Tuesday, July 15, 2008

Midwife Visit Report

I went to an appointment yesterday and after the new patient orientation spent TWO hours one-on-one with a midwife. We went over my chart, I had a couple tests done that weren't completed before, she answered my questions, we reviewed my packet they gave me to complete about giving birth at the birth center, she gave me an exam, explained the results, and introduced me to the one midwife I hadn't met yet, and we just chit chatted and got to know each other a little bit.

The level of care is SOOO different than from the obstetrician. For example, all this time when I've been getting exams, and they've told me nothing was happening, no one ever explained it like the midwife.

So there are several ways that labor starts progressing. The cervix starts getting soft (CHECK), the position changes from pointing towards the mother's back to moving forward (CHECK), the cervix starts thinning (1/3 of a CHECK - they said I was about 30% effaced), the cervix opens - I'm only 1 cm dilated, but something is happening, and the baby starts descending through the pelvis. The descent level goes from a -4 where it's highest up to 0 to +4 where it's showing and about to come out. The midwife said I was at a -1.

This is WAY more information than "your cervix is closed, g'bye".

We talked about some other things that I tried discussing at the doctor's office previously and I was much more satisfied with our discussions. For example, the whole induction thing. Now I know there comes a point where it's just not safe for the baby to be inside anymore, but I also know that if you have an uncomplicated pregnancy, that point is not 38 weeks, or even 40. The midwife explained that if the baby wasn't born by the 22nd, we'd do a Bio Physical Profile, which would include an ultrasound, measuring the level of amniotic fluid, and some other things to ensure it's still a safe environment. If by the 25th, I'm still pregnant, I should go in for a non-stress test where they'd monitor the baby's heart rate for about 20 or 30 minutes and how it reacts to contractions. And if after all this and the baby STILL hasn't arrived, we may do an induction on the 28th. They even mentioned they'd be willing to hold out another week until Aug 5, if that was what I wanted.

I felt comfortable with the 28th. My doctor's discussions about getting an induction involved making sure we got a spot on the calendar, and I felt I was being pushed into something just as a matter of convenience for the doctor; they didn't even mention anything about tests to make sure the baby could safely stay in the uterus longer.

I really feel like I did the right thing by switching to the midwives. And maybe, I subconsciously wasn't letting myself progress with labor because I felt so uncomfortable at the other practice. who knows.

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