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Old 04-08-2010, 10:04 PM - Thread Starter
 
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This past November, I had an exhilarating homebirth -- it really was everything that I had hoped for in a birth. It did end up being an accidental unassisted homebirth, and my midwife showed up after the baby arrived to do the newborn check and help me deliver the placenta. She also stayed around about 2 hours.

As thrilled as I am about the outcome, there are now several things in retrospect that bother and concern me, and I could use some help analysing and coming to terms with these aspects.

To begin, my labor was about 2 hours long from when I woke up feeling interesting to when my daughter was born. I woke up at 2am, and had one big contraction accompanied by a "pop" feeling in my abdomen. I went to the bathroom and noticed bloody show. Since I figured things would take a little while, I didn't wake up my husband and just listened to my hypnobabies for about 15 minutes before deciding to walk around the quiet house for a while.

At 2:30, I called my mother to tell her "this is it!" When I got off the phone with her, I called my midwife and told her I was having contractions 5-6 minutes apart. She said "thanks for the heads up!" My mom arrived somewhere right around 3am. When my mom walked in the door, I had a contraction so strong I leaned over my desk and breathed deeply through it. I hugged my mom and exhaled, "Wow... that hurt!" I then walked to the kitchen, a very short walk I should add, and leaned over the counter to sway and breathe through another contraction. My mom was surprised I got another one so quickly. She asked if I had called the midwife, and I said yes. They waves of contractions came pretty quickly, around 1-2 minutes apart, and I got on facebook to update my status ().

Around 3:30, I was lost in labor land, and my husband woke up. He paced around doing whatever (I don't know, I wasn't paying attention), and evidently he asked my mom worriedly if the midwife had been called. She said yes, but dug out my cell phone to call again while I ran water in the tub and crawled in to help me relax. When my mom called the midwife, she woke her up. Evidently my midwife went back to bed after my call at around 2:30.

At somewhere near 3:45, I started grunt-breathing at the end of every contraction. My mom called the midwife again and said the baby was going to come very soon. From what I gather, the midwife was still at home getting stuff ready to bring to my house. While I was in the tub, I instinctively "checked" myself and noticed the baby's head was right at the opening of the birth canal. It must have been right around 4 that I crawled out of the tub and waddled about 5-6 steps to my bed, grunt-pushing through the continuous contractions. I leaned over the bed and pushed, crawled up on the bed on all fours, and the baby slid out into my mother's hands. My mom wiped my daughter's face off and laid her on my bare chest and covered us with a blanket.

It was something around 15-20 minutes later that my midwife came and checked me and the baby, both of whom appeared to be in perfect health. About a half an hour after delivering the baby, I delivered the placenta with a bit of difficulty. I didn't appear to have any abnormal bleeding, and just a tiny "skid mark" of a scratch/tear that my midwife said didn't need stitching. My mom fixed us all breakfast and coffee, and after eating and filling out the paperwork, my midwife left somewhere around 6am.

That's the birthstory. It is a precious and empowering memory in my mind.

However... the next morning, I took my newborn to the pediatrician (as is recommended). Evidently I missed my midwife coming to do the first postpartum check. She had not made an appointment, but I had missed a text message on my cell phone from her saying she was on her way over because I was in with the pediatrician. When I got home, there was a note from my midwife on the door saying she would try to come again "tomorrow." She never did come back. Three days postpartum, I got the most horrible body aches I have ever experienced in my life. I hurt everywhere. Four days postpartum I realized my baby was not having any wet or poopy diapers after passing the meconium. I took her to the pediatrician, who had the lab draw bilirubin levels, which were 16 I think. The ped gave me formula and said the baby wasn't getting near enough to eat. After the ped, I ran by my midwife's birthing center and cried. She weighed the baby before and after a long, drawn out feeding and we ascertained that she was indeed not getting enough. A couple days later I went in for a check up, and my midwife's mom palpitated my breasts and tried to squeeze out some milk, only a tiny drop of which came out. I was still hurting everywhere, in all my joints and my head pounded and my breasts hurt the worst, and my postpartum bleeding developed a very funky odor. Baby lost over a pound from her birthweight and had to have two more labs drawn. When I mentioned the pain to my midwife and her mother, they both responded with a similar. "Hm." As in well isn't that interesting.

