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Discussion Starter · #1 ·
I have questions.<br>
I'm not pregnant yet, but I'm looking at all my options. I'm going to be looking at birthing centers, hospitals, and am now looking at the home birth option. I'm just a bit OCD about getting information, so please, bear with me. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/redface.gif" style="border:0px solid;" title="Embarrassment"><br><br>
This will be my first child. I'm overweight, but healthy. My blood pressure is normally, well normal, my heart rate is good, I'm not diabetic (or even close); basically I'm rather healthy, outside of my excess weight, which I am slowly and steadily losing. I'll be 38 / 39 when giving birth, depending on how well the IUI works. Oh, forgot to mention. I'm also single.<br><br>
I live rather far north of the DFW area and a minimum of 20 minutes from the nearest hospital, and about 30 minutes from a birthing center. That is the main reason I'm thinking of home birth. I know I want a water birth. I have some very good friends that are my neighbors that would be there to support me. My parents would come down from the north for the birth (only grandchild).<br><br>
So with that background, here are my questions:<br>
1. If you have a pet, where should she be at the time of the birth? In a kennel (boarded)? (I have a dog.) How long before she can come home?<br>
2. Would I want an CNM or a CPM? Is there a really huge difference between the two?<br>
3. Would I start by seeing an OB? Or start directly with the midwife?<br>
4. I had a LEEP done three years ago. If I need a cervical crevage, am I stuck with an OB and hospital birth?<br><br>
I know y'all aren't doctors, but there are some of the questions that I have. Amazingly, I don't have questions about the birth process itself. It's natural. It will happen. I have good, wide hips. (When I talked to one GYN about children, her exact words "You'll be able to pop those puppies out".) <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/orngbiggrin.gif" style="border:0px solid;" title="orange big grin"> That part doesn't bother / scare me. I know there will be some "discomfort"? <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/winky.gif" style="border:0px solid;" title="Wink"><br><br>
At any rate, thank you very much ahead of time for humoring me. I appreciate any information you can give me.
 

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I'm not a midwife yet. Just hope to be some day. But I thought I'd respond.<br><br>
1. Pets, we sent the dogs to the neighbor's house until after the baby was born but I've heard of many families who have their dogs present.<br><br>
2. There is a difference in the way someone was trained but not necessarily their philosophy of childbirth. I recommend interviewing midwives until for feel really good chemistry with someone and even then you are never "stuck" with a particular midwife you have the choice of who will attend your birth.<br><br>
3. I never saw an OB just a CPM. I trusted mine and her intuition to refer to an OB if it seemed necessary. It never did <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/orngbiggrin.gif" style="border:0px solid;" title="orange big grin"><br><br>
4. Not 100% but I'm pretty sure your not stuck with a hospital. Hopefully someone else knows this one.
 

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1. Depends on your dog. With my upcoming birth the safety and comfort of my dogs is a high priority. I'm fine with them being there but I wonder if that's what's best <i>for them</i>. What do you think it best for your dog?<br><br>
2. There is a difference in training, but overall I don't see a difference in qualifications. Usually the real difference is in scope of practice restrictions due to legal regulations and backup physician/hospital arrangements.<br><br>
3. Start with the midwife. She will direct you whether you need to have a consultation with an OB.<br><br>
4. Depends on the doctor and/or midwife. The cerclage itself needs to be inserted and managed by the doctor, but as long as it holds to term there's no medical contraindication to having a home birth. I've worked with doctors who would have no problem taking it out for you at term and sending you on your merry way. There are others who will not be so friendly, it will be up to you and your midwife how you choose to proceed in light of the physician's opinion.
 

