Things have been pretty crappy here at Casa de las Mariposas. After having two amazing natural births with a supportive midwife, I now am worried that my third child will be born via a very medical, possibly induced birth, possibly even a C-section. My midwives seem more like doctors in disguise. In fact, starting next week I have to see a doctor for some of my appointments, because I might “need” (or be pushed into?) an induction. At my appointment last week, my midwife told me that they absolutely 100% will induce me if I do not go into labor by 40 weeks. According to her, it is very risky to let pregnancies of insulin-dependent GDM mothers go past 40 weeks, because placental perfusion is compromised and the baby might not get enough oxygen. Is this true? I have no idea. I’ve been googling and googling, and can’t find any evidence either way. Part of me says it’s a CYA-in-case-of-malpractice-suit scare tactic, but I really do not feel comfortable refusing to induce unless I can find some evidence that I wouldn’t be putting my baby at risk.
She also was warning me about macrosomia and shoulder dystocia and all the possible problems that could cause. She listened to my birth plan, and then told me I should change it in light of the fact that an induction might be necessary, and bring it back next week. She did make a note in my chart that I want a natural childbirth. Now, I’m glad she wrote it in my chart for all possible caregivers to see, but geez, I thought it was just a given that if a mama is seeing midwives instead of OBs, it’s because she wants a natural childbirth. Is that not the case with most of their patients?
I had an ultrasound that showed the baby to be measuring three weeks ahead on head circumference and belly size. Now, I know (and the midwives freely admit) that the ultrasound is not very accurate. It could be off a pound either way, sometimes more. Yet they seem to be using this known-to-be-inaccurate sonogram as a diagnostic tool, warning me about the giant baby I’m having. Whatever happened to evidence-based medicine?
I’m not too worried about the head measurement, because Llani and Zeke’s head circumferences were always big. If I recall correctly, both were in the 90th percentile on head circumference when they were born. When Llani was a tiny baby with weight and height in the 5th percentile, she still had a head circumference in the 75th percentile. Adrian and his mom both have big heads, and Adrian simply makes big-headed kids. I had no problem birthing either one of them. And what does head size have to do with shoulder dystocia? If they were telling me that the shoulders were three weeks ahead, it might give me pause, but no one has said anything about shoulder breadth at all.
Right now, I feel like I am going to have to fight against interventions, against an induction, maybe even against being cut open. I feel like I am going to have to fight against my midwives, and I shouldn’t feel like that. With my first two pregnancies, I felt like my midwives were always on my side, working with me to give me the birth I want. With this one, I feel like these midwives are in opposition to me. I felt like my midwives in NY trusted my body, trusted the birthing process, and had faith that I could birth my babies normally and naturally. I am not getting that feeling from these midwives. I can’t help wondering if my midwives in NY would have handled my pregnancy the same way, or would I be having a much better experience with them? What about a homebirth midwife– would she be telling me that in my particular case a hospital would be better and that I really shouldn’t let the pregnancy go past 40 weeks?
It also doesn’t help that the other day I discovered this page. My hospital is Carolinas Medical Center in Charlotte. Yes, the hospital with ONE star out of five. If I’d seen that chart when I first got pregnant, I would have chosen a different hospital, and thus a different midwifery practice. Honestly, I think that if I drove I would be looking into other midwives and hospitals, even at 35 weeks along. But with limited time and very limited transportation, I am kind of stuck with the ones I have.
I have been researching gestational diabetes pregnancies and births as much as possible, researching shoulder dystocia and macrosomia. I’ve also researching natural induction methods so that I can encourage this baby to come before 40 weeks and thus avoid a medical induction with all it entails.
The amount of stress I’ve been under because of this is overwhelming. Added to that is the fact that I’ve been having sleepless nights. Zeke has a cavity that has been waking him up at night. Adrian has to see when he can take half a day off so we can take him to the dentist; meanwhile my poor boy has been feeling awful and whining a lot. I am dealing with lots of whining and crying during the day, lots of waking at night, a seven year old who seems to be going through a rebellious stage, fasting blood sugars that are still not where they should be on 40 units of insulin, and now having to fight to have a normal birth. Is it any wonder I am near tears a lot of the time? That I have almost no patience with the kids? That I am even feeling distanced from my wonderful sweet husband? I feel like my whole life is falling apart these days.
So, what am I doing? Research, as I said. But, more importantly, I am trying to build up my confidence in myself, my body, my baby, and the birthing process. As new-agey woo-woo as it sounds, I am trying to visualize having a natural birth, and repeating affirmations such as “My body makes babies just the right size,” “My body was made to birth babies,” and “I will birth this baby naturally.” I am making up my mind to be strong, to trust that I will have a natural birth and a healthy baby, and to fight if I have to. I am trying as hard as I can to replace the fear and stress and sadness I am feeling with hope, faith, excitement, and joy.