needles and nagged constantly about how you are doing.  Dr. C wants you to labor at home until you KNOW you need the hospital so you have less chance of someone butting in and throwing things off course
• The average labor lasts 18 hours
• A VBAC mom needs something different because she is nervous.
• Jeez so true.  I'm not even there yet, but after you feel like your body and/or the medical system has failed you, you are just plain nervous you won't be able to do it again the way you want to.  I know I'll need constant reassurance towards the delivery time that I'm made to deliver a baby the way I want to.
• You have a "love affair" with your OB and when you trust them and they let you down, it's heartbreaking and you're angry.
• Another true statement.  You trust your OB so much and when you're a first time mom and have really put all your naivety in their hands... you realize afterwards just how different it could have been if you had maybe not thought you knew so much and listened to others' experience and tried to learn from it.

Okay so the day after the meeting and after we had made our decision to switch from the midwife group, I called Dr. C's office to find out if I could get a consultation appointment or something so that I could be an existing patient before I became pregnant.  I figured with his reputation, he would be in high demand and wanted to make sure I would have him on my team when the time came.  So I call and talk to a receptionist and she tells me that Dr. C isn't taking new patients.  I was like "................what?  When WILL he be taking new patients??"  She said he hadn't been for months and didn't see it ending any time soon.  I asked about me being a VBAC patient and it didn't change her answer.  I was so upset when I got off the phone.  I jumped on the ICAN board and posted a new topic about this and my wonderful ICAN ladies replied within minutes telling me to call back and say I wanted a VBAC consult.  I did call back and talked to a different receptionist (who was a lot nicer!) and it turns out that Dr. C isn't taking regular OB patients anymore, as he wants to focus on VBAC and high-risk pregnancy mamas.  So long story short (or shorter...ha) we have a consult appointment for June 18th.  Daddy B and I are both looking forward to it!!

Unexpected Switch

Since the beginning of the VBAC journey, I have felt a little alone.  Other than my ICAN women, I didn't feel anyone around me truly understood how I felt about my birth with Baby C and why I want a different experience with our next child.  I mean, Daddy B has always been supportive, but I have never felt he truly "got it."  I worried how he would act under the pressure of an unplanned birth and probably a long labor.  I know my induction was hard on him and one reason he wanted the c-section was because he knew it would be over soon and I would stop being in pain.  

I have been doing research for months and months, probably more than a year.  I talk about it some with Daddy B, but he would interpret it as "I want a baby now," when it wasn't that at all.  Once we decided we were close to being ready to have another, or at least make steps towards that goal, I know he listened a little more about the importance of choosing the right care provider.  When I told him I felt we had 3 options of a good chance at the VBAC I wanted to happen in a hospital, he definitely leaned towards the closest location, which was the Nurse-Midwife group at 23 miles from our house.  I wrote about that appointment here.  I was determined not to jump at the first provider we saw, but we left the appointment and we were like, "okay I guess this works."  Then, I heard that the local ICAN group was holding its May meeting tonight and the speaker was a well known VBAC OBGYN in the area.  Dr. C isn't the typical OB.  He believes in VBAC just like he believes that God has His hand on every pregnant woman and her birth.  He sees the things that have happened with birth and is one of the few OB's that is determined to do things different.  I decided to drag Daddy B with me to this meeting.  I kept pestering him, sending him reminders about the meeting tonight and ensuring that he had no reason to "forget."  I figured it would be a good opportunity to just have Daddy B learn about VBAC and give him more insight.  

Little did I know, Daddy B sat there tonight absorbing it all.  When we left, he told me he thought we should make the hour drive and have Dr. C be our OBGYN to deliver our next baby.  I was shocked!  One of the most important things to me with this birth is that Daddy B be on board and be comfortable with everything that can and will happen.  To be honest, I had a feeling in my gut that wasn't convinced the Nurse-Midwife group was the right choice.  I thought maybe it was simply because I would never be sure.  

