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How to approach my desires with a new midwife

post #1 of 5
Thread Starter 

I am expecting for a second time, following a wonderful birthing center birth with my first a little over a year ago. Unfortunately, although I would love to use the same again, it is almost two hours away and with juggling appointments and a little one, we have decided that this route is not practical with our current circumstances. Also, we will be able to have pre-natal coverage for expenses this time, which we did not qualify for with my last pregnancy, and the cost of a hospital birth vs. birthing center was another, although smaller, portion of our consideration.

 

Since a more natural birth was the priority, and a homebirth is also really not an option (I'm still a bit uncomfortable with the idea, plus it would still mean the same for getting to and from pre-natal appointments as there are really no nearer midwives that will do a homebirth than there are birthing centers), I would like some advice on how to approach talking with the certified nurse midwives who are accustomed to working in the local hospital to make sure we are on the same page right away concerning birthing preferences.

 

Here's what I want (barring any REAL complications): No induction of labor or artificial quickening of labor; freedom of mobility and not being tied down to an IV or to monitors; the ability to shower and use a birthing ball for management of labor pain (I can provide my own birthing ball if needed); no artificial rupture of membranes until I am at the pushing stage and/or request that my water be broken; and control over when/if IV antibiotics will be used if I happen to be Group B strep positive.

 

After the birth, I want the baby to remain with me and family, I do not wish to use the hospital nursery in any way. Any testing necessary should be able to be done in the room (again, in the event that no complications arise). I wish for at least my husband to be present for baby's first bath, preferably for both of us to be present and able to participate. I want to breast-feed with no immediate introduction of the bottle, if we choose to do so it will be at our own pace and our own time, definitely not immediately. And I want for baby and I to be released from care ASAP. I do not want the hepatitis vaccination given nor do I want circumcision if the baby is a boy. I am OK with Vitamin K and eye prophylactics.

 

I am pretty firm on what I want if all goes normally (although obviously I am willing to accept changes if they are truly warranted). So I'd like to get this out in the air at my very first visit, so that I will have time to change practitioners or make other arrangements if necessary - as much as I don't feel like it, I know I could have things my way if I drove further, so it may be a consideration if there's no way to get this.

 

Any suggestions on how to be diplomatic, but let the new practice know that I'm pretty firm on having this baby on my terms?

post #2 of 5

If you are planning a hospital birth, I would recommend touring your local hospitals and asking them your questions about what normally goes on.

post #3 of 5

Since you have already had one baby unmedicated, I think that is really the best preparation you can have. You know that you are capable, and the only other thing you might have to worry about it telling them to just shove off and leave you alone ;)

 

Definitely bring up your desires with your care providers, but if they are anything like mine were (hospital midwives) they will be SUPER wishy-washy. They'll vaguely say that they support unmedicated birth, but if you start going into details they'll just say "oh just wait and see how it goes...." It was with my first baby and I was so un-prepared for how truly unsupportive they were. When I showed up at the hospital the midwives were all strangers to me, neither of the 2 I had my prenatal appointments with, and that didn't really matter anyhow because they aren't with you for labor at all and only show up to catch the baby. So I spend the entire time arguing with nurses saying that I didn't want an IV ("but you need it!") and all of that other stuff, which they very rarely even asked me before they started to do. I argued my ass off for "intermittent monitoring" but being confined to a bed for 30+ minutes ever 1.5 hours is hardly intermittent to me. If I were to do a hospital birth again I would not spend any time negotiating with them (they distracted me so much and I couldn't focus, so it wore me down and I got frantic and took the epidural at 7cm, grr) I would just tell them exactly how it is, haha. 

post #4 of 5
A Heparin lock is something you'll want to discuss (IV port in your hand unattached to anything). Also intermittent handheld Doppler monitoring or telemetry if your hospital offers it. Basically ask her to do all she can to support you getting upright and mobile, and allowing/facilitating non medical comfort measures. Also make clear you want to avoid time limits, but rather to drink, eat, and rest so you can go on as long as it takes. Going in later in labor with help them stay patient with you for sure and you with them, you'll be too far along to care what nonsense they say to you.
post #5 of 5
Thread Starter 

Thanks for the advice, and please keep it coming!

 

phathui5 - I've heard horror stories from other mothers about the hassle of trying to get a hospital tour in early pregnancy and of some of the larger hospital tours where they never even saw the facilities, just a slide show in an auditorium and no real Q&A session. But I think as soon as I've selected a provider, the hospital will be my next stop - better to start now!

 

Oread - Sorry about your experience! Sounds like a big let-down. I hear you on the "not really there," and to tell the truth that's the part I worry about - who really will be there and how they'll respect my wishes!

 

JamieCatheryn - Exactly! I'm amenable to accepting a hep lock if they feel it is necessary (although I'd prefer not). And I had intermittent Doppler with my first birth, again, that's no biggie to me. But the "avoiding time limits" is right on the mark. I do plan to wait out my labor as long as possible, since it would only be about a 15-minute drive to hospital vs. almost 2 hours to birthing center. But I feel that if my water were to break naturally I might want to go in at that point, as I feel that might be a definite indicator of advanced labor for me. I was one of three, and my mother had her membranes artificially ruptured each time. I was already pushing when they ruptured mine during my last delivery, I really felt like she would have been one of those few babies actually born in the sac if I hadn't wimped out and felt like it was too hard to push with her still in the sac. She was born 15 minutes later. I also was still only dilated to about 2 cm when my contractions were 5 minutes apart (and only 4 cm when they were at 3 minutes apart), so I feel that it might have pushed things TOO quickly if my water had been manually broken earlier. So that and my desire that my baby be with me are my real big issues!

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