something funny and 2 concerns/questions

[littlemomma]

First for the funny:

Yesterday at my MW appointment, when I went to pee in the cup, my belly was so BIG I couldn't see what I was doing down there and peed on my hand and the side of the cup! No urine test for me that day. They really need to install mirrors at the bottom of those toilets (not that I could see those either...hmmmm).

Now the serious:

1. I've been religiously doing my pelvic tilts and watching my posture and not slouching on the couch, etc. My DS was posterior and it suuuuuucked. When I told my MW I was being so proactive, she said that it didn't matter what I did or didn't do, that baby postioning is more about the fit of THAT baby with THAT mom at THAT point in time. She specifically said that lying around on the couch would not matter. Hmmmm....now I'm confused and not nearly as motivated to do my exercises, etc. What do y'all think?

2. This is a big one: My "due" date is Dec. 18th, based on a 28 day cycle. I KNOW when I got pregnant, as I was charting, using OPKs, KNOW when my LMP was, and KNOW when I had sex that month. However, my ultrasound at 11 weeks (which I'm now regretting) dated my little peanut 10 days bigger. If it is greater than 7 days, they change the due date. So, they think I'm due Dec. 8th. I brought my chart and explained that this was causing me anxiety, as I don't want to be pressured to induce or take tests and I want to give my baby his 14 days "over" and not cut him short. She said the ultrasound "trumped my chart." I explained that had I gotten pregnant when she said, it would have to be immaculate conception, as I was on my period and not having sex!!!! She said, let's not borrow trouble and deal with this as it comes, that it may not be an issue at all (which I know, but still). What should I do? BTW, changing MW is not an option, as they are the only MW practice in my town. I'm thinking about meeting with the dr that they work under and explaining my case to her/him to see if it would get me anywhere. Anyone else been here?

Thanks for reading this long one.

[Spark]

Oh! Littlemommma! :hug Man! What a situation!!!

Funny: :LOL That IS funny! If I want to check my urine I just hold the actual strip down near where I imagine pee will come out and pee right on it. It gets a little wet, but heck, it's just my own pee.

1. Serious -- Warning bells going off for me. A MW who doesn't know about encouraging proper positioning!?!? That really seems weird to me.

2. Serious -- MAJOR Warning bells.

I think I'd go back to the beginning with her and schedule an interview appt. You can explain it however you want -- "I realized we never sat down and really talked about your birth philosophy. I figured, no time like the present!" I'd do a complete interview with her. It's possible you don't really know where she stands about things.

Personally, and to be totally honest with you, I would leave her practice. Those two issues are enough to convince me that she's not listening to the person that knows most about your pregnancy -- YOU! I wouldn't be tempted to fall for the wait and see if something goes wrong, because now is the time to act.

You still have options. You're never totally out of options until you check yourself in while in labor or for an induction or cesarean.

You might consider posting this exact post (minus the funny) over in the Midwives/Doulas/Birth Educators forum. http://www.mothering.com/discussions/forumdisplay.php?f=228 They'll have lots of good feedback for you.

[littlemomma]

Thanks, Spark. And I will post over there. Good idea. The only thing is, like I said, these are the only midwives. To change practices would mean going to an OB somewhere, which would most likely be even worse. I'm trying to get an appointment with the OB over the midwives to see if she can be persuaded. I will keep you updated. Thanks for you response.

[Geofizz]

Too funny about the peeing in a cup. It had never occured to me to use Spark's method -- I'll keep that in mind.


1. I've been religiously doing my pelvic tilts and watching my posture and not slouching on the couch, etc. My DS was posterior and it suuuuuucked. When I told my MW I was being so proactive, she said that it didn't matter what I did or didn't do, that baby postioning is more about the fit of THAT baby with THAT mom at THAT point in time. She specifically said that lying around on the couch would not matter. Hmmmm....now I'm confused and not nearly as motivated to do my exercises, etc. What do y'all think?

There is a study (http://bmj.bmjjournals.com/cgi/content/full/328/7438/490) showing that starting pelvic rocking at 37 weeks does not improve positioning. *HOWEVER* this does not address the issue you have here: starting much earlier (with a smaller baby) to achieve anterior positioning. I can't find a single study on this, though. I *do* know that if I lie on my left side, I can cause the baby to shift positions, indicating the validity of the notion that your posture (or exercises) can affect positioning.

