Help me think this through

[Happiestever]

I thought it would be a great idea to look for a midwife who is comfortable coming out after the birth to take care of things like a laceration repair, and a newborn exam.

Well after talking to a few who said they would help me out (and a few who said they wouldn't) I am feeling very conflicted.

For example how likely is it that I would tear, when I only had minor labial tearing with my hbac? My main concern about the birth is not tearing, but bleeding- and I have decided to order Angelica and Shepherd's purse to help with that- this is something that I would take care of myself and wouldn't wait for a midwife to help with obviously.

And the newborn exam, I would think that baby pinking up, crying, nursing would be excellent indicators of a healthy baby. What am I missing here? I mean, I know they are trained professionals, but wouldn't I know if something was wrong (like gut/intuition) What other things should I be thinking of. I know I can't plan the birth, but the more I think about it~ the more I doubt I will even need someone there for a just in case situation. I plan on reading more about indicators of a responsive/ healthy newborn, but would be interested to hear your ideas on this.

What is everyone else planning? Are you planning on taking the baby for an exam a few days later, not at all? Anyone using a midwife as a backup? Is someone else looking for postpartum care only like myself? I am definitely having mixed feelings about all of this!

I know this is all over the place. Any thoughts? I plan on writing out everything - as soon as I can find a clean piece of paper

[Astraia]

I have a MW friend who has offered to come and check the baby out after he's born and check me for tearing. I don't plan to get stitches this time around unless it's pretty bad tearing, (in which case I'm sure I could tell myself) so I'm not sure if I'll bother with that aspect of it.

But I'll have her look over the baby. I do think that most severe things you'd be able to pick up on, but other things are much more subtle. We don't have peds here (unless your kid is VERY sick, they're reserved for kids who need them) and family doctors are impossible to find so my only option for getting the baby looked at is to travel out of province or go to the hospital. I don't like either option.

If she can tell me he's fine then I know I'll sleep easier without going to the doctor soon after he's born, and if there's anything that needs looking at then I'd like to know so we can find a doctor (out of province, likely).

[MittensKittens]

I don't think you're missing anything . Could you decide after the birth whether or not you would like anyone to come out, depending or whether or not you tear, how you feel about the baby, etc?

The herbs you ordered are excellent, also consuming placenta helps prevent bleeding

[GoBecGo]

I'm HBing but not planned UCing (though wouldn't mind if i did).

You could always look at what they do in the newborn check and do it yourself...? My GP did it and it was basically:
Undress baby and look to see there are no obvious deformities
Examine colour for blueness (cyanosis) or yellowness (jaundice)
Look at palms (abnormal lines on the palms can signal Downs syndrome)
Feel brachial pulses (just above the elbow, on the inner upper arm)
Listen for heart murmur and check heart and respiratory rate and clearness of chest during respiration
Palpate stomach to check for abnormal masses
Check hips for dislocation (there are tests the doctor could do which are unpleasant for most babies, a simple assessment is to turn baby onto his tummy and check that his butt creases below the buttocks are symmetrical)
Check baby swallows, pees and poo's and all the requisite anatomy for those looks normal, paying attention to checking the hard and soft palate's inside the mouth and checking a boy's penis carefully to acertain the pee comes out the right place (they can have a deformity where the urethra is on the underneath of the penis instead of at the tip, they usually show you the second you take their nappy off where they pee from and to (into your face usually!).
Check for tone - pick baby up and see if they are totally floppy or have good muscle tone.

To be honest NOTHING a doctor does out of the OR is magical or so hard a normal person cannot do it. You're having this baby at home, in peace. I'm pretty sure if you spend the time you want to spend naked with him or her, cuddling, feeding and checking one another out you'll figure out pretty quickly if something isn't quite right.

[BroodyWoodsgal]

I'm still so back and forth on this....I was planning a straight up UC and UP....then, ended up going and getting a midwife at around 30 weeks because I live 20 minutes from a hospital and didn't want to have to drag myself out of my house and to the hospital with a NB in the event that I should have a bad tear or if my baby is making weird noises and DH starts flipping out...so, then the plan changed to an "oopsie"...so I would have established care with a MW who could come right away if I needed stiches....so, that's kind of where I am now.

