Choosing a midwife, Part III

23 Aug

I had an appointment with my midwife Heather this morning.  Now that I’m in my third trimester, we’ll be seeing each other every two weeks, and I really look forward to it.  It was such a nice relaxing visit. 

I slept in this morning and was still eating my breakfast when Heather arrived at my door at 9:30.  Crook and Nanuq both snuggled with her as we chatted about my week; I told her what I learned from the physiotherapist and chiropractor and about my visit to the ER on Thursday

Last time we’d met, Heather had asked me to keep a food diary for a few days, so I gave that to her and we had a great discussion about nutritional needs during pregnancy.  For example, I should have protein regularly and she’s happy to see that I tend to have a bit of it spaced throughout the day because, hey, babies are mostly made of protein and fat.  Also, the need for iron picks up in the third trimester because babies start storing it to use in their first 6 to 9 months of life.  Besides meats, dark leafy greens are a good source of iron; vitamin C helps our bodies to absorb it, but calcium inhibits iron absorption.  Some of this stuff was new and some wasn’t, but it’s great to have an idea of what to focus on when I make food choices.

We discussed how birth practices in North America are changing.  Heather attended a vaginal breech birth a few weeks ago, which was fascinating.  I’ve been interested in this topic for a few years because a friend of mine in Ottawa has been very involved in advocating for informed choice of vaginal birth vs. c-sections for breech babies.  Heather told me that the Whitehorse Hospital recently changed its policy on vaginal breech births and doctors will now allow a trial of labour for breech births at the hospital.

We talked about things I could do while I’m still pregnant to try to strengthen my abdominal muscles so that I can avoid further separation and, I hope, ward off those nasty muscle spasms.  I was surprised to learn that Kegel exercises can help.  I know I should do these but I hate them, so I always end up conveniently forgetting.  Besides, when Heather explained how to do a “full” Kegel, I realized that there’s more to doing them right than I ever gleaned from the literature.  (She told me to lean back on a wall with knees slightly bent and picture a string behind my belly button being pulled up through the back of my neck.)  Kegels actually engage a lot more muscles (like the abs) than I thought.

One nurse at the hospital on Thursday noted a trace of leukocytes in my urine sample and was concerned that this was a symptom of a UTI, which could irritate the uterus, which could lead to pre-term labour.  (I thought the nurse was over-reacting a wee bit, don’t you?)  Heather had mentioned at an earlier visit that there are herbal therapies for UTIs, so even though neither of us think I have this infection (since the urine stick showed neither blood nor protein) we talked about herbs that are good for urinary tract health.  Apparently the Yukon is a great place to live if you have bladder issues.  Cranberries (the “regular” kind, as well as high- and low-bush cranberries) and kinnikinnick both work really well as natural remedies, and both are plentiful around here.  Kinnikinnick grows right outside our back yard, and both types of bush cranberries are easy to find close by.  Heather said that high-bush cranberries are also good for back pain and knee pain, so I may go looking for them as an additional boost for my sacral health “program”.

We did a physical exam (blood pressure, fundal height measurement, gentle palpating to see where Nugget was lying today) and then Heather broke out the fetoscope.  It was much easier to find Nugget’s heartbeat today and once Heather was finished listening, she passed the earpieces to me.  It was the first time I got to try out the device and it’s so different from using a Doppler, which has a definite mechanical/electronic sound to it.  With a fetoscope, it’s more like listening to something that’s happening underwater — which I suppose is exactly what’s going on!

We wrapped up our visit with a discussion about post-partum depression and set up our next appointment, to which I will bring Jade because I’d really like to have her involved so that she feels she is a part of the whole process.  By this time, it was after 11:00, making our appoinment almost 2 hours long.

I know that in my initial musings I wondered about how much pre-natal care I really need and what a midwife would have to offer beyond the exams one gets in a doctor’s office.  After learning so much from Heather today and having such a nice time on a social level as well, I’m feeling better than ever about my decision to choose a midwife.

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7 Responses to “Choosing a midwife, Part III”

  1. MommyTime August 23, 2008 at 3:22 pm #

    Ahhh…this sounds blissful. At my OB appointments, I had to have questions ready to throw at my doctor (whom I liked very much, actually) while she was still taking off her gloves, or else she would be out the door and on to the next patient before I could ask them. And this was at a good practice, very well liked, with doctors who were excellent when serious issues arose. But, like most OB practices around here, seriously over-scheduled. A 2 hour appointment would be unheard of, even in serious danger, as nurses and other medical people would also be in attendance. I wish I’d had such a relaxing option as this. What a great experience the birth should be, if this is the prenatal standard of care!

  2. Kara August 23, 2008 at 6:31 pm #

    That sounds so nice!!! I would love to have a midwife, but with the history of the last birth it is pretty much out of the question.

  3. Captain Momma August 23, 2008 at 9:08 pm #

    I will tout them to the ends of the earth! The best experience I ever had and a good portion of the reason I pushed my husband to move back to BC after I retired so I could still have a midwife for our (hopefully) future children.

