Vitamin K and other things - thoughts?

[ndunn]

Hi,

I am expecting my first daugther on March 30th and we are definately not doing the eye drops as I'm married and have no STD's judging from a very recent pap that I had done. I am going to do the PKU because I think its a good idea, but only after breastfeeding is established with my milk in and everything. The one we are contemplating is Vitamin K. Our midwives are giving us such a hard time about this one (as they are about not wanting the pitocin shot for ROUTINE 3rd stage management at a homebirth...I am open to it if it is an emergency but would like to trust my body first to do its job) and everytime I go to my appointments they railroad me so badly that I'm literally almost in tears when I leaving thinking that I"m doing this horrible thing to my child by not giving her vitamin k. Here in canada, we can't get anything but a vitamin k 1 in a base of a bunch of preservatives and I wouldn't give that orally. I did however , order a vile of natural vitamin k (alfalfa derived) in a base of olive oil from the USA and this nice midwife down there is shipping it to me. Incase of any traumatic circumstances, I am keeping that on hand to consider giving orally. THe problem is that this is keeping me up at night because my midwives make me feel like I'm crazy and horrible for my decision and it makes me second guess myself. I guess I'm just looking for some support as I see that SO many people and midwives from the US don't give vitamin k and are totally cool with it but up here in canada where midwifery is regulated in my province it seems like I might as well have a doctor because the care I'm getting is so bloody medically inclined.

Any thoughts?

Ps. they are giving me a really hard time about not wanting a 39 week internal and sweeping of membranes, even though my baby is in a great position etc etc etc. What is up with that?

[stayathomecristi]

Oh boy. sounds like you are between a rock and a hard place. Not fun.

Here are my thoughts:

1) If they are being such sticklers over these things prenatally, what other surprises will you find at the birth? You need to feel that you are safe and in competent hands when you labor. I think it's o.k. for them to have opinions on these things, but when you resist because you don't feel it's in your best interest and they do not respect that, it's not a good sign.

2) I'd bet it's a long-shot at this late date, but can you find another m/w?

3) On the other hand, having a midwife (almost any midwife) is much better than using an OB as far as interventions go.

4) I think that you need to write up a birth plan and be very specific.

i.e. I do NOT consent to Vitamin K injection for my newborn.
I do NOT consent to pitocin for the third stage of labor unless medically necessary
I do NOT consent to ointment in my newborn's eyes.
I will consent to the PKU test after my milk comes in and breastfeeding is well-established.

This way, you at least have some recourse in the event that they go ahead and do things that you have chosen not to.

5) My final thought is that I'm wondering if you can talk with them and tell them that you are feeling railroaded. Tell them that you are making informed decisions and that you appreciate their concern, but in the end you have to live with the choices that you are making. You would appreciate them backing off since they have given their opinions and you have seriously considered what they are saying, but have come to a different conclusion after researching.

HTH

[ndunn]

Thanks for your thoughts. I have tried and tried and tried to find another midwife. No one will take me (well I wouldn't want just anyone to take me anyway as I might risk them being the same way as these ones). The more natural midwives in town are either a)too backed up with clientel or b)too afraid to take me on because of the political backlash it could cause from my current midwives (yes, I think for this reason regulation is not always a good thing with midwifery). I think its so increadibly awful that the care for the mother is being compromised by petty politics between midwives. Anyway, I've tried. I wanted to hire an independent birth attendant so I'm trying to come up with the money for it but my husband and I are not really in the position to afford that! Nevertheless I'm trying hard to get a loan for it ($3000). In the mean time, I'm due in 6 days!! I feel like things are getting messed up because of this situation. I am afraid to go for walks or even be intimate with my husband because I don't want to go into labour and have these women at my birth as I'm so scared of them. I have told them that I don't appreciate them telling me what I should do and they told me, get this, that obviously I was doing the WRONG research if I decided against these things (doppler to listen to heartbeat at appointments, vitamin k, pitocin, vaginal exams, etc.) When I'm away from their office I feel supported and not crazy but when they enter the room I feel scared and vulnerable. So yes, I'm scared of them coming when I'm in labour because I'm afraid that they are going to say something is an "emergency" and they need to do a certain thing and I'm going to consent and find out later that I wouldn't have constented if I had of researched it myself. My darling husband is willing to go to bat for me but its sad that his attention would have to be focused on fending them off instead of helping me bring our baby into the world. I know I can research the heck out of most topics now and decide what my stance is on them, but there are unforseen things that can arise where I'd need to make a quick decision, and if I can't trust my caregiver, how could I trust their opinion in that situation?