2. This is a big one: My "due" date is Dec. 18th, based on a 28 day cycle. I KNOW when I got pregnant, as I was charting, using OPKs, KNOW when my LMP was, and KNOW when I had sex that month. However, my ultrasound at 11 weeks (which I'm now regretting) dated my little peanut 10 days bigger. If it is greater than 7 days, they change the due date. So, they think I'm due Dec. 8th. I brought my chart and explained that this was causing me anxiety, as I don't want to be pressured to induce or take tests and I want to give my baby his 14 days "over" and not cut him short. She said the ultrasound "trumped my chart." I explained that had I gotten pregnant when she said, it would have to be immaculate conception, as I was on my period and not having sex!!!! She said, let's not borrow trouble and deal with this as it comes, that it may not be an issue at all (which I know, but still). What should I do? BTW, changing MW is not an option, as they are the only MW practice in my town. I'm thinking about meeting with the dr that they work under and explaining my case to her/him to see if it would get me anywhere. Anyone else been here?

Thanks for reading this long one.

You're right. This is the biggie.

Do you have a local LLL group? I find that this is a good place to find recommendations for things like care providers. Remember that family practice docs can also attend births, so don't restrict yourself to OBs and mws.

If you *really* have no other choice for health care providers, remember that you can always choose to not show up for any appointment or induction.

[littlemomma]

Good point, Geofizz. Thank you.

[littlemomma]

I actually did not know that family practice docs could attend births. Do they all?

[Taedareth]

Oh my goodness, littlemomma! As far as point #2 goes, that's the type of thing I would expect from an OB... not a midwife! Ina May's book says that size/weight measurements by ultrasound can be waaay off. Obviously if you know when you ovulated and know when you had sex um... no ultrasound can change those facts! Immaculate conception, lol... How frustrating that some practitioners trust technology over accurate charts and common sense.

Maybe you will have better luck with an OB. I've heard some people say they were pleasantly surprised to find an OB who supported their decisions and was comfortable letting the client be in the driver's seat. But then, I've also heard people say they thought their OB was supportive of their decisions, only to find that in the birth room, he/she went into commando mode and they suddenly found themselves on the receiving end of unwanted interventions. :(

You sound very knowledgeable and clear on your facts. Stick to your guns! No practitioner can forcibly induce you. Even if your midwife or OB recommends it, you can always refuse. :hug

I actually did not know that family practice docs could attend births. Do they all?

The ones who can afford the malpractice insurance do. Ask around! There are some great family practice docs who attend births and are way more supportive of natural birth than many OBs. :)

[selazenby]

Funny - I am so right there with you on this! Last time I was attempting to pee in the cup I was flying totally blind. I ended up only getting a teeny bit actually into the cup and had to bend the dipstick in a million ways to get it all in there.

Serious 1 - I have to agree with Claire on the warning bells here, but I also sympathize with your situation of not having a lot of other options. I will tell you though that I can guarantee that pelvic rocks allow baby to change position easier - when this baby is in a position that is uncomfortable for me, I drop to the floor and rock away and she usually moves - at least for a little while. And there's certainly no harm in trying whether it's proven or not!

Serious 2 - Again, big, big and bigger warning bells. The whole ultrasound, dating, sizing thing makes me crazy because it's so often so off. And if you were charting then you truly do know - the fact that your midwife is not giving that (and you) the credit that it's due really bothers me.

I do not think that in every case and in every way a midwife is better than a MD. I feel very lucky to have my wonderful midwife, but if she didn't have the philosophies she does, I would certainly not stick with her just because she's a midwife. And I've known some OBs who are extremely supportive of natural childbirth. A Family Practice Dr is a great suggestion if you can find one who delivers babies.

I'm so sorry that you're in this situation at this point in the game. Good luck - and let your wonderful powerful mama instincts guide you!!

[BensMom]

I'm popping in here cause your friend Amy said you needed help! :wink Where in GA are you? There is a great network of GA mamas here (check out finding your tribe) or you can PM me and I can ask around for you. I am also a doula and part of the GA Birth Network, so I can ask around there for good providers as well. Have you considered home birth? There are some wonderful HB MWs in GA that will actually listen to their clients about due dates and are well versed in OFP. :D

Anyway, let me know if I can help. This would be a huge warning bell for me. How willing would they be to listen to your wishes in labor if you are completely disregarded in pregnancy.

