I've heard of birth plans.
I am a big supporter of them.
I had one and was glad I did.
I know things don't always go according to plan, but it's good to have an idea of a path you want to follow.
This time around, I had a "pregnancy plan."
This is different from a birth plan, this plan indicates how I want things to do in my pregnancy in relation to my prenatal care.
Some things included in my "plan" for this pregnancy included:
* New midwife
* No doppler checks for baby's heartbeat
* No ultrasounds
* No other interventions
* NO complications! (Of course, that one is just wishful hoping!)
But, we seem to have run into a few snags (already). Here's where we're at:
* New midwife {check}. I didn't want a new midwife, I was perfectly satisfied with the group of midwives I worked with when pregnant with Burkley and had an amazing birth experience at the hospital where that group of midwives worked. But, this time around we are on public aid, and therefore I have to be in a hospital in our state (Illinois) -if I want a hospital birth (and I do, at this point, with my birth history, I'd like to have "normal" hospital birth before attempting a homebirth, for my own peace of mind)- and Burkley was born in Iowa (we live right on the border). Turns out to have been a great switch. I am now seeing THE midwife of our area. I knew I wanted to stick with a midwife (versus an OB), so I switched to the group of midwives that serves my area in Illinois. I was nervous about a change, but I had heard such wonderful things about the midwives there that I tried to just assume all would be fine. At my first appointment, I was put at ease. She was wonderful, patient, kind, loving, compassionate...but generally concerned about a few things.
* I requested no doppler checks for the baby because of the research I've done on ultrasound and doppler waves and their impact on unborn babies. While final verdicts are still out on long-term effects, it is evident that the loudness of these waves is very disruptive to the peaceful environment of the womb. I also have never been one to care much about hearing my baby's heartbeat. Many moms I know just love that sound, but it was never "cool" or very meaningful to me with Burkley. Not sure why, I just didn't connect with the swooshing loudness of it all. My midwife agreed that it is my choice whether or not I want doppler checks, but also reminded me that it's the only way to determine viability without a doubt.
* Well, today I had an ultrasound. We decided that it was medically necessary, which is a different scenario to consider, I suppose. This was upsetting to me at first. But, my midwife was wanting to see if she could determine a reason for Burkley's early delivery (34 weeks). One hypothesis she considered was that I could have a short cervix. If I do, we would need to know this early on because I would be put on bedrest as well as possibly need to have my cervix sewn closed if my short cervix continued to shrink with the weight of a growing baby, leading to a condition know as incompetent cervix. My husband and I agreed that this is something we should at least check for (and hopefully rule out) so that the proper care can be in place if this issue does exist. Thankfully, today's check didn't turn up anything unusually "short." My midwife also wanted the ultrasound technician to check my baby's size so we can get an accurate due date on my chart. Though she knows we used Natural Family Planning and we know exactly when we got pregnant, she needs to have something "official" on the chart because if I go into labor, say, at 24 weeks, there would be a completely different route of action we'd take than if I went into labor at 26 weeks. Not sure what the differences would be, that was just an example she gave. Surprise, surprise, the ultrasound showed that I am more or less right exactly as far along as we knew I was (13 weeks). Because of the extended ultrasound exposure Baby C had today, I am glad I opted out of the doppler at yesterday's prenatal appointment.
* Regarding interventions, my midwife has asked that we consider her recommendation of taking the 17Hydroxy progesterone shot. I couldn't believe it. Here I was being told I should have regular ultrasounds and now hormone injections?! This was supposed to be my intervention-free pregnancy! But, I get it. We are still researching it, but this drug seems to really help with preventing preterm birth because it limits the movement of the uterus. Meaning, it can't really get jolted into labor by the movement of the baby or anything else because this hormone will keep contractions from starting until at least 36 weeks, when I would stop taking the shot. I've read some good success stories with this drug and side effects seem quite minimal. They also only seem to impact the mother and not the fetus at all.
* Still hoping and praying for no complications, of course. Both the progesterone and the ultrasound checks to determine a cause of preterm labor with Burkley are due to the fact that my midwife noted that for many moms who've had preterm labor, their next baby not only comes early, but earlier than the previous one. Of course this is not guaranteed, but it is fairly common. Praying for a full-term baby, for the sake of Baby C, but also for the sake of future babies. Maybe with them I can have an intervention-free pregnancy. My midwife was gracious to always remind me that the decisions regarding my plan of care are up to me, but strongly recommended we consider these courses of action and monitoring. With a history of an ectopic and then a preterm birth, she indicated that most hospitals would require me to be with an OB, not a midwife, but since she is so experienced and knowledgeable, I am safe in her hands.
So, for now things look good. I am not positive what we will check for at my next appointment in four weeks. By then though, I need to have decided about the progesterone shots, so I have some researching and praying to do. Have any of you ended with a different prenatal care plan that you expected to have? I know things can always go differently than planned in actual birth, but I hadn't considered not getting what I planned for in the pregnancy itself.
I am a big supporter of them.
I had one and was glad I did.
I know things don't always go according to plan, but it's good to have an idea of a path you want to follow.
This time around, I had a "pregnancy plan."
This is different from a birth plan, this plan indicates how I want things to do in my pregnancy in relation to my prenatal care.
Some things included in my "plan" for this pregnancy included:
* New midwife
* No doppler checks for baby's heartbeat
* No ultrasounds
* No other interventions
* NO complications! (Of course, that one is just wishful hoping!)