[stayathomecristi]

Ugh. I really feel for you.

You do NOT need this stress right now when you are preparing physically and mentally to have this baby. Babies are born with love or with fear and the fear alone can mess up your labor/delivery.

If you are not able to hire an independent birth attendant (and I really hope that you are), then perhaps you want to at least find a doula who will also go to bat for you while in labor. I know your husband will be there, but a doula's experience can be invaluable in situations like this.

I hope that you can work all of this out before the baby decides it's time.

I just read your p.s about sweeping membranes. I wouldn't do it personally. Sounds to me like the m/w's you have right now are more into speeding things along for their own benefit (same with the pit for the placenta--it's usually done for their convenience b/c it speeds the delivery of the placenta and can reduce bleeding, but as you know putting baby to breast right away can also facilitate birthing the placenta).

[veganf]

Originally Posted by ndunn

get this, that obviously I was doing the WRONG research if I decided against these things (doppler to listen to heartbeat at appointments, vitamin k, pitocin, vaginal exams, etc.) When I'm away from their office I feel supported and not crazy but when they enter the room I feel scared and vulnerable.

Wow, I can't understand why they'd treat anyone like that. Sounds awful and uncomfortable. I'd be nervous about how they'd treat me during labor and birth if they can't even be gentle and supportive now!

My midwife never did a vaginal exam until my 6 week postpartum visit! I never had pitocin, babies never had vitamin K, and she only used the doppler during labor, otherwise she used only a fetoscope. She never ever made me feel bad for asking for these things. Neither should your midwives, IMO, no matter what kind of midwives they are. I think you should have a talk with them about how they're making you feel.

- Krista

[ndunn]

I agree. I have mentioned how I feel and they basically laugh it off and act as if I'm this naive young mother (early twenties) who doesn't know what she's getting herself into and is just trying to be "natural" and "non-interventionalist" without anything to back it up. To me, it makes sense that since i have a)no history of anyone in my, or husband's family being bleeders b)an amazing diet consisting of only organic, non hormone, no preservative, natural, whole foods etc etc c)a habit of alfalfa, red raspberry, nettle and dandelion teas on a daily basis....and many other things, that my risk for having a baby with a problem without the vit k shot is very low (except ofcourse if I had a long traumatic birth experience which Idon't think is going to happen). The problem is that their philosophy of care is so different to mine and so MEDICAL for a midwife that I just can't get them to see things my way. Oh yes, and I've taken hypnobirthing and loved it and really can't wait to use it in labour as its helped so much in my daily life...but I've heard from countless people that my midwife favours a VERY coached pushing stage (I don't even want here there until the head comes out !!) and I'm scared she's going to do something to disrupt the atmosphere at my baby's birth. Doulas are expensive here, so I'm trying to find a free one...but they've all said that they wouldn't go to bat for me in terms of fending off the midwife, they would just help me remember my birth plan which I can do just fine on my own.

[sapphire_chan]

How disrespectful and unprofessional can someone get? You and your dh should at least discuss the possibility of going unassisted just in case you have to fire the med-wives during the birth.

