Doctor Visit

I saw Dr. Lopez yesterday. I'm so glad I didn't waste too much energy on worrying about stuff. (Yes, I had some concerns, but I didn't lose sleep over them.) He is feeling good, pain free and moving well. The reason he didn't come to the meeting last week is because he didn't have permission from his surgeon; he was still on bed rest. He says he is still enthusiastic about the home birth.

I came with a list of questions and he answered them mostly to my satisfaction. The only outstanding question is about the dosage and formulation of the Rhogam shot but he told me where I can get the information I want. He had an interesting reason for feeling strongly about me getting the shot postpartum if Baby is Rh+. He said that if for some reason in the future I need an emergency blood transfusion and they don't have Rh- blood available they could still give me O+ blood safely as long I have not already been sensitized. Hm.

Last time I saw him he had said he wanted to do an ultrasound. I told him I would give it some thought and I have indeed spent quite a bit of time thinking and doing additional research. I had eventually come to the conclusion that I would decline it. But he didn't even bring it up!

We did discuss and disagree on a couple of things. He believes that a single clamp should be applied once the cord stops pulsing since the baby will be up above the level of the placenta and gravity will cause blood to drain out of the baby and back into the placenta, causing anemia in the baby. My research indicates that once the baby has reached optimal blood volume, there is a reflexive closure of the umbilical blood vessels. So probably it's a moot point, since by the time Dr. Lopez wants to clamp the vessels would have closed themselves already. But I would prefer to keep the cord unclamped and uncut until after the placenta has been delivered.

The other point we disagreed upon was cervical checks. I don't want any, but he would like to do between one and three. To be sure I'm not in false labour, or way beyond where I think I am or seem to be. He has seen both cases fairly recently. It is for his own preparation and I appreciate that. He'd rather not be hanging around my house if I'm at 2cm, or be too relaxed and unprepared if I'm complete but coping so well that no one can tell. Again, I know that we don't always know how labour will go but I think that most likely I will know and they will be able to tell well enough how far along I am without doing an internal exam. And really, it's not the end of the world if either situation occurs. We left that one unresolved for the time being.

Andrew's advice was to concede on a few points so that the doctor can come into the birth feeling comfortable. Andrew makes a good point. On the other hand, I am not making these choices out of principle or stubbornness. I truly believe them to be the best choices for our baby. So I'm not inclined to compromise on anything. But then if our birth attendants are not totally comfortable that itself introduces an element of risk. So it's worth considering making a compromise or two.

I haven't gained any weight since I saw him three weeks ago. I've put on 30lbs total. My blood pressure was 100/70. Baby's heart rate was 128. I was a little surprised that it was lower than the 140's it has usually been at but he thought that was fine. He said Wee3 is for sure head down (whoohoo!). But floating quite free still. Head was much higher than where Lucia found it. Interesting. But it's not uncommon for baby #2+ to drop/engage right at the time labour rather than weeks ahead like with baby #1. He was happy with my blood and urine test results.

He wants me to have a non-stress test next week. They measure baby's heart rate and reaction to any contractions for 30 minutes. It also measures the health of the placenta. In Canada this is typically done when baby is overdue or if there are complications with the pregnancy. He would like to do it because he said it gives him quite a good insight into how baby will handle labour. He said it doesn't involve any ultrasound or anything. I did a little research and unless Lucia has a different kind of machine, it appears that the baby's heart rate is indeed measured by a doppler ultrasound. I'll be looking into it a little further.

In other news, I'm back to feeling really good!