Oh and as a doula in GA, i would love to know which practice this is, in case I encounter them in the future with a client.

Good luck to you!

[xmasbaby7]

My sympathies, too.

My only two cents is trying to be optimistic because the last thing you want is the stressof changing.

In email it is hard to know exactly how the conversation occurred, but maybe she was actually trying to offer a calm, "Don't worry about it" about the positioning thing beacuse she thought you seemed so stressed and she was only trying to help. Like, don't blame yourself you do all of this and the baby's still posterior. YKWIM?

As for the ultrasound, much more disturbing. Again, though, she could have been trying to say what my MIL always says, "Don't waste a good worry." Meaning they would be more open to listening to you at the time you start going late.

I would probably not set up an interview with her at this time because I think your *rightful* anxiety about this will backfire at this time. I would encourage you to look at other options with GA moms like homebirth or cool OB's people know of. If your gut tells you to change, then change.

Good luck!

[kir]

I TOTALLY sympathize -- especially with the bit about not being able to change doctors/MW's. My doc this week told me that with twins i have a 70% chance of c-section...I was like "even though one is vertex, i'm totally healthy, the babies are doing great, placentas are up top, i'm doing exercises every day to keep them moving, AND i want a natural birth??" She didn't see moved by any of this. I can't change docs b/c i can hardly handle the standing up and walking around required for regular visits....adding another doctor search at this point makes me want to cry. MY decision -- if this helps at all -- is to keep the conversation up with her, get my DH on my side, try to get my mom or dad in the room for delivery (they are both really experienced with all this), and just do those exercises and sleep positions and talking to the babies and all that RELIGIOUSLY so there is no real reason for anyone to fight me. My mom says i should write a birth plan, and i don't really know how to write one....but i'm planning to do that too.

But if this works out with GA moms helping you find a good network, that's even BETTER!!

As for the FUNNY PART: I also sympathize. The first practice where i was going had only an indian-style squat toilet!! By the time i was 20 weeks (when i left that place), i practically had to remove all my clothes just to do a urine sample, because i had so little balance and ability to control what i was doing. and the bathroom was tiny. It was terrible. What were they thinking???

[DreamsInDigital]

Honestly, I think you need to find yourself a new care provider. I switched at 30 weeks during my second pregnancy and I was extremely satisfied.
This time, I switched at about 28 weeks and I am ecstatic.
If it doesn't fit and you feel uncomfortable about the things she says, find someone who fits.

[littlemomma]

Thank you all so much for your responses. Your support and input makes me feel less "alone" with this.

I have an appointment in two weeks to talk to the OB.

Bensmom made a good point- if they are this inflexible now, how will they be in labor??? Luckily I will have a doula.

A GA mom recommended an OB she liked to me. I may look into that. Is there a deadline on when OBs will take you? Do I need to jump on this now? Also, I'm kinda thinking that I'll have the same issue with any OB.

Homebirth...wow. This may seem strange to you mamas having one, but it kinda freaks me out to start planning one *now*. I mean, it seems too late in the game. I think of them as being such a big deal- so much to buy, get, understand, plan...would I have time?

Thanks again mamas. You're the best.

[girrllie]

It sounds like you have a "medwife" on your hands, not a midwife. Is she a Licensed Midwife (LM) or a Certified Nurse Midwife (CNM)? There's a huge difference. CNMs typically (not all of them) buy into the entire medical philosophy. So a lot of women go to a "midwife," not knowing the difference and they might as well be seeing a very medical OB. It's also been my experience that it's usually CNMs that are associated with OB practices.

To continue this, women go to the midwife, thinking they have a better chance at a natural birth, are supported in their birthing beliefs, etc., and that's not the case at all just b/c someone is called a midwife. That is what happened with me with my first pregnancy. I so, so, so wish I really knew the difference between CNMs and LMs. I so, so wish I had listened to my instincts and gotten out of there BEFORE my DD's birth ended in cesarean.

