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Oh mamas, I need a HB pep talk; last mw appt bummed me out...

674 Views 4 Replies 5 Participants Last post by  girlsmamma2
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So here's the background info:

This is my 5th baby, but my first attempt at homebirth. I have a history of pre-eclampsia. My first two children were preemies due to PE. Then I did a bunch of research and had a bunch of testing done, did a lot of things differently, and went on to have 2 more babies who were born full-term with NO pre-eclampsia, just a touch of high BP in the last few weeks of pg, which was controlled by meds.

When I got pg this time around, I was good friends with a wonderful group of hb mamas who encouraged me to at least contact a few hb mw and see if I might be a candidate. Nothing ventured, nothing gained, right?

I talked to a few, and found a wonderful hb mw here in town and have been seeing her throughout my pg, along with monthly visits to a backup OB (recommended by my mw), so if/when I developed high BP again, I would have someone to prescribe me meds in the final weeks of pg.

Okay, so much for background. Here's what's going on now:

2 wks. ago, at around 30 wks., my BP started to go up and my ankles/hands started to swell. I had an appt. with my mw, we discussed what was going on and how it wasn't unexpected, and made a few decisions about how to proceed:
1. I would call up my backup OB and go on BP meds.
2. I would start seeing an acupuncturist and get regular prenatal massage.
3. I would increase my protein intake and drink more of my special pg tea (mw is a registered herbalist and made a blend just for my particular pg conditions.)
4. If I got to 36 wks. without developing any further symptoms and got the BP under control with meds, my homebirth could still proceed as planned. At 37 wks., she could even help "induce" me, if necessary (note: both of my full-term babies were born at exactly 37 wks. all on their own, so induction isn't likely necessary; my body just doesn't seem to cook babies until 40 wks.)

So I proceeded with the new game plan. Went on meds. Went to be poked at the acupuncturist
. Got kneaded by the masseuse. Drank nasty protein shakes and almost equally nasty cups of tea, lol.

I'm now almost 33 wks. and still hanging on!
I've had to up my BP meds twice now to keep my numbers at around 140/90 or less, the acupuncture isn't doing anything, but the massage is heavenly. Still wishing I could lose my tastebuds when drinking protein shakes and tea
. The swelling is largely gone, except for when I spend a long amount of time on my feet, then I get elephant ankles. I have no other symptoms. Baby Sophie is growing right on schedule and very active, doing great.

So why am I bummed out, you might ask? Because at my mw appt. this past week, she began hemming and hawing a bit regarding my birth plans. Now she says she really would prefer me to be at least 37 wks. along, not 36. And, oh, by the way, what does my BP usually run during labor? Because she now wants it to be in a certain range while I'm laboring, or she doesn't think it would be a good idea to hb. Although I really don't know what she expects, b/c if I'm in full-blown active labor, transition, or actually pushing and she decides my BP is too high, it's not like I'm going to be up for transporting THEN!
:

Okay, now I am NOT a very risk-taking kind of mama, especially when it comes to my health and that of my baby, but I'm also starting to feel like I'm being judged and found guilty before I've committed a crime!
The vibe I'm getting from her is that, while in THEORY, she was comfortable having me as a client, when faced with the REALITY of my situation, she's getting uncomfy. And instead of coming right out and saying, "I don't think you should have a hb," she's starting to place all these conditions on the hb, slowly making it impossible for me to fulfill them. I also don't feel that she is being very positive or supportive about my chances of a full-term birth anymore, since she has started using wording like, "If you get to..." I really don't think she thinks I'll still be pg at 37 wks.
And that's honestly the last thing I need from her right now, when I've got my own worries to deal with -- negativity is so hard to battle when it's coming at you from all sides!

I'm not sure how to proceed at this point. I've dealt with this EXACT same pg complication many times before, and I know how my body acts with it. And I'm doing fine right now health-wise, and really think it's likely I WILL make it to term with no further issues. But even if I do, I no longer have the confidence that I'll be having the hb I wanted. MW has said she will be my doula at the hospital if I have to be induced early, but I don't really feel like she is much of an advocate for me at the moment. Oh, and she won't be giving me any sort of refund if medical issues prevent me from having a hb, which I was fine with when I felt that that would only happen due to TRUE unavoidable medical issues (i.e. developing full-blown PE). Now that I sense her trying to "get out" of the hb, though, I'm not sure how I feel.

