[railyuh]

So here is the story... I had an early m/c in 2005, then conceived my DS just 2 months later. I gave birth to him in the hospital, was induced with pit (yeah, don't want to do that again) but I actually made it through without pain meds and for the most part had a good birth experience. But after that I knew I wanted a homebirth the next time around.

So then I had another m/c last Dec and then another one in April--both of them around 10-11 weeks. After that I went to an RE to get some testing and found out I have a genetic thing (MTHFR) which is related to blood clotting. I am taking folic acid, b vitamins, and baby aspirin for that. I am also taking progesterone suppositories because I had low progesterone too.

So anyway, my question is would you consider taking on someone in my situation? I did have a midwife set up for my last 2 pregnancies but obviously that didn't go anywhere since I m/c both times. From what I can understand, the MTHFR doesn't put me at higher risk as long as I am taking the folic acid/baby aspirin. Some people with MTHFR take heparin or lovenox but my RE didn't think it was necessary in my case. The only risk I've found associated with it is pre-e and I couldn't really find anything explaining why so I'm not sure if it is just a statistical relationship or what. I didn't have any pre-e symptoms with DS and had a very straightforward and "normal" pregnancy. My only "complication" was GBS+.

I do plan to ask my same midwife again once I make it past 12 weeks or so, and there are a few other midwives I can talk to if she can't take me. But I guess I am just wondering if I should prepare myself to not be able to have the homebirth I want because of my situation. A birth center isn't really an option as the nearest one is 2hrs away (and so are the homebirth midwives actually, but I've talked to a few that are willing to come here for the birth).

I personally feel confident about a homebirth and both DH and I really want it. I haven't been able to find a medical reason why I shouldn't, but I am also guessing that if I ask an OB they will probably tell me it's too dangerous just like they'd tell any pregnant woman.

Thanks.

 

[MsBlack]

I don't know what an RE is.....I get the main point of course, but I can't figure out those initials.

but other than that, none of what you've said about yourself makes me feel you shouldn't have a homebirth. Maybe better to say--all of what you reported sounds like evidence that you are someone who could well have a fine HB.

 

[etoilech]

It wouldn't bother me, but I would want to do some research before commiting and find out about the drug(s) you are taking. RE = reproductive endocrinologist I can't imagine why it would be a problem as long as you're monitored and the pregnancy progresses normally.

 

[dewi]

I live in NYC and a huge population of women utilize a reproductive endocrinologist to get pregnant, (we have a much older population of first time moms). However, they transfer to a midwife once pregnant and it is considered a normal pregnancy, if you have a healthy pregnancy it does not matter how you got pregnant.

They have homebirths, birth center birth, midwifes at the hospital.

 

[rebirth]

I had an RE, and I'll still have a homebirth. Laws vary, but for me I'll have to consult with an OB to clear me, b/c I've had 3 m/c and a uterine surgery. But I'll still be able to birth at home, I just need a doctor to say so.

THe recurrent M/C are more of an issue with homebirth then the RE, but it sounds like you shouldn't have a problem, so long as you don't need hep/lovenox... if you do you may need to see a high risk ob.

 

[maxmama]

With a consult, sure. I won't be doing home births as a CNM (related to life/family issues, not an innate objection to them) but that seems reasonable as long as the consulting doc didn't think anticoagulation was needed. I would be very, very proactive in watching for pre-eclampsia, though -- maybe consider some baseline labs in the first trimester and a 12- or 24-hour urine, jsut to know what your baseline is.

 

[railyuh]

Quote:

Originally Posted by maxmama With a consult, sure. I won't be doing home births as a CNM (related to life/family issues, not an innate objection to them) but that seems reasonable as long as the consulting doc didn't think anticoagulation was needed. I would be very, very proactive in watching for pre-eclampsia, though -- maybe consider some baseline labs in the first trimester and a 12- or 24-hour urine, jsut to know what your baseline is.

Yes, definitely. I had that in mind anyway. I plan to be completely honest with my midwife so she knows all of this beforehand and that way we can watch out for pre-e. I've only met with her a few times from the previous pregnancies but I really trust her so I know if at some point during the pregnancy she decides I need to see an OB or get certain tests done I will do it. I really hope she is available, although I know there are quite a few other homebirth midwives who are willing to come here if she isn't.

Anyway, thanks everyone. That makes me feel better to know that at least nothing in my story would automatically rule me out. I don't think any of the meds I am taking should be an issue since the folic acid and b vits are just vitamins. I'll stop the progesterone around 12 weeks anyway (when my RE clears me and refers me back to an OB/midwife). I guess maybe baby aspirin could be an issue, but I know a lot of people who take it during pregnancy and I don't think it should be a problem. It's the only thing I will be taking for most of the pregnancy that is an actual drug and not just a vitamin though (I have to ask my RE again, but I think I recall him saying they recommend you stop taking it around 36 something weeks).

 

[leerypolyp]

I saw an RE, and was taking progesterone and metformin at the beginning of the first pregnancy, and just metformin for the first trimester of my current pregnancy. None of it was a problem for my homebirth midwives!

I mean, if you do go on to develop pre-e, then you get risked out of the homebirth either way. But there's no reason as far as I can tell that you wouldn't just start down the hb road...

 

[Jane]

Your history would not be a problem for me. I find that offering standard, run of the mill, boring midwifery care to women that technology-laden conceptions to be very, very gratifying.
Every midwifery client is constantly being vetted to make sure she is still low-risk and a good candidate for home birth. I assume everything will be fine, very much, "Trust, but Verify", like the lifeguard at the beach. Everyone, including the lifeguard, hopes Pam Anderson stays on her butt in that lifeguard chair.

 

[cristeen]

We got pg with an RE, we're seeing an RE now to TTC, and really there's very little that an RE would do that would result in my turning down a client.

Complications can still arise through the normal course of a pregnancy, but that doesn't have anything to do with having seen an RE.

Maybe if you were taking an anti-clotting drug stronger than aspirin, it would be worth some research because of the risk of PPH, but otherwise...

 

[railyuh]

Quote:

Originally Posted by cristeen Maybe if you were taking an anti-clotting drug stronger than aspirin, it would be worth some research because of the risk of PPH, but otherwise...

Thanks, that's kind of what I was thinking and that is why I was VERY glad when my RE said he didn't think I needed heparin or lovenox. I am hoping what we are doing now is enough to keep this baby sticky for the whole 9ish months

 

[dewi]

Sticky thoughts!

:

 

[JessicaE]

Quote:

Originally Posted by Apricot Your history would not be a problem for me. I find that offering standard, run of the mill, boring midwifery care to women that technology-laden conceptions to be very, very gratifying.

I found natural birth, midwifery care and breastfeeding to be very healing after two high-tech conceptions with an RE (IVF).

I agree that as long as yours is considered a low-risk birth, you should be able to birth at home with a midwife. My second was born at home, and I wouldn't step foot in a hospital to birth again, save a major medical complication! I also found it quite a thrill to send my RE's office our second son's birth announcement, which of course mentioned that he had been born into his daddy's hands at home.

Tons of sticky vibes for you!!!

(As a sidenote to consider down the line, some women who have had long roads to conception may have some unique emotional issues that come up in birth, much as with VBAC... just an awareness that I discovered on my own journey (even though I thought I was confident, I still had moments during birth of wondering if my body was really capable of birthing properly, since it could not conceive 'properly'), and I've since heard this in talking with other infertility moms as well.)