Freaked out now...please help.

[micah_mae_]

I haven't done much googling about the 2 vessel cord issue until today. I'm 37 weeks and I'm reading about how a SUA increases the risk for placental abruption and about how some babies with SUAs don't do well with labor and end up being csections.
Well I'm having a home birth so I'm freaked out now that he's not going to do well and we're too far away from the hospital.
It doesn't help that my midwife is extremely hands off and takes her time getting to births. She's over an hour from me already. My friend delivered with her a couple weeks ago and she barely got there an hour before the baby was born, even after they called multiple times.
I feel like I'm stressed out. I want the baby out already so I can stop worrying about it. Any way to move labor along? I was having timeable contractions last night (bh? real?) that were 6 minutes apart until I went to bed when they stopped.

[chellebee]

Any gut feelings about this?

Wondering if your mw knows this is a concern for you. She may not be as hands off if you express that you have a concern about this...unless she just *is* a totally hands off midwife.

[kcparker]

If you feel worried, I would recommend talking to your midwife about coming earlier in labor and doing regular monitoring, listen for a few contractions every 1/2 hour or so, ask what her experience has been with SUA, if/how she would handle the labor differently than a regular cord. You can show her the articles you were reading that do indicate a slightly elevated risk for abruption, and explain that it would make you feel better (and that you feel you will have a more efficient labor if you feel safe instead of worried) to have her there sooner rather than later. If baby starts having trouble, heart tones will be a tip-off, and frequent monitoring will help determine how baby is tolerating labor. FWIW, the hospital-based midwives where I often doula do not treat SUA as a huge cause for concern, particularly in the absence of other anomalies.

If you are super-worried, would you feel better being in the hospital, or closer to it? There is no shame in transferring care or changing location if you know that you will feel more at ease by doing so.

It does sound like your baby and body are starting the process of gearing up for labor. I am sure you know all the usual tricks: sex, EPO, stay active, invite baby to come whenever he's ready. If you want something more invasive, ask for a membrane sweep...

Good wishes.

[micah_mae_]

Thanks for the replies..

Gut feelings...my gut feeling is that I'm fine. But I'm worried because I have a spot on my uterus about the size of a baseball, very localized, which has a very intense pulling/burning pain..especially when I lift or reach or something. I worry that I have a partial abruption already or something. It's been there for 2-3 weeks.

I can't really transfer care, everything has been paid for and my hubby very well might kill me. But I may go to the ER later and tell them about the pain and see if I can get an u/s to rule it out? Someone else said I might have a hernia which I'm not sure if that would be dangerous during birth.

I will definitely talk to her, we have an appt coming up. Maybe she's not really as hands off as I think she is..I just don't know what to expect from a homebirth mw? At the birth center if I called and said something was up they would immediately tell me to come in and get checked out...

[kcparker]

Is it possible that the pulling/burning pain is round ligament pain? If it is RL pain, a chiropractor trained in prenatal care can do a release on it, give you a pelvic adjustment, and ease that up in a few minutes.

My understanding is that an abruption can be painless, or is unremittingly painful -- it does not come and go like a contraction. I am not an expert, but I would think that if you had an abruption, you could also notice bleeding and/or decreased fetal movement, and your "gut instinct" might well kick in and tell you to go to the ER posthaste.

If it's a hernia, it won't interfere with the birth. Just try to labor down and don't add extra pushing pressure unless you have to.

I just don't know what to expect from a homebirth mw?

I think you should be able to expect caregiving that is responsive to your concerns, no matter what the delivery setting. If it's something that she cannot diagnose or treat and feels it is a concern, she can always refer you to a doctor or hospital for further evaluation and management.

[GuildJenn]

Instinct aside, if you are worrying a lot about an abruption, why not ask for an additional check up (whether that's just the doppler to reassure yourself about heartrate, or an ultrasound)?

I understand that you've paid the midwife. But from someone who lost a baby to a series of medical errors and a cord accident (not related to a 2-vessel cord) - if you think you are not getting the right care, please do address it, either directly with your midwife or by getting a second opinion. Just as not all OBs are good, not all midwives are good. She should at the very least be able to explain why she is not worried about the possibility and the distance to the hospital right?

[Megan73]

Talk to your MW. You may well find that when made aware of your concerns she's quite opening to monitoring that will reassure you and to coming earlier in labor.
If she's not, I'd transfer care although - to be fair - there really isn't any surveillance available, unfortunately, that can predict an abruption BEFORE it happens.
Yes an abruption can be painless and it can also be absolutely silent. I didn't have SUA but I did have an abruption that killed my daughter and had no bleeding beyond normal bloody show in labor. My MW explained away the reduced movement as normal for a term baby and said a doppler check was enough to confirm she was fine. If the abruption was relatively small, a NST or BPP might have revealed that she was in trouble before she bled to death or it might not have.
Sadly, my "gut instinct" didn't kick in to save my baby.

