no midwife for me? So very, very sad....

[Sage_SS]

I just checked out the midwives site for BC and after reviewing the terms and conditions of who is applicable for a midwife, I don't think I can have one

My last two pregnancies I was bedridden from 4 and 5 months on with severe pubic symphysis problems. This alone made me a moderate to high risk pregnancy. With my last pregnancy I had a pulmonary embolism at 31 weeks, and THAT rockets me into the high risk pregnancy. Midwives don't accept high risk pregnancies. :

I have such high hopes that this pregnancy will be totally different from my last two. I have dreams I'll be healthy and happy. I envisioned a homebirth with caring and knowledgeable midwives at my side, welcoming in our new addition with love and support.
Now I have horrible visions of hospitals and specialists... I'm too hormonal for this, I'm fighting off tears..

[sarah_bella1050]

You could always schedule an appointment to talk to the mw. What if this is a completely normal pg? Mw's usually have good backup midwives or OBs which you can use if this time turns out to be high risk too.

[Sage_SS]

Thanks Sarah, but my last two pregnancies I had obstetricians that specialized in high risk pregnancies. I don't think my history will convince them...

[sarah_bella1050]

Originally Posted by Sage_SS

Thanks Sarah, but my last two pregnancies I had obstetricians that specialized in high risk pregnancies. I don't think my history will convince them...

Maybe you could at least go with the mw's backup OB, they will probably be the most considerate of you wishes and more open to natural birth.

[Sage_SS]

Good idea!

I'm also going to look into a doula.. we'll see what happens tomorrow.

[mothercat]

I'm not sure I would give up hope just yet. If the biggest problem was bedrest R/T severe SPD then why not be proactive about the SPD.

Just found a book that was actually published in 1999 by a physiotherapist, Cecile Rost. It's called Relieving Pelvic Pain. Great explanations about the instability of the pelvis and how to fix it. The first section is self-help, but if that doesn't do it, she wrote the second half for physical therapists. She tells women to take the book with them to the PT and the PT will know what to do. You can get a referral for that from your doc.

Linda
CNM, who thinks we should keep looking for answers.

[Sage_SS]

Thank you for the reminder to be optimistic mothercat!

Can you please tell me what R/T and SPD and CNM mean?

[mothercat]

The first two are directly related to the last. I am a Certified Nurse Midwife who has a home birth/birth center practice. My last baby was born at home.
Unfortunately when I am tired or ill I tend to short cut my messages and resort to jargon.

R/T is "related to" and SPD is "symphysis pubis dysfunction".

I think that chiropractic care is a good first step in solving pelvic instability problems like SPD, but without strengthening the muscles supporting the bones of the pelvis, the effects of chiropractic care are unlikely to provide long term pelvic stability.

Had a conversation with one of my clients today. She has complained for years about the low back pain and after several visits and conversations she was finally convinced to go see a chiropractor. She had one visit yesterday and has been relieved of pain she has had for months. Pregnancy was starting to make it much worse. She can't believe the difference it has made. Turns out that one side of her pelvis at the lower end of the sacroiliac joint was torqued and this was causing all the other problems.

Correcting these things can make a huge impact (beneficial) on the pregnancy and birth.

Hope you can find some help and get this resolved soon.

[Defenestrator]

I don't know the system in BC very well, but one thing that I would encourage you to do is to consult with multiple midwives in person or on the phone before ruling this out entirely. I have found that different midwives have radically different ideas about who is high risk and who isn't. Some midwives might also have systems in place for consulting occasionally or co-managing with more high-risk OBs. I can't tell you the number of times I have encountered women who said that they walked into a midwife's office and were told, "Blahblahblah makes you totally ineligible for midwifery care" when it is something that another midwife wouldn't bat an eye at.

I would guess that the pulmonary embolism was related to the months of bed rest and if you can find a way around that then you would be at less risk for it. As a midwife that is the first thought that I had and if you didn't present any other independent risk factors then I would focus on trying not to duplicate the situations that caused the embolism this time.

I had pretty horrible SPD with my last pregnancy, so I sympathize. Chiropractic was helpful for me, as was binding. I also found that strengthening my back muscles helped me not adopt postures that stressed the joint.

Good luck!

[MsBlack]

Last year I had a client who was told by her hospital care providers that her SPD ruled out a normal birth, made her 'high risk' all by itself. I was so shocked at the treatment she recieved w/her first birth--they forbade chiro care, she became bedridden for last part of pregnancy and couldn't walk at all for some weeks following the birth. Used a walker for more weeks after that. Before meeting me for second time around, she'd discovered chiropractic and the benefits of exercise. Her second pregnancy was HUGELY different!

She used exercise, chiro and binding to great effect. NEver became immobilized tho she did have a small degree of pain in last weeks. Nevertheless, she had an easy delivery all on her own steam and was up and walking immediately afterward without ado.