As we talked in the car, I felt for the first time that Daddy B and I were on the same page.  He understands more about why I want this for us, for me, for our baby.  I'm so happy I could cry!  I told him I felt deep down that the Nurse-Midwife group wasn't the right choice but didn't voice it because I thought he wanted to go with them.  He told me he felt the exact same way and had a knot in his stomach about the whole thing!  We feel so confident in our choice to switch.  I can't believe we are committing to such a drive, but I had an ICAN mama say it best, "the drive is worth it to get the birth you want."  

Maybe it's my crazy hormones from the Mirena being removed a couple of weeks ago, but I get choked up every time I think about how thankful I am for my husband and for him being supportive and honest.  

I'll do another post soon about the words of wisdom I took from Dr. C tonight.  It was two hours packed with good info and advice!

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'!  :)

Excited

I haven't posted in awhile... but it's mainly because our MacBook is on the fritz and I haven't wanted to sit at our PC to blog since it's right outside of Baby C's bedroom door.

I wanted to take a moment to let all of you know how EXCITED I am to have another baby.  I know it has it's challenges, I think any mother knows that.  But I have such a different outlook this time when it comes to getting pregnant, carrying a life inside of me and bringing it in to this world.  Not to mention the countless hours you get to spend afterwards just staring at this little being in awe that you brought this child in to this world.

Our CNM appointment is quickly approaching and I'm so happy to say that I think Daddy B and I are BOTH looking forward to it.  When you want something like a VBAC so bad, you have insecurities that maybe the Daddy isn't as excited as you, but I can tell you that Daddy B is really looking forward to the idea of number 2! 

Tonight I was looking at Baby C while I was getting him in jammies for bed and couldn't believe how big he is.  He's almost 2 for crying out loud!  He was in his diaper and socks and had his legs just so that I was thrown back to those first few days of him as a newborn and simply couldn't wrap my head around how much of a big boy he is.  I mean we are at the beginning stages of potty training, he's practically running and trying to imitate everything I say.  Not to mention his dance skills!  He loves to dance!

I can't imagine loving another child as much as I love Baby C.  And to add what I hope to be an empowering birth on top of that... well that would just be icing on the cake.  My heart is full!

Plus, we make REALLY cute babies!  What will our next one look like?! :)

Birth Center vs. Hosptial

There are a lot of debates about a birth center versus a hospital.   I think you know by now that our hospital experience wasn't ideal.  So why would I want to do it again?

First of all, I'm not set on it.  I'm hoping it could work out, but I am very aware that I could go to this nurse-midwife appointment and realize that this isn't for me.  And Daddy B will be there too, it could not be right for him either.

Second, like I said in my previous post, those two other OB's are 50+ miles away.  I've heard from a few different mamas that the driving distance is worth it to get the birth you want.  I'm not sure if we will be looking directly to an OB if the Nurse-Midwife group doesn't work out or if we will start looking in to birth centers closer to our home.

Why am I considering another hospital birth in the first place?  Here's what's on my mind:

1. I was raised by a nurse who taught me to trust our medical system.  Now I know this system failed me last time (for the most part), but I also still have faith in our trained medical personnel. Amiga C is a nurse, my mother is a nurse... I trust nurses and doctors who are like them.   I just don't know if I got the best pick the first time.
2. I feel a little pressure.  Aunt K has told me many times that she wouldn't feel comfortable without a NICU close.  Would I?  I haven't explored how I feel on this completely but I'm afraid that she could have a point.  I think I need to interview a birthing center to be sure.  
3. I don't know if Daddy B would feel comfortable in a birth center.  I haven't directly asked him.  I guess I plan to do that if the Nurse-Midwife group doesn't work.
4. When I visited that first OB, she made a good point about a birth center I was considering.  She said, "The biggest piece of advice I can give you about using a birth center is to make sure they have doctor backing at a hospital in case you end up in a c-section."
5. It scares me to think that I could be laboring in a birth center and realize I need a c-section, only for an ambulance to have to be called and go through a scary ride to an OR.  After the traumatic experience last time... I just couldn't imagine adding that on to it.

I'd welcome advice on this issue.  I don't plan on moving forward with a decision until I explore this Nurse-Midwife group next month.  Know of any good Birthing Centers in DFW? Centrally located?

P.S.  No matter what, we will be using doula.  Just thought you'd like to know.