[secondimpression]

We kinda-sorta know each other, hi and HUGE HUG.

With my last pregnancy, DD had a suspected circumvallate placenta (a condition where the placenta implants too deeply and peels away from the wall of the uterus). The ultrasound suggested that it was severe which led to lots of research. It came down to about a 13% risk of a catastrophic abruption at any given time and the associated risks of stillbirth and maternal death. There was also risk of growth restriction (I measured 5 weeks small 2 days before she was born so this looked like the case) and premature labor. So there was some fear about what I would do if I did have a complete abruption and there's a hospital 1.5 miles from my house. It came down to the fact that I was pretty much screwed if I did have that variety of doomsday abruption. But the only way to prevent it 100% would have been to switch to a very conservative OB and beg my way into a very early scheduled C/S. Ultimately, I took that leap of faith knowing that if I *did* have an abruption, my odds were only slightly better if I was in the hospital. Of course, the placenta was totally normal upon examination and DD was average sized and perfectly healthy.

I can also address some of your MW concerns since I delivered with the same one. She arrived just minutes before DD was born at 2:25. I called her just a little after 1:00 (I was about 4cm so I went FAST) so if you do the math, she jumped out of bed and hauled some serious butt to make it in time. She told me later on that she'd had a hunch I would be a fast labor. Her new assistant lives in Annapolis so she'll probably make it to you first and fairly quickly. The new assistant arrived at my house about 30 minutes after I called the MW but I was her first birth so she wasn't much help which I didn't want anyhow. The regular assistant was second to arrive and only a few minutes before the MW. It's true that the MW is typically very hands-off and that's why I hired her but I also liked that she could be very hands-on if needed which I wanted and wound up needing PP.

Tell her about your concerns at your next appointment. She seems aloof but she does listen and take them to heart. Remember, you are hiring her for her services and as one of the most expensive MW's in our state, you have every right to expect her to deliver.

My only real advice is to do some serious soul searching. You deserve to feel at peace this late in pregnancy and do everything you have to do to get to that peace. I'm here if you need to talk and s

[micah_mae_]

Originally Posted by secondimpression

We kinda-sorta know each other, hi and HUGE HUG.

With my last pregnancy, DD had a suspected circumvallate placenta (a condition where the placenta implants too deeply and peels away from the wall of the uterus). The ultrasound suggested that it was severe which led to lots of research. It came down to about a 13% risk of a catastrophic abruption at any given time and the associated risks of stillbirth and maternal death. There was also risk of growth restriction (I measured 5 weeks small 2 days before she was born so this looked like the case) and premature labor. So there was some fear about what I would do if I did have a complete abruption and there's a hospital 1.5 miles from my house. It came down to the fact that I was pretty much screwed if I did have that variety of doomsday abruption. But the only way to prevent it 100% would have been to switch to a very conservative OB and beg my way into a very early scheduled C/S. Ultimately, I took that leap of faith knowing that if I *did* have an abruption, my odds were only slightly better if I was in the hospital. Of course, the placenta was totally normal upon examination and DD was average sized and perfectly healthy.

I can also address some of your MW concerns since I delivered with the same one. She arrived just minutes before DD was born at 2:25. I called her just a little after 1:00 (I was about 4cm so I went FAST) so if you do the math, she jumped out of bed and hauled some serious butt to make it in time. She told me later on that she'd had a hunch I would be a fast labor. Her new assistant lives in Annapolis so she'll probably make it to you first and fairly quickly. The new assistant arrived at my house about 30 minutes after I called the MW but I was her first birth so she wasn't much help which I didn't want anyhow. The regular assistant was second to arrive and only a few minutes before the MW. It's true that the MW is typically very hands-off and that's why I hired her but I also liked that she could be very hands-on if needed which I wanted and wound up needing PP.

Tell her about your concerns at your next appointment. She seems aloof but she does listen and take them to heart. Remember, you are hiring her for her services and as one of the most expensive MW's in our state, you have every right to expect her to deliver.

My only real advice is to do some serious soul searching. You deserve to feel at peace this late in pregnancy and do everything you have to do to get to that peace. I'm here if you need to talk and s

Thank you for this I did talk to her and I feel relieved. She said if it was an abruption my uterus would be contracting constantly to try to get the placenta out..which it's not.
She also said that she was already planning on coming right away since my labor with Corbin was so short. I feel much better.

[secondimpression]

Originally Posted by micah_mae_

Thank you for this I did talk to her and I feel relieved. She said if it was an abruption my uterus would be contracting constantly to try to get the placenta out..which it's not.
She also said that she was already planning on coming right away since my labor with Corbin was so short. I feel much better.

Glad to hear you're feeling better! You're going to have a wonderful homebirth mama