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Homebirthers with dual care...WWYD?

post #1 of 4
Thread Starter 

So, I'm planning my second home birth and have been getting dual care from a CPM and an OB practice (one tangle is that I work as an OB RN with this practice on a contingent basis). Everything normal with me and baby. At my OB appointment last week (36 weeks), I had decided I was going to tell them about my plans for home birth.  I was all amped up heading in, and had a high BP reading (140s/80s). No big deal was made. I met with the MD, who is brand new to the practice (I've never met her) and she had no idea how to respond to my announcement, saying she'd talk with her partners, one of them would call me, blah blah blah.  No phone call, no contact since that appointment.  

 

My BP was rock solid normal (110-120/60-70) at my own home checks (I have a manual cuff) and at my midwife appointment last week. My midwife is unconcerned, as am I, about the abnormal reading at the OB office. Baby's moving normally, growing normally and heart tones are always normal. I've never had protein on a dipstick, have almost zero swelling and have gained about 1lb a week in third tri. No headaches, belly pain or other pre-e signs.

 

I went to my 37 week appointment yesterday (I'm 37+5 today), amped up again because I was anticipating a difficult conversation.  BP 140-150/80s again with the nurse.  No OB provider, just the nurse practitioner to do the measure, listen, etc. We briefly discussed my concern that my BPs were related to anxiety/emotions and that I'd been monitoring at home with normal readings, and a normal reading at my midwife visit.  The NP wanted me to go to L&D for monitoring (I declined), and she ordered pre-eclamptic labs and a 24 hour urine screening for protein, etc.  I didn't do the labs yesterday. 

 

Just wondering how you might handle my situation. I think I'm going to do the bloodwork today, just to prove I'm normal. I don't think I'll do the 24 hour urine unless the bloodwork shows something. If abnormal, then I'll cross that bridge when I come to it. I mean, I'll have this baby any day (or at least within 2-3 weeks). If transfer became an issue, it'd be helpful to have shown "normalcy" by their parameters.  But, I feel this BP issue is definitely related to emotions and am trying to balance whether I want to keep going to the OB office or not.  If so, I need to find a tool to keep myself chill for the visit so I don't get all worked up into high BP.

 

Thoughts? Suggestions? 

post #2 of 4

I guess I wouldn't see any harm in participating in the labs. If there is nothing to worry about, then the labs won't show anything is wrong. I am a little curious why you would have been pursuing both types of care all along. That seems like you'd constantly be getting conflicted information. But now that you're this far into it, I think I'd try to cooperate with them. If there's nothing wrong, the labs will vindicate your position. If there is something amiss you'll have more important information to work with in your decision making. 

post #3 of 4
Thread Starter 
Thank you. I was doing dual care because I've had a previous preterm birth and wanted to be established with a medical provider if I had another preterm labor, or needed to transfer in labor.
No news on the labs so I'll follow up tomorrow. If all is normal, I'll likely not go back to the OB office again.
post #4 of 4

I go to a CPM, and have OB back up. I go to the CPM for all my regular prenatal appointments. And I go to the OB so I have a doctor that's midwife/homebirth friendly in case I need to transfer. My OB does know my intent is to have a home birth (and OB is totally supportive of the choice), and that I would only transfer in case of emergency or in the case that my midwife couldn't make it to my house in time (winter birth living in rural/small mountain town - midwife lives much further from me than the OB/hospital).

So I would probably take all the results to my midwife and discuss them with her. And I'd also try to get more information on why they wanted to do follow up testing. 

Also, meditation and breathing do wonders for keeping me calm. :)

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