O2

Lucia arranged for rental of an oxygen tank in case we need it. It was delivered today. It is somewhat larger than I expected...


I was going to get him to put it in the office where we have the birthing pool stashed. After he told me it weighs 80 kilos I decided it might be a better idea to put it a little closer to where we will be.

Birth Attendant Home Visit

Lucia and the pediatrician, Dr. Luis Flores, just left. Dr. Lopez didn't come because he's still recovering from his back surgery. That worries me a bit, and I'll discuss it more later on in the post.

Let me start with an on-the-record apology to my family. I slept in a bit this morning and during that time I dreamed that the team came over for this meeting but the house was a wreak and I was so upset and embarrassed. The bed wasn't even made. The playroom was a disaster. And Andrew had decided to revamp the living room configuration into something that was hugely aesthetically displeasing. I was mad at my family and mad at myself for letting it happen and the anger carried right into my real morning. Sorry family, for being so grumpy and impatient and curt this morning. I shouldn't have slept in if I was so concerned about getting the house in shape for visitors. I really wanted the house to look orderly and clean for this visit, because these people are doing something out of the ordinary on our behalf and I wanted them to feel very comfortable with their decision to attend our home birth.

Anyway we got the house cleaned up to my satisfaction, the kids went to Xochi's house to play while we had the meeting, and the meeting itself went quite well. We went over the list of supplies and who was responsible for what items. Then we toured the house. I had thought that we would put the tub in the front entrance but we decided to put it in our walk-in closet. Not as weird as it might sound. It's actually a walk-through closet. We walk through it from our bedroom on the way to our bathroom. Which means that I have shower, toilet and bed all nearby, and it's a nice intimate setting. Not the best for photos unfortunately. But I'm confident my highly motivated husband will figure something out. I'm sure it will include hanging some sort of backdrop. I can see it now... it's 3am, I'm in the throes of labour, and Andrew is hammering nails into the cement walls so he can get nice photos. Which of course I'll be glad we have after the fact, but possibly not so much at the time.

The neighbors also might not be so happy with this plan if I give birth in the middle of the night. But I've put up with a party or two so they can put up with some birthing noises (and some hammering) ;)

The pediatrician seemed quite relaxed with the home birth and with my low-intervention preferences. He thought it would be fine to wait on the vitamin K injection and just watch baby for any sign of hemorrhage. When I mentioned oral vitamin K he put it in my court so I am going to follow up on that. The oral application seems like a good compromise to me, plus ensuring that I have lots of vitamin K rich food in my diet.

About the OB. He had his surgery 2.5 weeks ago. I spoke to him a week later and he was feeling great and said that his recovery was ahead of schedule. He expected to be back in action two weeks after his surgery. So I was surprised to hear that he couldn't be here today. I think he may have overdone it or something in the last few days. Yikes. Of course I wish him a full and speedy recovery for his own sake. And also of course I'm a little concerned about what this might mean for my birth, especially if Wee3 decides to come a little earlier than we expect.

But there's not much I can (/will) do to influence Wee3's birth day and there's nothing I can do to influence Dr. Lopez's recovery. All I can do is continue to pray that God blesses this birth. I think we do have a backup OB, but I don't really like that element of the unknown. That said, Andrew expressed again that he is more than willing to protect our birth plans if things start to go off track without good medical reason.

On Tuesday Lucia will pop by with the hose from the tub so we can make sure that it fits my plumbing. The following Tuesday we will pick up the tub and stash it here in the house.

Before Lucia left I had her check baby's position again. It was the same as last time... at first she thought that baby was breech. Then she really dug in low and felt fairly sure that she had identified a head. I believe it that Baby's head is really low because I am feeling it in my ligaments, muscles and nerves. I sometimes get shooting pains down my thighs and I have to be a little careful how I move and turn otherwise I get very sore in my groin area.

Wee3, we trust you and our Lord to choose the perfect birth date. We will do our best to provide you with a gentle, peaceful, safe entry to this world, and we trust that God is in control even if the circumstances aren't exactly as we planned. We love you so much and we can't wait to meet you!

Home Birth Safety

Here is a link to a Journal of Perinatal Education document called Birth Can Safely Take Place at Home and in Birthing Centers.

The abstract of the document says:

Although most women in the United States give birth in hospitals, a substantial body of research suggests that planned home birth or birth in freestanding birth centers have equally or better outcomes for low-risk women. Out-of-hospital birth often facilites mother-friendly care. Rationales and systematic reviews of both home birth and freestanding birth center birth are presented.

And only a few days ago the results of a very large study from the Netherlands was released. Here is the abstract from that study:

Objective To compare perinatal mortality and severe perinatal morbidity between planned home and planned hospital births, among low-risk women who started their labour in primary care.

Design A nationwide cohort study.