    Such excellent care and relieves the pressure on the doctors yet most will throw up their hands or walk away from you if you say you want one. Why don’t they get it? They are not gods and cannot provide any substantial amount of support at all. I LOVED the long visits I had with the midwife to discuss lots of things and take the time to discuss them as well. Mine always made tea for you and asked all about how you were feeling about various things. No rush at all. Bless them all:)

    Good on ya for taking the plunge! I don’t think you’ll regret your decision.

    Kelli

  4. Chris August 24, 2008 at 5:27 am #

    That was what I loved about going with a midwife for both my pregnancies. It felt more as if I was talking to a very knowledgeable friend than anything else. No pressure, no rushing through questions. The other thing I loved was that at the actual birth, everything was so calm and peaceful in the room (except for me of course). The lights were dimmed and there was only ever the midwife, myself and Charles in the room so no excess traffic or unfamiliar faces. The post-partum care was amazing as well! As you can see, I have nothing but great things to say about midwives!!
    Happy you feel good about your decision!
    Chris

  5. ecohumanist August 25, 2008 at 1:45 am #

    congratulations… I had two homebirths with a wonderful midwife and I really support this choice!
    i’m also happy to learn that breech vaginal births are spreading! that’s aloso grat news!
    bye!

  6. Bubblybunny August 25, 2008 at 5:56 am #

    I’m pregnant with our first child (1.5 weeks overdue now, Eeeek!!) and I switched to midwifery care in my 3rd trimester. It was a tough decision because it was so late in my pregnancy that I didn’t know if it was a good idea to switch.

    I originally went with an OB because I work at a hospital and it was super easy for me to make my appointments with the OB without having to take 1/2 a day off at work. But I got sick over Easter and I was bounced around from department to department at the hospital like a basketball, barely able to walk for more than 5 min because of the pain (turned out I had stomach flu). I had never been so miserable in my life because I was super sick and I was so worried about the baby. And yet, I found the hospital staff so mean and cold, including the nurses at the maternity triage and clinic. Then I talked to a couple of women at my prenatal classes who were under midwifery care and they had nothing but praises for their midwives. I kept thinking that I wish I had that kind of care when I got sick.

    After talking to a few more people and discussing it with my hubby, I’ve decided to make the leap and switch. I am really glad I went with a midwife. About 2 weeks after I switched, my hubby and I got into an car accident, nothing major, just a little fender bender. But I was scared and I was sooooooo thankful to have my midwife by myself to take care of me. She pre-arranged everything with the triage nurses and I was ushered into the exam room as soon as I arrived. I didn’t have to say/do anything; it was the easiest, most pleasant hospital visit I’ve ever had!!

    I am not saying my OB wasn’t a good doctor. She was very friendly and very enthusiastic. But everytime I had an appointment with her, I’d go with a list of questions and I’d go through that list with the nurse first and then fire the same set of questions at my OB as fast as I can before she runs out of the exam room. I just felt so rushed all the time and I almost felt guilty for taking up 10 min of her day!! But with my midwife, I was never rushed; she always took time to answer my questions, always asked me if I have any more questions, etc. She was very knowledgeable and has years of experience. I’ve met with other midwives from the same clinic while mine was on holidays and I received the same wonderful care from those midwives as well. I just can’t describe how happy I am with my midwifery care and this is probably the best decision I could’ve made for myself and my baby.

    I think a lot of people (including doctors) have misconceptions about what midwives do. When I told people I have a midwife, everyone automatically assumed I’m having a homebirth (that totally freaked out my mom and my in-laws). But I’m not. I’m not comfortable with the homebirth idea and I know I will need my drugs. What they don’t understand is that midwifes DO NOT promote natural birth ONLY. Instead, they promote informed choice. They take time at every appointment to go over the information you need to know to make that informed-choice about you and your baby. For example, just the other week, we spent about 20 min discussing immunization. I didn’t know I had the choice; I thought you have to vaccinate your baby because I had the full regimen of vaccination when I was a kid.

    Sorry this is such a long comment but I have one final comment to make. I know some doctors think that when midwives “screw up” a pregnancy, they are left to clean up “their messes”. But that’s not true. If the midwives have problem with the births, chances are, the doctors would have the exact same problem. Midwives are trained medical professionals and in my opinion, it’s the experience the caregiver has that counts. I fail to see how a new medical resident with only 1-2 birth experience can be compared to a midwife with 20 years of experience. Also, people forget that labour can be long, but not as long as the 9 months of pregnancy. So while it is important to ensure the health and safety of the mom and baby during labour, it is just as important to ensure the woman receive proper care and be fully informed during those long months of pregnancy. This last point is what I believe to set midwifery care apart from the current medical care.

    Sorry for such a long comment. I’m just so happy I switched and I want to tell everyone about it. 😛

  7. Asheya August 30, 2008 at 5:39 pm #

    It is pretty interesting how there is so much to discuss with your midwife that is beneficial to you and your pregnancy that you would never have time to discuss with a doctor! I know I felt very cared for during my whole pregnancy because of my midwife, and that carried into the birth as well. I really liked how Christina had all sorts of alternative remedies to offer, just as you are experiencing with Heather. Glad to hear that you are discovering more of the benefits to your decision to go with a midwife!

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