The positioning thing: Yes, babies move. That is exactly why all the positioning stuff is so important. *Med*wives are rarely trained in positioning and sometimes don't even know how to turn a posterior baby. Listen to your instincts around this and keep doing your exercises. They do work!

Some OBs will not take you past a certain week. Yes, jump on this now.

As for planning a homebirth: That's a really personal decision. You aboslutely have time to plan for one if you truly want one. There are a ton of places that sell kits for homebirths. You order it and that's it. You have all the stuff. That takes, what . . . a couple of days to do? The harder work is finding a midwife you like. And what's to understand? Anything more than what you understand in the hospital? Probably less since you won't have machines beeping away at you. That's what the mw if for - she understands everything so you don't necessarily have to.

Edited b/c I accidentally put Licensed Nurse Midwife! I meant Certified Nurse Midwife (CNM)!

[xmasbaby7]

Homebirth...wow. This may seem strange to you mamas having one, but it kinda freaks me out to start planning one *now*. I mean, it seems too late in the game. I think of them as being such a big deal- so much to buy, get, understand, plan...would I have time?




Uhh, now you are freakin' me out!!!!

I am having a homebirth, but I haven't DONE anything yet. What am I supposed to be doing? :blush I mean I have planned and read all about how to handle a natural birth to the point that I am really comfortable with it, but as I far as I can tell, all I have to do is order the birth kit by November for my MW.

You sound like me in that you are really proactive about your actions and gathering information ( I am hardly a laid back type about life events), and my MW teased that I am one of those "prepared Moms", too, but I honestly haven't done anything yet.

If you are intrigued about homebirth, interview some HB MW's and some recommended OB's and see what feels right.

Good luck! You'll make the right choice for you! Don't be afraid to explore your options.

[Spark]

How willing would they be to listen to your wishes in labor if you are completely disregarded in pregnancy?

:yeah:
That's the real danger of the situation. It's certainly not anything to take lightly in my book. I take those warning signs very seriously. Sometimes you just get a little warning outside of a lousy labor/delivery.

What a great option to ask in the Finding Your Tribe about a good provider to listen to you. :nod Other mamas know! Someone might even have some more information for you about your current CNM.

[gonnabeamom]

(Dropping in from Nov)
I think the only thing you need to consider for a homebirth is getting Ina May's Guide to Homebirth, and reading up to see if the idea feels like it suits you. If it does the work to change will be less than the anxiety of continuing, and even I who make a big production out of everything don't think getting things together will be that hard.

I'm wondering if this midwife is the only one in your practice. If not is there someone else in the practice you can talk to about the interaction you had with her? Is this her usual behavior/attitude(i.e. is she usually dismissive)?

If not is is it possible she was having a bad day? I'm NOT encouraging you to put up with bad care, I don't think you should have to, or you should go into you birth feeling like you need an advocate with your midwife (that's what OBs are for), but if the idea of a switch is stressing you out, maybe you can see if the situation is repairable.

[littlemomma]

Thank you thank you thank you all for your responses!!!!

I can't believe I am about to type this-

We've decided for a homebirth!!!!!!!!!!!!

I feel so happy about it. For some reason, all along, I never really considered homebirth for me. I don't really know why. Last night I was ranting to my DH about this due date issue and these CNM (yes, you all were right- I didn't know there was a difference, I thought a midwife was a midwife was a midwife) and I finally said, "or we could do a homebirth." MUCH to my surprise, he was supportive! Then we kept thinking of more and more reasons why a homebirth would be better for our family. I got a recommendation from my doula and I already called her and we are meeting Tuesday to meet! And as a pp mentioned, what really is there to do extra besides buy the package online?! This was a great point and it made me stop and realize that I was assuming stuff about a homebirth without stopping to really think about it. I think now that perhaps all that crap with the medwives was necessary to help me get on the path I was supposed to be on for this baby's birth.

Thanks again for all your support. :heartbeat

[xmasbaby7]

Oh that is so great! It will be my first birth, but what I love about homebirth is that it keeps you grounded that this really IS a natural event that doesn't need a lot of planning. The birth would probably be fine even if you didn't order a birth kit!

Find a really good, experienced MW who is comfortable with knowing her limits. I interviewed several until I met the one whom I though was channeling Ina May Gaskin-like wisdom and calm to me. I have no worries about her decision making and how she would handle more tense situations if they arise.

