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Hi. this will be long. I posted here years ago, long time reader of Mothering, don't see any names I recognize from the old days. Anyway, here is my situation.

I'm expecting #5 in mid-late december (the due date itself deserves a thread of it's own). I have preexisting hypertension, have had it since I was 20 y/o with no known cause (I'm 35 now). Been through the gamut with each pregnancy. 1st: highly medically managed, but easy pg and delivery at 40 wks, no bp meds during pg or labor. 2nd: saw midwife who put me on aldomet at 20 weeks and turned me over to OB at 36 weeks, labor immediately induced, but still a nice birth with healthy baby, 3rd: different midwife, aldmomet from beginning of pg, turned me over to OB at 30 weeks, induced at 35 weeks due to poor bio-physical profile. Cytotec and magsulfate hell on earth with unhealthy baby and mom. 4th: You won't believe this, home water birth of 43 week 9# baby, best birth and healthiest of the lot. I had "high" bp through that pg, but my lay midwife just felt it was "normal" for me, and not to worry unless I spilled protien in my urine, swelled or had other signs of problems. Never did, felt great, babk on my feet within the day. ONly meds were CoQ10 and blue green algae. My bp was usually in the 140-150/80-90 range, sometimes 160. Keep in mind, my nonpg normal is the same.

So, this pg, I am living in a new state, where lay midwifery is illegal, and I could find NO ONE to attend a homebirth. My husband REFUSES absolutely to entertain the idea of an unattended birth at home, so I went with the most liberal of the three docs in my town that attend deliveries (all are family practice, no "OB/GYNs" in town. REally I had little choice, b/c one fo the three would not even accept me as a pt due to "high risk", and the other would have fired me long before now. My doc has been pretty good actually, but she is still of the medical mindset, and now at 30 weeks we are headed for a lot of conflict.

I'm taking the max doses of aldomet and hydralazine now, and my bp is the same as it was at the beginning of the pg, usually 150s/80s. No matter how much medication they give me, it stays relatively the same. Sometimes, higher, sometimes lower, but is fairly consistant in this range. My dic feels this is unacceptably high, has told me my midwife and I were irresponsible and lucky in my last pg, and it is time to stop "living in denial." I know she just want the best outcome and is doing what she thinks is right, but I'm getting VERY stressed out about the whole thing. She calls me at home to check on me, has been trying to find a doula for me (more on that later), lent me all kinds of Reiki and meditation CDs, etc. I was taking prenatal yoga, but I had to quit for $ reasons (my doc even internened and got the instructor to charge me a little less, but it is still too much for me), time constraints, and the odd fact that I cannot STAND being around other pregnant women. I do not want to discuss my pg or theirs, and it seems pg and babies are all they are capable of talking about. People ask me about my pg and I just say "fine" and change the subject, even family and friends. Weird I know.

I take cal-mag, blue green algae, coQ10, fish oil, multivitamins, folic acid and alfalfa. I take more pills than a nursing home patient. I am supposed to meditate every day, but I don't have the psychic energy, so I just sack out on the couch.

Problems ahead: My doc has mentioned on SEVERAL occassions that I will not go to term, and to get used to the idea of an induction. She told me point blank water birth is out of the question since I will have to be on the monitor (the hosp doesn't have a tub anyway), and probably need IVs. I told her I would refuse mag-sulfate, and she told me that in that case I might have to be transferred to the big hospital 80 miles away b/c the nursees will refuse to take care of me here. I will be assigned to the obstetrical teaching team on call and have a nightmare birth for sure in that case. She wants me to have an epidural to help lower my bp, and placate the nurses . i had an epi during my first birth, and hated the foley catherter, internal monitor, and all the other crap that went with it. Never had any pain control with subsequent deliveries, even with pit, etc. I don't know anything about this so called epi-light, except that I don't want it.

My doc recommended a doula, and I thought it was a great idea, until I met her. I didn't click with her at all, it seemed like she was more in support of my doc than she was of my birthplan. Very nice, but no spark. She also made several comments that didn't exactly turn me off, but indcated she isn't of the same mindset as I. She is very religious, (I am not) and made several comments to the effect of "The Lord want you to have a healthy baby, the Lord is blassing your pg, and will watch over you in labor, etc etc etc..." Even if we clicked, she charges $350, and I siply cannot afford that. I work, and as it is we only have enough money saved up for a 3 week maternity leave. I'm hoping to have enough for 4-5 weeks by delivery, but paying a doula would take a weeks leave off, and if I go out earlier than my "due date" I'm screwed.

I should tell you that this was an unwanted pg, I came very close to having an abortion (dh wanted that baby and told me it would "grow on me") and honestly, wish every single day that I had. I know abortion discussion is not allowed, and I don't bring it up to start controversy, just to point out where my head it at here. The whole idea of going to the hosp to have this baby, much less bringing it home and taking care of it makes me physically ill and I cry all the time. I have toured the hosptial birthing area, and it is a nightmare. In fact, I literally have nightmares about it. I dream that I am running through the hospital trying to get away from people who want to do things to me. I spoke cosicidentaly with a nurse who works there, who rolled her eyes at me and called me "one of those earth mothers." She counselled me NOT to bring a doula, b/c it will just piss the nurses off more, and after a few moments of discussion abhout what I wanted and what I'm afraid of, she said "You have better be careful, they will call it endangerment and call social services on you if you refuset he standard of care."

So what do you suggest? I can't stomach the idea of going there, and fear the worst if i do, but what choice do I have. Dh won't support birthing at home, there is no other doc and no other hospital to consider, I have no friends to turn to (just moved to town) and distant family who think I'm nuts and should just get a c-sec at the earliest possible date and stop whining.

I work nights, so I'll be back tonight and appreicaite you thoughts and suggestions.
 
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