Hi ladies! This is lengthy, but I'm having a hard time processing my current birth options and could really use some advice/ideas/related stories.
My first birth was in a hospital before I became knowledgeable about birth biology, and I was induced at 41 weeks for "low fluid". I was not in labor at all at that point, and the induction was difficult but took and my son was born vaginally the next night. There was no talk of my placenta that I remember, but I was also sort of drugged so I might not have remembered if there was.
During my second pregnancy I became excited about the idea of a home birth as I read more and more about it, and decided to have one. I was completely at peace with the whole process, even though labor didn't start until 42 + 3. Labor was spontaneous, uneventful, and she was born perfectly. She was large (9 ish lbs), had no vernix left, lots of dry peely skin, and very long fingernails, as well as meconium in the fluid. I think those characteristics classify her as a truly "overdue" baby, not just one that had miscalculated dates. She was perfectly healthy, though, and I loved the whole birth experience. However, when my placenta was born, it was discovered to be very small, almost black in color, and really deteriorated (as in, falling apart). Pieces would easily fall out of place with gentle touching, so the midwife had a difficult time determining if it was delivered complete or not. I was bleeding throughout the day, passing large clots, and passing out when I got up to use the restroom. My midwife advised going to the hospital, but I was in such a "I just had a baby at home, I am freaking Super Woman, no way am I going to the hospital" frame of mind that I refused. For the next 8 days I got very sick, but I didn't really know it. I just assumed that I should feel like crap after I had had a baby. I was very pale, had a fever (but didn't realize it) and just in general felt really bad but I couldn't put my finger on the problem. I actually stopped bleeding at only three days post partum, so I felt that I was physically fine. But on the eighth day I was so sick, I just started crying and told my husband that I had to go to the hospital, something was wrong and I couldn't handle it anymore. I sat there all day while they were convinced it was anemia and sleep deprivation. Finally, right before I was about to leave, a nurse took my temperature, saw that I was feverish, and ordered an ultrasound. According to her, there was "a lot of placenta in there". They scheduled me for a D&C that evening to remove it, since my cervix was obviously closed at that point. I was very anemic before the surgery, and apparently lost a good amount of blood during the surgery, that they gave me a blood transfusion after. Within a day I felt totally normal again.
During my third pregnancy, I planned another home birth. I had loved my last one and had no real reason to believe that my placenta problem would repeat itself, but it did. I again carried past 42 weeks (42 + 2) and labor was spontaneous, short, and awesome. Birth was smooth, and I actually felt good after instead of feeling awful like I had before. But my bleeding was worrying my midwife again, and my placenta was actually worse than my last had been (blacker, smaller, falling apart to the touch). This baby was similar to my daughter in size, lack of vernix, and meconium. We were unable to determine if all of the placenta was out, so we tried herbs (I know Shepherd's Purse for sure, can't remember if we tried more) and I had a smoothie made with a small chunk of my placenta. I was drinking lots of coconut water and laying in bed, nursing. I felt good, so I was still refusing to go to the hospital, but when I tried to get up to pee within a couple of hours of the birth, I passed out and my hubby and midwife carried me downstairs and took me to the ER. I had been receiving secondary care at the hospital, so after the baby was born and I had been having a lot of bleeding we had phoned to let them know we might be coming in, so they were expecting me. The ob on call was actually the high risk ob, and he was surprisingly nice and kind, and never really brought up my home births or made them an issue. They immediately gave me a shot of methergine to encourage any remaining tissue to come out, and he then went in for manual extraction to try and remove the remaining pieces that were visible on ultrasound. It was the most excruciating thing I have ever been through in my life! But he was unable to get the pieces out, which convinced him that they were actually adhered to some uterine scarring. That was the previous diagnosis as well, considering I had given my body eight days after my daughter's birth to expel the pieces and it didn't. I went in for a second D&C and was able to go home that evening without needing the transfusion again.
I am now 29 weeks pregnant with baby #4, and contemplating the upcoming birth. During the first half of this pregnancy, I was planning my home birth like normal, encouraging family to fly in during the 42nd week like normal, and that I would carry on like I always have. But I'm now feeling that my body is operating outside of the normal realm, and that I shouldn't act blind to it. It's so hard for me to consider that something could actually be "wrong", because I am such a huge believer in birth and biology and love my home births so much. The idea of even going to the hospital makes me really upset. But I have so many questions that nobody seems to know the answers to. It seems to me that, considering the size and conditions of my babies, my body isn't going into labor when it should (when the babies are ready), but it is going into labor when the placenta begins falling apart. That to me seems...risky. I feel that, reviewing my last two births, waiting until labor starts on its own in that 42nd week may be a risk to the baby's health. I know that post dates aren't usually an issue, but they become an issue when the placenta begins deteriorating, which mine clearly does. So I wonder, if I let this pregnancy carry to spontaneous labor, would that be putting my baby at risk? Why did my body not go into labor earlier the previous two times, and what if it doesn't go in to labor on time this time, or labor takes longer and I lose the baby? That seems to be a legitimate worry when you have such a sad, black placenta. I also believe that induction is a huge risk, and not one I'm willing to take in the hospital without a clear medical reason (is this a clear medical reason?). I have seriously considered trying to self induce around 40/41 weeks with a cohosh or castor oil, but both of the local midwives I have talked to are very against that idea. I can't decide if waiting for labor is more or less of a risk than inducing in some way. If this baby passes meconium, then I know inducing in any way is more dangerous, but I can't even image dealing with the grief of a still born and feeling like it could have been avoided if they had been born a little earlier.
A few more points about my pregnancy history and general health: I have had hyperemesis with all 4 of my pregnancies that lasts up until about the halfway point. I am unable to eat anything for months on end and live on white bread, apples, and lots of medication. I can't help but wonder if the hyperemesis could in any way have to do with the placentas, because I know that nutrition is a key component in healthy pregnancies and placentas. I also get very anemic in all of my pregnancies, and supplements have had little impact. I am not usually anemic outside of pregnancy unless I am on my period. And lastly, I get pica in all of my pregnancies. It has always been a strong craving for smells, such as gasoline, bleach, sharpies, etc. But in my last pregnancy I was craving paper, and started eating a lot of it. I was so embarrassed I didn't tell anybody. This time it is happening again, and while I am doing much better at not letting myself eat it, the craving is huge and I have no idea how to conquer it. So, I have HG, pica, anemia, super decaying placentas, and very post dates babies. What is the safest course of action for this birth?