I lay in bed and rested and drank water and nursed around the clock and pumped after every feeding and took a whole arsenal of herbal galactalogues. By six weeks, we were able to wean off the formula supplements, and my pains subsided.

While the experience of the birth itself is crystallized and cooled into a profoundly awe-inspiring memory, the postpartum period comes back to haunt me on occasion. My baby was nearly failure to thrive and was at one point very close to being hospitalized. My strange and nearly debilitating body aches confound me. The way my milk didn't come in... things just don't add up neatly in my mind. I don't know what went wrong. I don't know what I could have done differently to have a better outcome. I don't know whether to be disgruntled with my midwifery care or not.

My baby is now almost 5 months old, and she is gorgeous and thriving and plump in all the right areas. But it took me every ounce of determination I had to get us to this point.

If you even made it this far... Thank you. Any insight to share?

Wifey to Hubby, Mama to Boy (2004) and Girl (2009). 
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Old 04-08-2010, 10:46 PM
 
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I read it all, and I have to say I really really dislike this midwife! What the hell!? If your midwife is licensed, I'd file a complaint because this is just bizarre behavior. Absolutely bizarre.

I almost wonder if you had some retained placenta or something similar? That's a total shot in the dark, but weird pain and milk not coming in makes me wonder if you had an infection going on. UGH! I am so sorry! That is absolutely *not* what midwifery care is supposed to be.

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Old 04-08-2010, 11:09 PM
 
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When you called the first time and she said "thanks for the heads up," did you interpret that she was coming to help you? Did she say that she'd be over soon? Or did you ask her to come over? I would interpret "thanks for the heads up" as "call me again when your contractions are x minutes apart"...but of course, that would only be if you had agreed on what the "x minutes" was beforehand.

The post-partum stuff seems really bizarre. I'm sorry you went through that, and I wish your midwife had been more help to you. She should have been more help to you.

RedOak ~ Momma to DS (8) , DS (4) , DD (3) , & DD 9/10 ~
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Old 04-08-2010, 11:24 PM - Thread Starter
 
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Originally Posted by RedOakMomma View Post
When you called the first time and she said "thanks for the heads up," did you interpret that she was coming to help you? Did she say that she'd be over soon? Or did you ask her to come over? I would interpret "thanks for the heads up" as "call me again when your contractions are x minutes apart"...but of course, that would only be if you had agreed on what the "x minutes" was beforehand.

The post-partum stuff seems really bizarre. I'm sorry you went through that, and I wish your midwife had been more help to you. She should have been more help to you.

You know, these are very good questions. I've asked them to myself as well. One thing that comes back to me again and again is that my first labor was about 4 hours in length, so I have a history of short labors. Second babies oftentimes come quicker than their previous siblings sometimes in half the time, as was my case. I feel like my birthing experience should have been taken into account with the "head's up" call. When I called, I didn't sound like I was in labor. I was doing hypnobabies pretty successfully; I told my midwife I was planning on doing hypnobabies. But in all honesty, I didn't mind so much having an unassisted birth -- that part doesn't taint my birthing memory in the slightest. It is just all of it combined....

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Old 04-09-2010, 01:52 AM
 
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Coming from a student midwife perspective:

The missing the birth was understandable, although with a history of short labors she should have moved pretty quickly to you once you said you were definitely in labor. We miss a few births a year that unfold like yours, simply because getting anyone to you in that short of time can be a challenge with traffic and such. If you are coping with contractions so well that our flags don't go up, it's especially tricky.

The postpartum issues, otoh, is inexcusable. It's our job to see you. If she couldn't reach you before she came over, she should have kept trying until she did. And if you had called/paged her with the symptoms you describe, it's her JOB to help you figure out what's going on. My preceptor fields these calls constantly for 6 weeks postpartum and responds to every. single. page in a reasonable amount of time. If a mom is showing signs of infection, you investigate. If a baby isn't thriving, you do the appropriate work until she is. It's our JOB. Midwifery differs from OB care in the fact that we follow moms and babies as a pair, and at least in my state, we can be and often are the only provider a baby sees until after the 6 week checkup.