Ugh. I hate this!
I've had such a great relationship with her up until this point, and I don't want it to all go south now. Plus, I'm hormonal and anxious and that's not helping me be objective.


I'd love some input. How would you handle a situation like this? Should I just give up on the homebirth idea altogether now, so I won't continue to get my hopes up for something she doesn't intend to follow through with? Should I be blunt with her that I sense her discomfort and want to talk about it? Should I continue to advocate for a hb under the circumstances?

Thanks for listening!
Guin
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I'd pick up the phone and ring her. I'd tell her that you're stressing out over what she said, and ask her if she's trying to break her contract with you. Her response should tell you everything you need to know.
Although she has said that she won't be giving you a refund for medical reasons, you could also consider consulting a lawyer. There's such a thing as obtaining money through false pretenses, which could be an issue here: but tbh I think she may well come through for you. 33/34 weeks seems to be a popular time for midwives to start talking seriously with their clients about what they're expecting their labour to be like. Also, it sounds like she's just been doing some serious reading on the implications of PE and a homebirth and is realising what she's committed herself to: which is a good sign in many ways. I'll admit, expecting you to go to 37 weeks when the most pregnant you've ever been is 37 weeks seems a little optimistic- did you talk about this earlier on in your pregnancy?
The stress isn't good for you right now. If you have the baby today, you have to go to hospital. Tomorrow, you can deal with in the morning. Get yourself to 36 weeks (only 3 weeks) and then start worrying about HB or not.
Oh- something else. Is there any way that you could find yourself a doula? Even a voluntary one? Whether you HB or not, it sounds like you really want someone who's unconditionally on your side.
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Sorry you are experiencing this! Even though it may be a bit uncomfortable I would sit down and talk to your midwife about this. Let her know how you are feeling and ask her to be honest with you about your homebirth plans. If you cannot talk openly with her beforehand, the labor and delivery might be uncomfortable as well. Also, have you read up on the Brewer diet? It was developed to prevent Pre-Eclampsia. It is a very well rounded diet of fruits and veggies but most importantly about 100-120 grams of protein a day. Good luck with your plans! Just take it one week at a time and before you know it, your 37 weeks will be here. Also, talking to your body and your baby is helpful too. When I was pregnant with my twins, almost on a daily basis I would talk to the babies and tell them we were going to make it 40 weeks, they had plenty of room, plenty of fluid, etc. I would tell my body it had the ability to stretch and grow and the placentas were perfectly nourishing the babies, etc. I personally think that kind of thing makes a big difference.
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I second the doula recommendation. Also talking to her straight out about it. Sounds like you've really been able to take things into your own hands with your bp in the past and get the results you wanted, that's great! It must be empowering to be able to listen to what your body needs, do the research, and get 'er done, yk? I'm sure you'll be able to draw on that same strength again to get you through this, regardless of the outcome. I really don't know about high blood pressure -- I tend to have the opposite problem -- so I really have no advice about how to proceed. But as for the yucky protein shakes -- bone broth and gelatin help your body digest protein better. You might find you can cut back on the shakes using gelatin rich broth.

Oh, you might also try the midwives & doulas section to ask about the best way to approach your midwife with this, etc.

Good luck!
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I too would talk with her about this. What have you got to lose at this point? I think you'd much rather have her be honest and bail at this point, rather than during labor. Ask her if there is a way you both can work together to ease the fear and tell her what you said, how you have seen this before with your own body etc. I think it's good you are covering yourself with having an OB. And like pp said, i think that this is the time when things get more serious in mw's minds and also when preggo mammas start some serious second guessing themselves, as i am , if there are any issues "out of the box" of the perfect low risk scenario. I do think also that a lot of mw's have sooo many low risk mammas's that some have only dealt with a small handful of out of the box cases and those results may have varied. So when things get shakey or border on the line, it's then when you have to try and get her to be honest with you and also to be honest with yourself yet still determined to get what is best for you and your baby . whatever that may be.

good luck mamma. i'm finding too, this time is very stressful in pregnancy if like I said, there are any issues making it not possible for a hb. Keep up the good work. I'm having an issue with extra fluid, and the diet to try and control that is killing me and I have found it very stressful. It's also hard to have a circumstance where all the answers are really at the end, during labor. At least you can see your PE building and can try and head it off.
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