Sunday, November 21, 2010

My Birth Plan

I was planning a Home Birth.  I felt (and still feel) that a natural birth is the best thing for both Mother and Baby, and I had a lot of faith that my body would be able to do what it needed to do.  In Darwin, we have a government run home birth service, where a team of midwives provide prenatal care and attend the births of women wishing to have their babies at home.  I had called the home birth service when I was 5 weeks pregnant and spoken to a midwife named Jane.  Jane came over a few weeks later and talked to Rod and I about it, and we were happy that this was what we wanted to do.  (Well, Rod was happy to let me do whatever I wanted to do!)  My family was not overly keen on the idea, especially as my mum had a lot of difficulty when giving birth to me, She had a small pelvis and I had to be born using forceps and vacuum extraction.  She did not attempt a vaginal birth again when having my two younger brothers.  A lot of people I spoke to thought I was a bit crazy, especially when they found out you cannot have drugs for pain relief when you are at home.  I was much more afraid of the drugs (especially an epidural) than I was of the pain though!
Jane was nice, and I had my first proper appointment with her when I was 15 weeks pregnant.  At the appointment, she pulled out her doppler and said we could try and find the baby's heart beat but that we might not find it that early.  Of course, by that stage, I was an absolute pro at finding it and told her exactly where to look!  :)

The idea is that you see the same midwife throughout your pregnancy, and then in the last few weeks you meet a second midwife from the service who will also attend your birth along with your primary midwife.  Unfortunately though, Jane had some health problems that meant she was unable to keep working with the homebirth service, so at 29 weeks, I met my new midwife, Meryl.  Meryl was different to Jane, but I liked her too.  She was older and had a lot more experience to draw upon.  Not that I thought Jane was not experienced enough, but Meryl just seemed wise :)  I am pretty sure Meryl thought I was a nut case though.  From the time I had my first appointment with Jane, my blood pressure had been on the higher side, but this was pretty normal for me as it tends to be elevated whenever other people take it.  (White coat hypertension)  I did have a blood pressure monitor at home that had belonged to my Dad, so generally I would take it myself before my appointments so that if it was elevated I could say, well this is what it was before you got here.  This particular day though, I took it before Meryl was due to arrive and it was pretty high.  I tried to lay down and relax for a while, and then took it again.  It was still high.  By the time Meryl got here, I was having a bit of a freak out.  She was able to talk me down and by the time she took it, it was not as bad as what I had been getting.  Phew!

A few days later though, I woke up in the night feeling unwell.  I felt really dizzy, and my vision was blurry.  Initially I thought perhaps it could have been due to the position I was sleeping in and that the weight of the baby was on a nerve or affecting my blood flow.  I managed to go back to sleep for an hour, but when I woke up again, I didn't feel any better.  In fact, I felt like something was really, really wrong with me.  I took my blood pressure and it was higher than usual so we went up to the hospital and were sent straight up to the delivery suite.  They took my blood pressure and it wasn't too bad (pretty much what the homebirth midwives normally get) but they hooked me up to the monitors to check how the baby was going, and they also took blood and urine samples to rule out pre-eclampsia.  The baby was great, moving all over the place and my blood and urine came back normal.  So they sent me home and told me just to keep an eye on my blood pressure and if it got high again, then to come back in.  It was a once off, I never felt unwell like that again, but now I was well and truly paranoid about my blood pressure.  I REALLY did not want to have my baby in the hospital but I was so worried I was going to end up with pre-eclampsia and that I would have no choice, that I would be forced to go to the hospital, that I would have to be induced due to high blood pressure and the dreaded cascade of interventions would happen to me.  Induction = Epidural = Failure to progress = C section.  The whole thought of it freaked me out.

So after Jane left, they were looking for a new midwife to replace her at the homebirth service.  Meryl was going away on holidays just a few days after my due date, and being my first baby, the chances of going over were pretty good, so she thought it would be best to assign the new midwife to me as my primary midwife and that she would be my second midwife if I went into labour before she went away.  So at 36 weeks, Meryl came over with my new midwife, Josie.  I liked Josie too, so I wasn't too bothered about all the changes in midwives.  However, when Josie took my blood pressure that day it was BAD.   About 150/100.  AUGH!   Thankfully, by this time Meryl knew I'd be freaking out, so she left it and told me to take it myself later on and to text them and let them know what I got.  When I took it later, it was higher than I was typically getting in the past, but no where near as bad as what it was when they were here.  From then on though, it was high like that everytime someone else took it.  Once I hit 37 weeks (which is considered full term and alright to have a homebirth) I practically prayed to God every day that I would go into labour.  I just did not want to have to deal with all this high blood pressure stuff, I just wanted to have the baby and be done with it.

Like many other pregnant women, I was trying all the tricks to get things going...  walking, sex, spicy food, red raspberry leaf, evening primrose oil.  I just wanted my homebirth with no drama!!  Come on baby, just come out so Mama doesn't have to deal with all this stuff!  Apparently, he wasn't listening though.  I had to go and see the Doctor for a second opinion about everything.  Of course my blood pressure was high for her too, but again, she tested my urine and there was no proteins.  She sent me off to have the blood work done to rule out pre-eclampsia (again).   It all came back fine for pre-eclampsia, but there was some anomalies with my liver function test.  However, the levels that were out, can be out due to pregnancy so it was likely that was the reason.  In any case, I had to repeat the blood work.  I was annoyed with the whole thing, I just wanted to have a baby and not have to worry about all these things, and I wanted to have my baby at home!  All of this stressed me out a lot, because I had no control over it and it had the potential to take away the birth experience that I wanted.   The doctor said though, that she thought I was ok and I could go ahead with the homebirth.  I had everything all ready, a birthing pool, a big exercise ball, some heat packs and a few other random things.  I didn't know what it was going to be like, or what I would want during labour so I tried to cover all my bases.  I bought "The Pink Kit" and read another book about Birth Skills to try and prepare myself to cope without pain relief as best as I could.  I was ready, and aside from the blood pressure issues, I was not at all anxious about the impending birth.  I knew it would hurt a bit, but I didn't think it would be anything I couldn't handle.  Bring it on!  


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