[ndunn]

Yes, I'm contemplating that. I was thinking I could see how it goes and then if all goes well call them when she comes out and have them come to do the exam etc. I would just be afraid incase she didn't breathe right away when she came out I don't know what the "norm" is since I've never been at a homebirth so I would be kind of apprehensive. Plus, what about things like shoulder dystocia, and the cord around the neck? And as well, they say they have to listen to the heartbeat every half hour during labour and almost continuously during pushing so does that mean to not listen if I did it unassisted would be irresponsible and asking for trouble? I don't have a fetoscope.

[Tofu the Geek]

Wow, sorry you have to go through this! My province doesn't have regulation which has resulted in us having only ONE midwife in my city. She's more medical than the midwife from my last birth (in another province) but she is NOTHING like what you are getting! I sometimes wonder what the purpose of a midwife is if she isn't doing anything different than the doctor...okay, I guess she is coming to your house, but I don't know how many people would want their doctor attending their homebirth!

Oh, not sure if you've doing any reading on the "virgin gut", but I know that some people wish to avoid oral vitamin K so they don't disturb the gut flora of a breastfed baby (which is important not to do especially at an early stage). Not sure what choice this would leave you with though...I opted out of vitamin K entirely my first birth, and that was the hospital and nobody gave me a hard time.

As an aside, what the heck is "sweeping" the membranes? I've heard it mentioned before but have no idea what it means.

[violetbutterfly]

Wow, you might as well be going to an OB, huh? I think it could be tricky since it's your first baby but how would you feel about "forgetting" to call them until baby is out or almost out and then have them there for just a look over of you and baby? Besides hiring an independent midwife (some take payment plans) I don't see any other way around their horribly negative and controlling attitudes. That's not good for you or baby. Of course you could have them there and still have a great experience but I think someone would have to just get downright rude with them. Please keep us updated...you deserve a wonderful birth experience and i'm praying you get it.

[ndunn]

Technogranola, what province are you in/were you in? Just out of curiosity...

[ndunn]

By the way, here is some info on membrane sweeping from gentle birth archives:

Stripping membranes involves sticking your finger into the cervix and separating the cervix and lower uterine segment from the membranes. It generates local production of prostaglandins and frequently brings on labor in someone who is close anyway. It almost certainly increases the risk of chorioamnionitis and premature rupture of membranes. Its use is controversial in the obstetrical literature, and in my opinion, for what that's worth, it is dangerous and unnecessary. Labor starts when it is time, leave well enough alone.


When mom is ready and relaxed (as much as possible), start as if a usual internal exam. It helps a lot if the mom can be in a position to give you a greater reach -- lying on firm surface with bottom elevated on low pillow helps. Using sterile gloves, and sterile technique, (gently) put one and then two fingers into the cervix. You will attempt to "follow the cervix around", loosening the membranes from their attachments. As you slowly do this, gently stretching the cervix, you should feel it opening and relaxing. (Often you can only get one finger in at first, after a minute, the cervix will open another few centimeters). Moving gently and slowly, you should gradually be able to move your finger(s) more deeply to the sides, separating the bag of waters from the lower uterus... take your time, be very gentle, move slowly -- five minutes is not too long -- stop and wait (or back off) if it's too uncomfortable for the mom. Move your fingers outward, to the sides, not upward toward the BOW. STOP if you feel firm adhesions, or a gravely surface (this might be placenta).



To me it sounds totally wrong. Like someone I know once said, if she ever stuck her finger up the foreskin of a grown man hard enough to draw blood she'd be arrested.

[Tofu the Geek]

Okay, that sweeping the membranes thing sound scary and painful! There is no way I'd let that be done to me to start labour. I'll play it the old fashioned way and let it happens when it happens!

I know when I was in labour for my first I was stuck at about 9.999999999 cm () for hours. My midwife reached a finger in and did a little push (I think the said she was just going to push the cervix back a bit) and I was so exhausted I didn't even worry about what she was doing. It only took her a second, and right away baby's head was on its way (and after 12 hours of already being in labour I was ready for that!). So I'm not sure if she was doing the same thing, and not sure if I'd allow it again, but it seemed to do me good in my case at that late stage in labour.