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1. My dog is just going to be at the house. I can't imagine why I would need to board her or send her away. I have actually heard from other HB friends that the transition for their pets was easier because they were around when the baby was born- rather than this strange little being showing up randomly smelling like a hospital.<br><br>
2. I live in MA, and CNM are not allowed to attend HBs here- only hospitals and hospital run birth centers. My MW is actually a Direct Entry Midwife (which is legal in MA). She attended a midwifery school, worked as a doula, apprenticed under a very busy homebirth MW and then started her own private practice a few years ago. She brings another experienced MW and at least one apprentices to all of her births. I really do know why she did not go the CMW route- I didn't ask because the title is really not important to me.<br><br>
3. I saw an OB once when I was trying to get pregnant (I had a very long cycle) and did NOT like her AT ALL!! When I got pregnant I knew I wanted a natural birth, so I started seeing a large practice of CNM that do births at a local hospital (the only local birth center is just too far for my comfort). After a few months I started to realize that they were not much different than an OB (I would call them medwives, rather than midwives). For example the epi rate at the hospital I was planning on delivering at is 95% and the section rate was over 30%- which makes no sense consider they have 17 midwives practicing there. So, I started to get nervous and even with a doula lined up, I was afraid of having to battle for a normal birth. Then DH and I saw the BOBB and all of a sudden it clicked- we wanted a HB. I asked my good friend who had a beautiful HB the previous year for a recommendation and found my MW. It was the BEST decision I could have made. I get FAR superior care now.<br><br>
My HB is not covered by my insurance (I have an HMO). My MW is charging me $3000 for everything (prenatal care, birth, and postnatal care). She didn't give me a discount for switching late, but she did give us a discount for paying upfront by 28 weeks (she normally charges $3600). The thing is that my deductable for a hospital birth would have been $2500- so my HB is not much more. That said, because I didn't switch until 25 weeks, all of my tests and u/s were covered under my insurance. This might be something that I do again with future children- see someone covered by my plan for tests and u/s and see the HB midwife too. Of course, MA could come around and start requiring that HB be covered too- a girl can dream.<br><br>
4. I'm sorry. I am not familiar with LEEP and can't comment on this.<br><br>
Since I am on a role, I will comment on the rest of your message too. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/lol.gif" style="border:0px solid;" title="lol"><br><br>
I am also overweight, but my MW says that is no big deal as longs as I am healthy and taking care of myself. She does ask lots of questions about what I am eating and exercise (which she does to all of her patients). Good nutrition is very important while you are pregnant. MW in general seem to focus on nutrition and health during pregnancy- they want to prevent complications. OB (in general) seem to wait and treat a complication when it arises. This is of course a generalization, but something I have observed nonetheless.<br><br>
As for your age, I can't comment on all MWs, but I do know that my MW would have no problem with taking you on as a client as long as you are healthy and taking care of yourself. She also takes VBACs and delivers breech babies. That said, what I was most impressed with is how strict she is about transfer. She has a very low transfer rate, but insists that if we need to transfer for medical reasons, that she wants to make sure that we know she is serious and will need us be ok with that. I personally appreciate that she is strict about this.<br><br>
As you can see, everyones answers are going to be different, not only based on what they want and their personalities, but on the state they live in, insurance, laws, etc.<br><br>
GL!
 

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Discussion Starter · #5 ·
This is exactly the kind of information I'm looking for. I really appreciate the responses.<br><br>
Thanks!
 

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I can offer a comment about the dog: We had a dog at the time of our birth, and we started with her in the house. However, she ended up being banished outdoors til it was all over. She was a border collie, who ended up being too hyper with all the noise & activity. She was *MY* dog, so sending her away-away would have been far more traumatic to her. Her hyper reaction was probably also mainly an instinctive need to protect me since I sounded like I was in pain.<br><br>
We did formally introduce all the pets to the MW on house-visits, so we could determine how they would interact. (we have cats & rabbits and the dog) The cats & bunnies scattered at the time, but we didn't do anything different with them, except make sure the bunny litter box wouldn't get in *my* way in the bathroom/bedroom.<br><br>
It's wise to investigate your options regarding the medical aspects of the delivery - those answers will likely determine what type of credentials your mw needs. We chose to go with our CNM because of her 23 years of experience and over 1300 births. Her CNM status played a secondary role in our decision.<br><br>
good luck<br>
--janis
 