Since bringing a MW "on board" I have had a few "ugh" moments. I REALLY was enjoying taking care of my own pregnancy and having someone else there checking BP, etc, really feels like "sharing" sometimes...but the MW I've found is such an unbelievably awesome chick, that it's okay with me. I've been really open with her about wanting to be alone for my birth and a few times have thrown it out there that I wouldn't be too upset if she missed it...you know, just to be honest about my feelings without outright stating my intentions. Then...she said that she has an RV and doesn't mind coming to my house and being in the RV with her assitant watching movies, etc to give me space..and that sounded really promising to me...but then she sort of explained the way she likes to do things and said that she does like to monitor the baby (during super active labor) every 30 min and my heart sunk...I really really do want a UC....I really really don't want a MW there while I'm in my labor place. But I also understand that technically I'm her "patient" and that there are risks involved for her if something should happen to me and she wasn't monitoring me "properly"...so, I get where she is coming from....but the whole reason we choose to opt out of the "system style" birth, is because the "system" and medical community are beholden to risk assesments preformed by insurance companies and stupid rules and state mandates and federal mandates and on and on....and I don't like that. I like being beholden to my gut, my own sense of what and where risk are....I believe that the safest birth is natural, unhindered and "gut led" birth....so, I don't know.

I still do not plan on calling her until my baby is here..."Oh man, he came so quick!" - but I've been pretty open about my feelings that I don't want her around while I'm laboring...and she knows how fast my first delivery was...the lady is a smart cookie, I mean...she's no spring chicken, I think she knows what my preference is and I think if I call her and say "hey, I may or may not be getting closer, things may be picking up, I'll keep you posted" - as I've promised to do - that she may come out in her RV and camp in my woods!


I don't know what to expect. So....that's my answer. I started with a UP, straight UC.....and have now landed in a much more complicated place than that, simply because I don't know what my post partum will look like. I tore with DD, not horribly, but badly enough that I needed to be seen/stiched right away. DD was perfectly healthy when born and I knew it, it was very plain to see that she was in perfect health. If I don't tear this time, will I feel stupid for having brought this midwife into the mix? If DS looks great, like DD did...will I feel a total sense of "ugh" at having altered my plans for "just in case"....is providing for JIC scenarios as good as inviting them? I don't know...I don't know.

But...I'm due in like, 30 days. We had snow fall on Saturday and Sunday...nothing crazy, but that's insanely early....what if this is a bad winter? What if I tear like last time? What if I have to bundle up me, DH, 18 mos old DD and brand new DS hours after my birth to drive through the snow and ice to a hospital so I can get stiched up? What would I give NOT to have to do that...ykwim?? So...THAT'S why I chose to incorperate this MW into my plans...I only hope it goes as well as I anticipate it will.

Sorry for the book...but I'm asking myself the same questions you are every day...I hope I'm making choices I will look back on and smile about, yk?

[Happiestever]

These are all very interesting replies. It's funny that the pp should mention driving in snow. When we were thinking about conceiving, I was adamant that it wouldn't be in winter again, but was okay with it if we moved to San Diego, so here we are with nothing but sunshine.... I digress.

I just feel like money is a huge issue, and I don't want to look back at the situation and think "Wow, what a waste of money", but I also don't want that to be the deciding factor, yk? If my insurance would actually pay a midwife I would have no problem with finding a midwife to come hang out while I am birthing, but that is just not the case unfortunately.

To my dh, money is very much a deciding factor. I found one midwife who will work with us, but I am still mulling it over. I would still be on my own for however long it takes the midwife to finish her clinic hours (maybe) or get away from a birth where she is getting $4k. As one midwife put it, that person comes first, because my money wouldn't even put food on her table for a week. Which I understand and all, but it stings a bit.

[GoBecGo]

Which I understand and all, but it stings a bit.

It sucks that joyful birth isn't the norm, free for all women. My midwife HATES that she has to charge at all, because she used to be NHS, but she just can't do the job she needs to (a proper midwife by her own standards) the way the NHS would make her operate.

[tessie]

What about other testing? If you don't have a midwife do you have someone who can do a hearing test, PKU etc?

And are you rh negative? If so will you be able to test the baby's blood, if necessary?

[Happiestever]

I am planning on taking the baby in for a ped visit at a few days old. Which there I am sure they will test for everything- as usual.