She dropped the ball, and I'm PISSED on your behalf.

Megan- mama to 3, midwifery student , doula, , runner , knitter .
Violet Lane Birth Services Doula care and placenta encapsulation serving Seattle to Mount Vernon
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Old 04-09-2010, 02:48 PM
 
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As a midwife myself, I have to remember that there are two sides to every story. However, a low milk supply, funky odor to lochia, and body aches is a clear sign of infection (generally caused by retained placenta). I am very careful when it comes to making sure baby is getting enough to eat. I think I read this was your second baby. If so, it's unusual that you would have a low supply if it was normal with the first (although it can happen). Just some strange things going on here.

The call in labor is also concerning. A second time mom calling to tell me contractions are 5 minutes apart typically is not a "heads up" kind of call! It's a "get your but up and get ready" call. I know this did not bug you, but as a midwife, it bugs me : )
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Old 04-09-2010, 06:19 PM - Thread Starter
 
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With my first baby, I had painful engorgement over-supply by the third day. I almost always had an over supply with him the whole time until he weaned at 3yo. I was perfectly confident in my ability to make enough milk, which is one of the reasons it came as such an awful surprise when my daughter lost so much weight and didn't soil any diapers.

I wondered about maybe a retained piece of placenta or something, but I never had any hemorrhaging. I was unable to birth the placenta effectively until I stood up and pushed very hard and let gravity help it come out and fall to the floor on a chux pad.

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Old 04-10-2010, 12:31 PM
 
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I think you have every right to be bothered! I think your MW should have asked when you called if she should come over right away. I think she assumed for some reason that you were going to have a long labor. I know that with my HB, we called my MW twice. The first time to say labor had started. She said "call me back 30 minutes before you want me to show up, or if she asks for me." (DH called). We called her back about an hour later and she came right over (she was up and ready). I find it weird that not only was she asleep, but she wasn't ready to come over.

I beleive that after the birth, your MW didn't give you the level of care you deserved and needed. She should have scheduled several PP visits with you. With mine, I had one the next day, one on day 3, on on day 7, and the last one on day 14. I was also told to call her anytime I wanted with questions on BF, baby's health, my health, or the normal phases of recovery. She also called me after about 4 weeks just to check in and see how things were going with BF/my health/etc. With the oder/low milk issues you were experiencing, you deserved even closer care related to infection (either due to the birth or a breast infection).

I think you should write a letter to the midwife explaining your feelings on the PP care you received. I personally think that everyone should be given the oppurtunity to learn from their mistakes, and that this MW made several in her care of you. This is not an attack, just a way of letting her know that you don't feel you had an ideal birth. You could say something like "my birth didn't go quite the way I wanted, and I just want you to know why as I know you take pride in your work and are constantly striving to perfect your midwifery practice." Then explain the issues (missed PP visit, lack of other PP home visits, your feeling unheard about your health/breastfeeding issues). Close with the positive point that you and your child are happy and well now.

CD'ing, homebirthing, milk making school teacher. Supporting my family on my income and trying to get out of debt in 2013!
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Old 04-12-2010, 01:53 AM - Thread Starter
 
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Thanks so much for the feedback. I really do appreciate it!

My husband and I were discussing the other day if we might want more children, and while we haven't quite decided on that at this point, I know that I wouldn't really want to birth at a hospital unless it were absolutely necessary, but my midwife and her mother are the only homebirth midwife practice in my town, so I would most likely be going there for any subsequent pregnancies...

Again, missing the actual birth in and of itself doesn't bother me. It is incredibly special that my mother got to catch my daughter, and though my mother and I have had a strong friendship for years, our relationship became so connected through this experience. I think I just wish I could have been heard more postpartum in regards to the strange pains and the lack of milk.

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Old 04-12-2010, 07:02 PM
 
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Perhaps there are mw's not in your town but still close enough to make it? I have to import mine since the only one here is one I am not comfortable with.

caution: one-handed nak

typos likely

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