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1. If you have a pet, where should she be at the time of the birth? In a kennel (boarded)? (I have a dog.) How long before she can come home?<br><br>
For both of my homebirths, we put our dog outside. Once the baby was here and I was in bed with the babe, we let him in. If it was going to be too long, we would have alternated between putting him in a bedroom or outside. There is no way that I would want my dog too far away from me. My dog sleeps at my feet and has never ever been a problem around the babe. That might be different with a different dog. Only you know your dog.<br><br>
2. Would I want an CNM or a CPM? Is there a really huge difference between the two?<br><br>
The big difference is the philosophy. I find that the CNM's are little more medicalized. I think the big thing is to create a list of questions and just start calling and see which one you like. I called until I found one that I liked and scheduled a consultation to make sure that my husband liked her and that she was okay with what we wanted. I had a list of a bunch of questions that I asked and I made sure that she answered all of them to my satisfaction.<br><br>
3. Would I start by seeing an OB? Or start directly with the midwife?<br><br>
I have always started with the midwife directly. She will do a risk assessment right off and let you know if you are too high risk for her to take on.<br><br>
4. I had a LEEP done three years ago. If I need a cervical crevage, am I stuck with an OB and hospital birth?<br><br>
I think that this will depend on what the OB and midwives are willing to do. It is hard for anybody to guess on this one because it will really depend on how things progress for you as an individual.
 

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One of the things i'm glad about having a HB (this is the first time I've admitted this to anyone) is that my dog will be there. I'm 6 months pregnant & she hasen't figured it out yet that a baby is comming. She is very much a part of the family & I'm hoping that she will help me get through the birth as well as hopefully accept the baby better if we try really hard from square one to include her on the whole process. I know she will be much more resentful if she starts getting separated from the family because of baby.<br><br>
I don't know about the LEEP or anything, but I do know that I started out overweight (by my own opinion & the BMI charts - 5'7" 175lbs) but I'm also really active, good BP, no diabeties etc. and pretty healthy. I'm kind of just a big framed person too (hoping that helps for an easy birth!)<br><br>
I was really suprised when my MW didn't seem to agree w/ all of my concerns that were tied to being "overweight" she basically said "those things apply more to people who are <b>really</b> overweight" You might be happily suprised at how much more laid back a midwife could be then an OB. I have friends who are very slim who's OB's are like weight natzis. My MW is like "well... just eat healthy and stay active and whatever you gain is what you gain" (for the record - I've gained 6lbs @ 6months without regulating my diet or attempting more activity then I usually do - so she was right)<br><br>
While I'm w/ ya 100% on the whole "big boned" thing and birth being easier, I think that "discomfort" might be a bit of an understatement. I would definatly read Ina May's guide to childbirth & maybe attend some childbirth classes once your pregnant. If it does end up being just "discomfort," well, then all the better, but if you go into labor and find yourself in mind-bending pain it might be easier to handle if you prepared yourself mentally to push the limits on your pain threshold.<br><br>
Best of luck for early sucess & a healthy pregnancy. A close friend's partner got pregnant on her 2nd round of IUI at 39 years old & they have a healthy 8yo. Technology has only gotten better in the last 9 years!
 

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jrabbit: I have border collies also. They have separation anxiety, and I think that sending them away for the birth might be worse for them than being in the house during labor. I think it will be easier for them to accept the baby into the family if they're here when it's born, but I am prepared to send them to a sitter they are familiar with for a few days after the birth if I am unable to give them enough attention with the new baby to take care of.
 