Talk about good hospital back up options with her on Tueday, too, so that you have a plan in place to make everyone else feel more supportive of your choice. (This helped my family accept out choice much more easily).

Once all of this was ironed out, I was able to begin thinking about the beauty and security of laboring in my own home. It will be a party!

Sorry I am only stating all of the obvious; but I am really excited for you both!!! :thumb

[Spark]

:banana Yay Littlemomma!!! :banana

You seem sooo much more aligned with this decision! Way to go!!! It's like the relief and happiness just shines through in your post! Yay!!!

I've had both my babies at home and will have this one at home, too. I haven't even ordered my birth supplies yet. (And, actually, I'm just going really minimal on them anyway) There really isn't much to do other relish in the joy that your innate knowledge of your body and your baby will be respected!

I hope you love the MW. Great work asking your doula about rec'd. She'd know for sure. And, really if you don't hit it off with the MW, ask around to interview more. Really, you have the time to set yourself up for the best posssible birth. :)

Oh, I'm just so happy that you seem so happy!!! :hug

[selazenby]

Oh, yay! I'm so happy for you that you came to this decision that you seem so excited about! I cannot say enough how wonderful, wonderful, wonderful homebirth is!!

[Turtlemum]

I feel like I am coming into this thread a little late...it seems you have received so much great support and advice already! Reading your last post you seem so much happier I almost cried. Good luck with your interview!

Kelli

PS Technology NEVER trumps a woman's knowledge and inuition EVER!!

PPS I have encountered two schools of thought in regards to fetal positioning (and then a rant from a recent birth I attended):

One is that prenatal postures and avoidance of slouching positions etc can increase the chances of your baby settling into your pelvis in an optimal position (OA). It makes sense even if there are no or few studies to back it up. Also, it does no harm to do these exercises prenatally.

Two is the thought that doing said exercises will not make a difference prenatally and that positioning in labour is more important. Some babies will enter the pelvis in an OP position even if a mother did the exercises. As the baby's head moves lower and encounters the pelvic floor muscles it changes positions to find the path of least resistance. Some babies need more encouragement to turn and then forward leaning positions can be adopted, lunges can be done, massage and finally manually trying to turn a baby while the mother is in a hands and knees position using the midwives fingers can work. Also it helps if your attendant has homeopathics near by to use...

...my rant from a recent birth goes like this:

A transfer of care occured for a number of reasons to obstetrics. This client's contraction pattern then changed and they started to space out and instead of coming every 2-3 minutes, they started to come every 2 minutes for 10 minutes and then every 8 minutes, then 2 then 8 etc. Part of my report to the obstetrical team (including the nurse) was that the baby had been in an OP position at the beginning of labour and then moved to an OT position (meaning the baby is trying to turn to a OA position). What bugs me is that I had to fight tooth and nail for the client to be allowed to adopt helpful postures!!!!! The nurse kept saying things like "why don't you lie back dear, you look tired", "leaning on your husband is just going to hurt his back, why don't you lie back on the bed" (she also told her not to lean on me as I was pregnant!). Anyways the nurse decides to do a vaginal exam at some point and says to the woman that she is STILL only five cm dilated. I asked if any other signs of progress were there (ie. position of baby, effacement, station etc). She didn't know!! She only assessed dilation! Another nurse I spoke with made the comment that that nurse was not experienced enough to assess baby's position...what?! How can we correct positioning without knowing where the babe is? Why do a vaginal exam at all then? and why is this nurse touching women if after 10 years in L&D she has no idea how to assess progress!!!!! So frustrating! How many needless c-sections have taken place because professionals have no awareness of positioning or the mechanisms of normal labour?

Sorry I kidnapped this thread but it really gets to me when I hear stories like these and common sense is thrown out the window at women's expense!!!

[girrllie]

Turtlemum - I'm right with you on this one!!! Had a friend who gave birth a week ago today. I kept telling her the baby was posterior and giving her positions to do. She never did them. Labor exactly like you described - stalled at 8 - cesarean. The baby was posterior! So frustrating!

Anyway, littlemomma, you sound so much more confident and happy! Sounds like the perfect decision for you! Woo-hoo!