[BanditaMamacita]

I'm kind of hoping my birth center mw (who i dont plan on calling until the baby is out) will come out for a brief home visit, which they usually do they day after a birth anyway. I tried to ask at the office how things would go if i just didnt make it in time, but the mw i saw that time was new and looked at me like i was crazy and pretty much told me to just get there sooner. The other mws, who i've actually had for previous births, know how fast i go and wouldnt have questioned it, so i'll have to ask at another visit.

But anyway, if they don't, as long as I feel everything is ok (normal breathing, normal nursing, normal peeing and pooping...), I'll take the baby to the ped a day or two after birth. We've always ended up there for weight checks shortly after birth anyway, bc of serious nursing issues.

As for myself, i'm not particularly concerned with tearing... If i did tear enough that i felt i needed stitches, i assume we would just go to the hospital. Not an ideal in December with a newborn and two toddlers, but whatcha gonna do? Bleeding is my only real concern, and I have some herbs on hand and have read everything i can find about dealing with it at home...

[Happiestever]

Originally Posted by MittensKittens

I don't think you're missing anything . Could you decide after the birth whether or not you would like anyone to come out, depending or whether or not you tear, how you feel about the baby, etc?

The herbs you ordered are excellent, also consuming placenta helps prevent bleeding

It seems as though I would have to make a plan with them and pay them either way. Which I am not thrilled about, but it is the whole being on call issue. My DH definitely has an issue with that as well, and I would have to talk to the mw's to double check, but I think once you make an agreement with someone, it is pretty binding. Thank goodness I have not agreed to anything yet!

[ChristSavesAll]

Originally Posted by GoBecGo

...checking a boy's penis carefully to acertain the pee comes out the right place (they can have a deformity where the urethra is on the underneath of the penis instead of at the tip, they usually show you the second you take their nappy off where they pee from and to (into your face usually!).

Just and FYI this is caused by too much soy during pregnancy, many people love soy and claim positive benefits but we have too much in our food supply that it inhibits your thyroid from functioning properly, unless one takes an iodine supplement. Also fluoride, bromide, and chlorine also inhibit thyroid function and we have too much of those in our food supply as well, 95% of people are iodine deficient and don't know it because it's not a standard test, in fact you have to order it online specifically.

Iodine deficiency causes birth defects and abnormalities, mental retardation or other developmental delays, miscarriage and still birth to the baby during pregnancy.

Sorry to go off topic but wanted to share it while the opportunity presented itself.

[tessie]

Originally Posted by Happiestever

I am planning on taking the baby in for a ped visit at a few days old. Which there I am sure they will test for everything- as usual.

Sounds like you have that aspect covered.

[tessie]

Originally Posted by ChristSavesAll

Just and FYI this is caused by too much soy during pregnancy,

I've never heard of this. Do you have any links so I can read more?

[MyBoysBlue]

I thought it was plastics. There is a great documentary on how plastics are affecting our male children, causing genital deformities. It's called "the Disappearing Male". It's made by the CBC, Canadian Brodcasting Corporation, You can see it on their website if your in Canada but I think it was on Youtube as well.

Several copies on Youtube:
http://www.youtube.com/results?searc...rch_type=&aq=o

[joyousbirther]

It's comforting to know that I'm not the only one in this position.

My back up midwife told me yesterday that she will be out of town and will not be able to attend my birth, so now I have lots of praying to do and am asking lots of questions.

[Sijae]

I don't think it hurts to have an experienced person look at your vulva and baby after the birth. It's possible a problem could be picked up that you might not notice right away.

On the other hand when I had my third child UC I never took her to see anyone. I didn't feel like it was necessary.

I personally think pediatricians should be avoided for at least a few weeks. Peds just usually don't have much experience with that age group and their understanding of breastfeeding, jaundice and other normal newborn things is also often limited/incorrect. I think it's better to see a ped (if ever) after breastfeeding is established and baby has gained back her birth-weight.

If you plan to do newborn screening you'll need to see someone at around 3 days. I suggest going with the midwife.

Laura

[onelilguysmommy]

Originally Posted by GoBecGo

You could always look at what they do in the newborn check and do it yourself...? My GP did it and it was basically:

Examine colour for blueness (cyanosis) or yellowness (jaundice)
Listen for heart murmur and check heart and respiratory rate and clearness of chest during respiration
Palpate stomach to check for abnormal masses
Check hips for dislocation (there are tests the doctor could do which are unpleasant for most babies,

This is what the ped did when we went after my UC'd baby was born from your list(and nothing more.). She was asleep until he checked her hips

I did the checking of everything after birth and would have gone in if I'd noticed a problem.. She was screaming before her head was totally out so breathing wasn't an issue (VERY thankful but it was still funny. I wasn't quite expecting that! )

Originally Posted by tessie

What about other testing? If you don't have a midwife do you have someone who can do a hearing test, PKU etc?

