The Saga Continues

You've heard my first son's birth story and the subsequent choices we made for our second son's birth. I practically drooled over my midwife and how happy we were and how glad I was to have her to count on for our third baby's arrival in May. Not only have we established our relationship and our trust, we've been there and done that! She's been in the trenches with us and she was our rock! I felt even more secure in our choice because our midwife is also a nurse. She was able to adjust my medications so I didn't have to visit my primary care doctor in addition to the prenatal visits with my midwife.

Sounds too good to be true, right?

Our midwife very kindly and painfully told us this week that she is no longer allowed to attend VBACs. Yeah, that's me!

That's right. Some insurance guy somewhere decided that a natural birth after a mother has had a c-section is too risky. In all my research (and it was quite substantial) I could only find a 2% increased risk of uterine rupture in VBAC patients (vaginal birth after cesarean). 

I feel discriminated against! 

Nevermind that I've already done it once! Nevermind that our midwife has delivered scores of VBAC babies. Nevermind that the evidence out there does not show a significantly increased risk--and where the risk is highest is in those patients who have transverse scar (naval to pelvis) rather than a more typical bikini line (hip to hip) scar! Nevermind that it's my body and my baby and my choice!

Did you know that insurance requires a surgeon to be on duty--not just on call--when a VBAC patient is in labor? It's much easier for the doctor to just schedule a c-section, and it costs the hospital less money.

{deep cleansing breath}

So what are the options?

1. We could go against everything we learned with the second pregnancy/delivery and sign up with an OB. I am 35 which is considered 'advanced maternal age'. That means extra appointments and tests with the OB. I probably would not be allowed to carry the baby until I went into labor naturally. My babies tend to stay content in there until around 42 weeks. (My OB for my first son scheduled the induction at my 40 week appointment. Um, the average gestation is 41 weeks, 2 days. That means for every baby born before that time, there's another baby born later than that! If I was allowed to wait for the natural onset of labor, once I checked in to the hospital I'd have to be continually monitored because of that lovely VBAC status. I'm sorry, but continual monitoring, so many staff members, interruptions and the impersonal environment of the hospital are not at all what I want during labor. I don't want to have to stay in the hospital for several days and be away from my boys and my home, be checked on during the night and have continual new faces 'helping' me. I know I sound negative and I'm happy for those out there who have not had the experience I did with hospital deliveries. Really, I am, but it's not for me.

2. There's another midwife option. Our first midwife recommended someone to us and gave me her contact information. I called her immediately and have heard nothing for 2 days, so I'm having a hard time getting excited about it. This is probably the option we will go with as there aren't many others! I'm glad it would still allow us to have a homebirth. This midwife can still attend VBACs because she's not a nurse. Now does that make sense to you? Yes, she's had hours and hours of training. She's assisted in many births and been the head midwife for many many more. She has had to take classes and pass tests and get certified by the state. But because she's not a nurse like the first midwife, she's still allowed to attend VBACs. Wouldn't you want someone with more of a medical background if the risks were higher? 

You never know, we might love her. I'm determined to make it work--any question about that and you'll just have to re-read #1 above! This might not be the big deal it feels like right now, but it's hard to develop a trust relationship and invite someone into your home for an extremely intimate and personal event and then have to start all over again. {sigh}

I'm sorry if this sounds like whining. Maybe I am whining! I guess it's all in an effort to work through my anger and frustration. I feel so wronged! Our midwife is loosing several clients and has to deal with this too. I could go into a tirade about politicians and impersonal insurance companies... but I'll refrain. Hopefully the next update will include a tale of love-at-first-appointment with the new midwife. If she ever calls me back. 

On a happier note, the little guy (or girl... but I doubt it!) who all this fuss is about is 18 weeks along! He weighs about 5 ounces and is about the size of a bell pepper. AW! I'm very excited to meet him (or her... but probably him) and hope and pray we are as thrilled with his birth story as we were with our second. 

AND!!! I felt him (or her... or not) move this week! I'm pretty sure I'd felt the movement before, but this was very definite. So fun!

I promise to have a DIY before-and-after home-improving post tomorrow!