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<div>Originally Posted by <strong>Angi</strong> <a href="/community/forum/post/11537265"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">1. If you have a pet, where should she be at the time of the birth? In a kennel (boarded)? (I have a dog.) How long before she can come home?</div>
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Our dog is a bit of a spaz, so she went to stay with a good friend (that she had stayed with before) when I went into labor. She came home the next day. I have a friend who has 3 adopted greyhounds. They stayed at home.<br><br>
2. Would I want an CNM or a CPM? Is there a really huge difference between<br>
the two?<br><br>
Depending on the climate/law in Texas, you may even want a LM (Lay Midwife) Certification guarantees a minimum level of technical knowledge, but it doesn't guarantee that the person provides the Midwifery Model of Care. My midwife was a CPM, but only got the certification in the last year or two when it looked like the climate for LM's would be changing in Maine.<br><br>
3. Would I start by seeing an OB? Or start directly with the midwife?<br><br>
Some people see both, or see an OB for some medical tests that they want (blood work, ultrasound) if the midwife can't provide that. But I only saw a midwife.<br>
[/QUOTE]
 

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Discussion Starter · #11 ·
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<div>Originally Posted by <strong>DisplacedYooper</strong> <a href="/community/forum/post/11541308"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Our dog is a bit of a spaz, so she went to stay with a good friend (that she had stayed with before) when I went into labor. She came home the next day. I have a friend who has 3 adopted greyhounds. They stayed at home.<br></div>
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Oh. I can guarantee that my dog will be a spaz. She sleeps at the foot of my bed, and after 2 1/2 years, still follows me around the house. Her favorite spot is right next to me on the couch. I am afraid of her getting really upset and hard to control when there is pain during delivery. (And yes, I know there will be pain. <G>)<br>
There is a boarding kennel I take her to when I can't take her with me on trips, or if I just need to do a real deep clean without her attacking the vacuum cleaner. They love her there, and she loves it. She gets her own "room" with a bed, "patio". Yep, she is spoiled.<br><br>
Y'all have given me so much to think about. I really appreciate the candor and advice. Thanks!
 

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i'm not a midwife at all; just a UCer. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"><br><br><i>1. If you have a pet, where should she be at the time of the birth? In a kennel (boarded)? (I have a dog.) How long before she can come home?</i><br><br>
i think some people have their pets around, others have them in another room, and i suppose others board their pets if needed.<br><br>
your midwife may not want the dog around or may be ok with it entirely. who knows? up to the two of you, i guess. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/orngbiggrin.gif" style="border:0px solid;" title="orange big grin"><br><br><i>2. Would I want an CNM or a CPM? Is there a really huge difference between the two?</i><br><br>
CNMs generally practice in hospital settings and/or birth centers, where as CPMs are more likely to practice home births. so, look for CPMs to start if you're looking to homebirth.<br><br><i>3. Would I start by seeing an OB? Or start directly with the midwife?</i><br><br>
CPMs here provide the same testing and prenatal care that OB offices do. they have OBs for "back up" if they need to refer a client there. so you can just start with your midwife of choice.<br><br><i>4. I had a LEEP done three years ago. If I need a cervical crevage, am I stuck with an OB and hospital birth?</i><br><br>
i have no idea about this, sorry! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/orngbiggrin.gif" style="border:0px solid;" title="orange big grin">
 

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1. If you have a pet, where should she be at the time of the birth? In a kennel (boarded)? (I have a dog.) How long before she can come home?<br><br>
Our dogs were with us at home. They really didn't care, just slept in another room. They became interested at delivery so we just sent them to a different room. We have a lab and a weim.<br><br>
2. Would I want an CNM or a CPM? Is there a really huge difference between the two?<br><br>
It depends. I had a CNM, which are legal (we are in the same state). But she is trained in midwifery to do homebirths, and I liked that she would write scripts and what not.<br><br>
3. Would I start by seeing an OB? Or start directly with the midwife?<br><br>
No need to see an OB.<br>
4. I had a LEEP done three years ago. If I need a cervical crevage, am I stuck with an OB and hospital birth?<br><br>
No idea, but my guess is that it will depend.
 