And are you rh negative? If so will you be able to test the baby's blood, if necessary?

Here, the hearing test isn't done anywhere but a hospital or an outside place you get referred to if you didn't have a hospital birth.
Te nweborn stuff, a ped can do and it is better to do after a few days anyway. Actually, you can do it and just send to a lab yourself if you want it done.

Originally Posted by tessie

Thank you for for taking the time to provide the links but I really question your sources. WND links it to homosexuality!

Without looking at the links, I'm thinking maybe they are thinking that the extra estrogen would make the more feminine and we know what that infers...

[Rockies5]

If you can't afford it, and it isn't an emergency situation I'd probably just give birth normally, and then deal with any concerns if they arose.

May hap you have a physician or nurse practitioner that you are OK with to check you for any tearing? Tearing that needs stitches needs them within a few moments, if no medical person is attending the birth anyway then stitches at an hour post-partum is basically the same-- stitches on swollen, raw tissue.

While having the option of calling a trusted HB midwife to your home to do the after care is preferable..think it through a little. I mean, would you call her for a little chicken skin or only something rather serious?

And, if only for something pretty obviously serious..why not just have the practitioner that is regularly dealing with SERIOUS tearing, like an OB? I mean, I refer most things to my MW but if I needed stitches I'd probably just call my OB clinic because I know they do repairs at every birth, where my MW's role is to support preventing tears.

As far as the NB exam, it's personal choice. I have no real opinon on it.

I'd also talk to the mw about the option to do pay-for-service. If she's asking for up front that means she might suspect that you want her as a back up if the birth is more diffrenent then you expect. Reiterate with her that you ONLY want her as a OPTION for aftercare for yourself so that you don't have to transfer for something minor like tearing. Maybe this will make a difference in when payment is due. If not, look for other options. (and if so, set aside the money for the option until after the birth!!)

hope the birth its all you expect--

[Happiestever]

Originally Posted by Rockies5

If you can't afford it, and it isn't an emergency situation I'd probably just give birth normally, and then deal with any concerns if they arose.

May hap you have a physician or nurse practitioner that you are OK with to check you for any tearing? Tearing that needs stitches needs them within a few moments, if no medical person is attending the birth anyway then stitches at an hour post-partum is basically the same-- stitches on swollen, raw tissue.

While having the option of calling a trusted HB midwife to your home to do the after care is preferable..think it through a little. I mean, would you call her for a little chicken skin or only something rather serious?

And, if only for something pretty obviously serious..why not just have the practitioner that is regularly dealing with SERIOUS tearing, like an OB? I mean, I refer most things to my MW but if I needed stitches I'd probably just call my OB clinic because I know they do repairs at every birth, where my MW's role is to support preventing tears.

As far as the NB exam, it's personal choice. I have no real opinon on it.

I'd also talk to the mw about the option to do pay-for-service. If she's asking for up front that means she might suspect that you want her as a back up if the birth is more diffrenent then you expect. Reiterate with her that you ONLY want her as a OPTION for aftercare for yourself so that you don't have to transfer for something minor like tearing. Maybe this will make a difference in when payment is due. If not, look for other options. (and if so, set aside the money for the option until after the birth!!)

hope the birth its all you expect--

The stitching needing to be done right away is a great point. I was thinking about that very thing myself. I am definitely leaning towards just going to the ped a few days later for the newborn exam and testing. I just don't think $700 for someone to look at the baby and my vulva is money well spent. Especially if I have to wait 18 hours for them to stop by, when the hospital is 15 minutes away if there was like a nuchal hand or something.


I had an ultrasound yesterday and baby is looking perfect with my placenta way at that top. Saw babies little chubby cheeks, so precious. Which is exactly the thing I needed to move forward with planning my UC. I told the tech that I didn't want to know but she kinda said a couple of things that made me think it is a boy. Though again, I really don't care as long as they're healthy.

I think I will call V and see what she says about MAYBE using her.

And thanks for the list of things done at the newborn exam.