And I agree with pp--so very likely that your embolism was related to bedrest!

There is much you can do for yourself--get started now, and don't give up hope. With the right kind of actions on your own part, and help from the right professionals, you are very likely to move out of that high risk category altogether.

[Sage_SS]

I'm all for preventative measures.

[Sage_SS]

I just got home from my appt with the midwife. She had to refuse me, I'm the first one this year. I knew it would happen, I got all the crying done about it awhile ago, but having it confirmed just sucks.

The PSD sucks, but its not what makes me high risk. The pulmonary embolism is the "nail in the coffin" so to speak. The chance of transfer of care is nearly guaranteed. So now I have to find an obstetrician

I start chiropractic care tomorrow to try the preventative way to deal with the PSD. The midwife also told me its nearly guaranteed since I had it with my last two pregnancies, but she does have a lot of faith in the power of positive thinking. I guess we'll see what happens! If it turns out that the PSD isn't as severe as its been the last two pregnancies, then it might be possible to do a late transfer of care. I have an ultrasound on May 7th to confirm my due date.

[Jane]

Have you had testing for clotting disorders like factor V leiden and MTHFR? Are you planning to be on anticoagulent therapy to prevent PE?

I'm sorry you are "risked out" - but I am confident that you can develop a plan for your birth with people you trust in the next 30 weeks.

[Sage_SS]

No I haven't. I've just been told that aside from not being able to take birth control pills there are a number of medications I can't take. My doctor is useless and needs to retire. Around here, I need a better reason than "my doctor sucks and doesn't do anything for me" to qualify for a new physician.

As far as I know, according to the PE I had last time, there are no treatments for it while pg. I spent two weeks in the hospital because there were no treatments they could give me, the only reason I went home is because I demanded to, since they couldn't treat me anyway. By that time I was seeing the OB weekly anyway so he kept a really close eye on it.

See, the thing is, I am believing with everything in me that I won't get the PSD again, which will at least lessen the chances of the PE since I probable got it due to the bed rest. I have fighting against the odds, but what I believe or don't won't get me anywhere. Decisions for my care are based on my medical history, and according to my medical history, I will be bed ridden from earlier than 4 months on, and I will get another blood clot, somewhere, hopefully not my brain.

I'm remaining optimistic and branching out to acupuncture and chinese traditional medicine, along with chiropractic care and naturopathic care. I will do everything in my power and exhaust every avenue to have a healthy and enjoyable pregnancy.

[clutterbug]

Originally Posted by Sage_SS

As far as I know, according to the PE I had last time, there are no treatments for it while pg. I spent two weeks in the hospital because there were no treatments they could give me, the only reason I went home is because I demanded to, since they couldn't treat me anyway. By that time I was seeing the OB weekly anyway so he kept a really close eye on it.

Hmm, I am not a professional but I thought anticoagulant therapy during pregnancy was very possible to prevent clotting (and to treat it - someone I know just had a shot a few weeks ago for a suspected clot). Maybe they couldn't agressively treat the PE once it had already formed, but I thought there were safe preventative therapies out there to avoid it happening again, should you find yourself on bed rest again this time (I hope not!).

[Sage_SS]

hmm. I don't know about preventing. I guess I'll find out when I talk to the OB.

[Ilaria]

There are many mamas here on anti-coagulant therapy (heparin/aspirin) during pregnancy. Also many mamas with clotting disorders. Just do a quick search.

[maxmama]

Um, if you threw a clot in a pregnancy, then YES, you need to be anticoagulated in this one. Pregnancy predisposes you to clots anyway. It's much more risky than taking OCPs.

And yes, if you're anticoagulated, most midwives cannot care for you under the agreements they have with their backups/hospitals, and if anticoagulated, you should not birth at home, IMO.

[NatureMama3]

The midwife also told me its nearly guaranteed since I had it with my last two pregnancies, but she does have a lot of faith in the power of positive thinking. I guess we'll see what happens! If it turns out that the PSD isn't as severe as its been the last two pregnancies, then it might be possible to do a late transfer of care.

I had severe SPD with my first 2 full-term pregnancies (twins and a singleton) and the most I've heard from it so far this pregnancy (going on 33 weeks) is just a twinge here and there. And there's not really anything different with this pregnancy aside from a larger baby. So while it may not be common, it is POSSIBLE to avoid SPD a 3rd time.

As far as the PE goes, I would definitely ask about anticoagulant therapy. There's no reason to 'wait' and see if you get one and then have that crisis.

[Sage_SS]

Thank you all for your words of advice, encouragment and support.

When I see the OB, I'll def. ask him about the anitcoagulants. I'd really rather never have a PE again, it was a horrifying experience.

I'm on my way to kick off my chiro therapy! I'm really excited to see what kind of difference it will make! I've heard alot of good stuff from women on here.