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Regarding our dog: her being a young border collie definitely is a big part of why she reacted that way. Sending her outside was as far away as I could have ever sent her, though! When things calmed down, she came back in, and she loved the baby. Since the baby smell was everywhere and mingled with my smell, possibly that's why she never resented her.<br><br>
At any rate, I believe that unless the dog is going to flip out and become loud or vicious, the dog will do better at home - rather than being sent away only to return day(s) later to find a baby in her place.<br><br>
--janis
 

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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>Angi</strong> <a href="/community/forum/post/11537265"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">So with that background, here are my questions:<br>
1. If you have a pet, where should she be at the time of the birth? In a kennel (boarded)? (I have a dog.) How long before she can come home?<br>
2. Would I want an CNM or a CPM? Is there a really huge difference between the two?<br>
3. Would I start by seeing an OB? Or start directly with the midwife?<br>
4. I had a LEEP done three years ago. If I need a cervical crevage, am I stuck with an OB and hospital birth?</div>
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1. Our dog will be outside. She's a spazzy Dachshund who is neurotic and odd. Her main focus is play and her ball, so she wouldn't care about what's going on with me or all the people, she'll be trying to get everyone to play with her!<br><br>
2. It dosn't matter if you have a CPM, LM, CNM, lay midwife, whatever. THe difference is education, as a CNM is an RN with midwifery training and has worked in L&D before. Philosophy, education, and experience can vary greatly and it's important to find one who is competent and meshes with you, regardless of the letters (or not) behind the name.<br><br>
3. Midwife. In general they are a good judge of high and low risk, whereas a doc usually automatically labels you high risk from the moment you walk in, reagrdless if you are or not.<br><br>
4. You've already had good responses for that....I have no experience with that.
 

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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">4. I had a LEEP done three years ago. If I need a cervical crevage, am I stuck with an OB and hospital birth?</td>
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nope, you're not stuck. both myself and one of my midwives saw perinatologists about cerclages. she got it done (her fifth), i was ineligible for surgery because of other factors. but we saw different doctors, and both were fine with our using midwives and birthing at home. the doc i saw wanted two or three appointments after surgery for monitoring, i think my mw goes every month or six weeks. in both cases, doc wanted/wants to remove the suture at 36 weeks and part ways amicably!
 

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<div>Originally Posted by <strong>DisplacedYooper</strong> <a href="/community/forum/post/11541308"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;"><br>
Depending on the climate/law in Texas, you may even want a LM (Lay Midwife) Certification guarantees a minimum level of technical knowledge, but it doesn't guarantee that the person provides the Midwifery Model of Care. My midwife was a CPM, but only got the certification in the last year or two when it looked like the climate for LM's would be changing in Maine.</div>
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Texas does license lay midwives. I use a direct entry midwife and she is awesome. You can go to <a href="http://www.texasmidwives.com" target="_blank">www.texasmidwives.com</a> and look for midwives (all types) in your area.
 

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<div>Originally Posted by <strong>thefragile7393</strong> <a href="/community/forum/post/11542960"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">a CNM is an RN with midwifery training and has worked in L&D before</div>
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Not necessarily. Quite often nurses go directly into CNM training after getting their RN without working as RNs first. Others know they could never work in L&D and work in other hospital departments while completing the CNM program.
 

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my CNM midwife (in Texas) has had her own practice for 23 years, and has been CNM certified for the last 15 years. I don't think she was ever a hospital nurse, but I could be wrong.<br>
--janis
 

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<div>Originally Posted by <strong>jrabbit</strong> <a href="/community/forum/post/11546458"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">my CNM midwife (in Texas) has had her own practice for 23 years, and has been CNM certified for the last 15 years. I don't think she was ever a hospital nurse, but I could be wrong.<br>
--janis</div>
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I'm pretty sure she was <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/shy.gif" style="border:0px solid;" title="innocent"> I've heard her mention it.<br><br>
Congrats BTW!<br><br>
-Angela
 
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