But, we seem to have run into a few snags (already). Here's where we're at:
* New midwife {check}. I didn't want a new midwife, I was perfectly satisfied with the group of midwives I worked with when pregnant with Burkley and had an amazing birth experience at the hospital where that group of midwives worked. But, this time around we are on public aid, and therefore I have to be in a hospital in our state (Illinois) -if I want a hospital birth (and I do, at this point, with my birth history, I'd like to have "normal" hospital birth before attempting a homebirth, for my own peace of mind)- and Burkley was born in Iowa (we live right on the border). Turns out to have been a great switch. I am now seeing THE midwife of our area. I knew I wanted to stick with a midwife (versus an OB), so I switched to the group of midwives that serves my area in Illinois. I was nervous about a change, but I had heard such wonderful things about the midwives there that I tried to just assume all would be fine. At my first appointment, I was put at ease. She was wonderful, patient, kind, loving, compassionate...but generally concerned about a few things.
* I requested no doppler checks for the baby because of the research I've done on ultrasound and doppler waves and their impact on unborn babies. While final verdicts are still out on long-term effects, it is evident that the loudness of these waves is very disruptive to the peaceful environment of the womb. I also have never been one to care much about hearing my baby's heartbeat. Many moms I know just love that sound, but it was never "cool" or very meaningful to me with Burkley. Not sure why, I just didn't connect with the swooshing loudness of it all. My midwife agreed that it is my choice whether or not I want doppler checks, but also reminded me that it's the only way to determine viability without a doubt.
* Well, today I had an ultrasound. We decided that it was medically necessary, which is a different scenario to consider, I suppose. This was upsetting to me at first. But, my midwife was wanting to see if she could determine a reason for Burkley's early delivery (34 weeks). One hypothesis she considered was that I could have a short cervix. If I do, we would need to know this early on because I would be put on bedrest as well as possibly need to have my cervix sewn closed if my short cervix continued to shrink with the weight of a growing baby, leading to a condition know as incompetent cervix. My husband and I agreed that this is something we should at least check for (and hopefully rule out) so that the proper care can be in place if this issue does exist. Thankfully, today's check didn't turn up anything unusually "short." My midwife also wanted the ultrasound technician to check my baby's size so we can get an accurate due date on my chart. Though she knows we used Natural Family Planning and we know exactly when we got pregnant, she needs to have something "official" on the chart because if I go into labor, say, at 24 weeks, there would be a completely different route of action we'd take than if I went into labor at 26 weeks. Not sure what the differences would be, that was just an example she gave. Surprise, surprise, the ultrasound showed that I am more or less right exactly as far along as we knew I was (13 weeks). Because of the extended ultrasound exposure Baby C had today, I am glad I opted out of the doppler at yesterday's prenatal appointment.
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| Baby C, meet my readers! |
* Regarding interventions, my midwife has asked that we consider her recommendation of taking the 17Hydroxy progesterone shot. I couldn't believe it. Here I was being told I should have regular ultrasounds and now hormone injections?! This was supposed to be my intervention-free pregnancy! But, I get it. We are still researching it, but this drug seems to really help with preventing preterm birth because it limits the movement of the uterus. Meaning, it can't really get jolted into labor by the movement of the baby or anything else because this hormone will keep contractions from starting until at least 36 weeks, when I would stop taking the shot. I've read some good success stories with this drug and side effects seem quite minimal. They also only seem to impact the mother and not the fetus at all.
* Still hoping and praying for no complications, of course. Both the progesterone and the ultrasound checks to determine a cause of preterm labor with Burkley are due to the fact that my midwife noted that for many moms who've had preterm labor, their next baby not only comes early, but earlier than the previous one. Of course this is not guaranteed, but it is fairly common. Praying for a full-term baby, for the sake of Baby C, but also for the sake of future babies. Maybe with them I can have an intervention-free pregnancy. My midwife was gracious to always remind me that the decisions regarding my plan of care are up to me, but strongly recommended we consider these courses of action and monitoring. With a history of an ectopic and then a preterm birth, she indicated that most hospitals would require me to be with an OB, not a midwife, but since she is so experienced and knowledgeable, I am safe in her hands.
So, for now things look good. I am not positive what we will check for at my next appointment in four weeks. By then though, I need to have decided about the progesterone shots, so I have some researching and praying to do. Have any of you ended with a different prenatal care plan that you expected to have? I know things can always go differently than planned in actual birth, but I hadn't considered not getting what I planned for in the pregnancy itself.
with a history of preterm birth i think you are absolutely right to make exceptions to your pregnancy plan. The 24 week issue is one of so-called "viability". They need an official date because if, God forbid, you were to have your baby at around 24 weeks, some hospitals will not intervene to save the baby without official confirmation that they are at least 24 weeks gestation. You've got yourself a well.informed and sensible midwife, there. Hope you have a healthy, happy and full-term pregnancy.
ReplyDeleteBeautiful baby pictures! Will be praying for you!
ReplyDeleteGlad everything is looking good so far! There is only so much planning you can do, I've learned sometimes you need to be really flexible. When it came time for our 20 week ultrasound, I still wasn't decided if I wanted it or not when we were in the room. I think the tech was getting kind of impatient with me as I sat there deciding what I wanted to do. I was finally like, okay, but be fast! Then of course there were 2 heads and it wasn't fast and we've had 8(!!!) ultrasounds total now, and will have one more when I go into labor to check on the second baby's position. Definitely not what we had planned, but the risk of ultrasounds certainly outweighed the risk of no monitoring.
ReplyDeleteHopefully you will be the exception and not have another preterm babe. I will be praying for you guys! Happy researching!