Setting The entire Netherlands.

Population A total of 529 688 low-risk women who were in primary midwife-led care at the onset of labour. Of these, 321 307 (60.7%) intended to give birth at home, 163 261 (30.8%) planned to give birth in hospital and for 45 120 (8.5%), the intended place of birth was unknown.

Methods Analysis of national perinatal and neonatal registration data, over a period of 7 years. Logistic regression analysis was used to control for differences in baseline characteristics.

Main outcome measures Intrapartum death, intrapartum and neonatal death within 24 hours after birth, intrapartum and neonatal death within 7 days and neonatal admission to an intensive care unit.

Results No significant differences were found between planned home and planned hospital birth (adjusted relative risks and 95% confidence intervals: intrapartum death 0.97 (0.69 to 1.37), intrapartum death and neonatal death during the first 24 hours 1.02 (0.77 to 1.36), intrapartum death and neonatal death up to 7 days 1.00 (0.78 to 1.27), admission to neonatal intensive care unit 1.00 (0.86 to 1.16).

Conclusions This study shows that planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives and through a good transportation and referral system.

Dr. Rixa Freeze's Stand and Deliver blog contains some comments and links to news stories about this study.

Grrrrrrrrrreat Prenatal Appointment!!

All signs of urinary tract infection are gone! I was dreading the possibility of needing antibiotics so that was a relief. Seems that the vitamin C tablets and copious amounts of cranberry juice did the trick. That or the sterile sample container vs the jam jar I used for the first lab test ;)

My blood pressure was good at 110/70, though perhaps slightly elevated due to the doctor's scale indicating a 22 pound weight gain since my first appointment!!! Definitely wrong. Most definitely incorrect. Heart good, kidneys good, reflexes good, no edema, fundus height bang on. Baby's movements very good. Too early to detect a heartbeat with a stethoscope unfortunately, but the movements tell most of the story.

I passed along my Dr. Sarah J. Buckley Gentle Birth, Gentle Mothering book with a few chapters marked for his special attention (Ultrasounds, Undisturbed Birth, and Third Stage). He seemed interested in reading through it. He is also planning to attend the conference in Monterrey at the beginning of May at which she will be speaking. I'm SUPER DUPER EXCITED to be planning to attend this conference.

Then we talked. I told him that I have been thinking, dreaming and praying about the birth... and I am seeing it at home. His response? "Why not?" My heart leaped! I love how this has fallen into place so naturally. At first I received a lukewarm response to the idea from Andrew, Dr. Lopez and from Lucia. I didn't want to push for anything with which my support team was not comfortable so I focused on planning a waterbirth in hospital. But every time I thought about having this baby, I was labouring in water at home. I have even been looking at appropriate kiddie pools and daydreaming about it while I'm grocery shopping. I spoke again with Andrew about it a while ago and he was much more open to it, quite supportive in fact. Dr. Lopez's response seals it.

We are officially planning a home birth!

For those who are concerned about my and the baby's safety, here is a link that might help to ease your mind: http://www.gentlebirth.org/format/myths.html

I am thrilled for so many reasons. I won't have to endure the uncomfortable drive to the hospital or dance through contractions while trying to answer questions about who I am and how I'm paying or deal with the limbo that is triage. I will be able to focus entirely on relaxing into the process of birth and letting my body do the work God designed it to do. I won't need to worry about childcare (assuming Mom can be here at the time that baby chooses to join us on the outside). Eva and Micah will get a chance to witness the miracle of birth if they choose. We will all five get to climb into our deliciously cozy bed and get to know the new member of our family very soon after he or she is born. I will have my own food, my own bathroom, my own familiar spaces and things, my whole family surrounding me during and afterward. There is less risk of infection and unnecessary intervention. With no hospital staff waking us up to poke and prod us, baby and I will be able to enjoy the beautiful undisturbed restorative sleep of two people who have worked hard and need the rest. (I experienced this with Micah, coming home a few hours after his 1pm birth; that first night was a wonderful gift).

My hope and desire is for a straightforward, undisturbed birth and I believe I am doing my part to that end: nutrition, education, exercise and prayer. In the event that this birth requires medical help, I will have three skilled and prepared caregivers in attendance (midwife, OB/gyn and Pediatrician) and a top quality hospital within 15 minutes drive.

WOW I'm excited. :D

Dreaming of a Home Birth

I can't stop thinking about having this baby at home. When I told Andrew, he told me he was supportive! He trusts me to do my research and make a good decision. My heart leaped! I have been daydreaming about where it would happen in the house and the more practical aspects of preparation. I will have long discussions with Dr. Lopez and with Lucia in the next months.

I left this in draft after I wrote it so as not to freak out any mothers and mothers-in-law unnecessarily ;) But I wanted these thoughts to have a place in this journal.