Mar 29, 2009

Does Not Play Well With Others...

Lately I'm wondering if I need to wear a sign that says something like "Normally I'm more personable than this, honest." I'm not going around yelling at people or anything (for the most part), I'm just having a hard time engaging very much with those around me.

I think there are, like, 5 or so layers to this whole thing. The most obvious aspect is the impending arrival of Kiddo #2, and to that extent I expect to draw inward as I prepare for it. I'm down to the last few weeks, where I'm thinking "There is not room for the both of us; the belly HAS to go," and my extremities all feel rather noodle-like and sometimes even like they might fall off if I'm not careful. Good for getting babies out. Bad for, say, putting out the trash while trying not to slip on the icy driveway because the Cat Daddy got stuck out on alert an extra night due to the snowstorm, otherwise he'd be glad to do it, but the trash is overflowing and MUST get out and it's too late to ask the neighbor for help so it's this or be overrun by a mountain of trash until a week from now. Or just wanting to walk around for more than 10 minutes at a time. Neither is fun. All to say I'm a little out of it in general, but this will remedy itself over time as my hormones all realign and re-regulate and whatnot.

Then there's the meeting people angle. Where the last time I had a kiddo we were well established and had close friends to make sure I didn't withdraw from society completely, I felt free to be less outgoing and concentrate more on the mental prep for crunchy birthing. But now we are still in the phase of needing to be more outgoing so that we can form such connections with others. I'm uncomfortable meeting new people to begin with, but lately I'm particularly unmotivated about it. I feel like somehow I should be more enthusiastic or something, I dunno.

Here's the thing. Over the years I've tried several ways to describe myself in a nutshell. "Benevolent subversive" is still by far my favorite. I've also used "Ragamuffin" from Brennan Manning's "Ragamuffin Gospel," but that still doesn't quite capture the warped-humor side of things. Lately I've been describing myself as "a little inappropriate sometimes," which while not very specific, is quite true.

I don't necessarily come out and say this immediately upon meeting someone, mind you; I try to be a little more subtle. I might toss out some sort of mildly odd or random comment and see what happens. The most encouraging reply is a smile, laugh, or snarky retort. This is how I knew I was in good company when I joined my moms' group on base (Spouses Helping Spouses, or SHS, it's called).

Then sometimes I get a blank stare, which is unfortunate but I can deal with it. It, um, actually happened quite a bit in grade school, come to think of it. The worst response, though, is when the other person appears frightened. This one I feel badly about because it usually comes from someone who seems very, very, very nice, which means I've just made them nervous, which then makes me nervous, and at that point I'm looking for some sort of sign marking where the inappropriate people should congregate so they can snark on each other and stop scaring people.

This happened at the meeting of another spouses' group on base a couple weeks ago, by the way; I'm not making it up. I've thus far not joined the base spouses' club, but different squadrons within the base will often have a spouses' group to promote unity and help people get to know each other and all that, and I met a couple of really cool ladies through the one I went to in California (neither of whom came to Wyoming, bummer), so I figured it was worth a try here. Alas, tons of nice people, just no kindred spirits yet. And no special section for the inappropriate people, so I was stuck sort of watching the craft time from the side. Of course I could have participated in the craft, I'm aware of that. I didn't though.

I feel really torn about it, because how ungrateful is it to lament meeting nice people? This makes me wonder about my attitude, and if I should be fighting against my cynicism some, or for heaven's sake cutting people some slack before deciding they're too nice for me to be friends with. How ridiculous is that! On the other hand, how long do I keep repeatedly forcing myself into a situation before letting myself off the hook and saying "OK, this one just isn't my thing" and concentrating my energies elsewhere? Where is the line between being kind and courteous, versus feeling like I'm stifling myself to the point of painful pretending?

Oh, and THEN thoughts creep in, like "Gosh how narcissistic, Skerrib. It's not all about you, you know." And other things that send me into what Homer Simpson calls a shame spiral, and it's all just very messy and a bit hard to sort out.

There's a hopeful note in there though. We've been to a few more churches in the area, and to one in particular a few times now. Here we have met a cool couple, and even scored a dinner invite & had a lovely evening chatting it up way past our kids' bedtimes, and went to their small group & had a good time, etc. Things might be looking promising here.

The challenge with this place is that it's a little more churchy, and intergenerational and all. I'm all for respecting the old (OLD) people and their tastes, especially when they are nice about accepting the changing styles, and don't think drums are inherently disrespectful (a personal peeve, go figure). The bummer is that consequently this involves compromise on the musical stylings, and I have a hard time with compromise on the musical stylings (See? The attitude!). The compromise is not so much on the song choice as the amplification methods and levels, meaning that while the music selections are good and have some nice variation, the volume and mix make me feel a little sad.

That and the drummer in the fishbowl, complete with topper, creating a drum chamber. Now this could be helped greatly by rigging up the drum chamber to have large sums of money flying around like in old game shows. That would make being relegated to the fishbowl much more bearable; then again, it would likely be kind of expensive, so probably not.

But the people are cool. They're really nice. And I'm a firm believer in people over things. The question is, will they still like me when they find out I'm a little inappropriate sometimes? (The insecurity!) With the cool couple, I'm almost certain yes. Because when I just came out and explained about it, and they seemed cool with it. But how well do I have to behave around the old people?

So we could try to find something else. Realistically, as far as comfort goes in the way of style, music, and such, I think our best bet is the other church we went to for several months...but then because of the theological differences I would likely leave every week feeling neurotic, and who wants that? Or we could stay, and I could allow myself to be challenged and find out where the fine lines are, and maybe get over myself and relax a little bit. And maybe find some old people who are a little inappropriate sometimes. That would be cool. They are very big into grace and grace alone, so if I'm going to be looking for fine lines, this is a safe place to mess it all up in the process.

And actually I get the feeling the pastor is a little inappropriate sometimes. In a very pastorly way (as opposed to my warped and wonderful compadres at the home church), but still if that's the case...well, we'll have to see what happens...

Mar 24, 2009

So Are the Days of Our Lives...

I was wishing a good friend a happy 30th birthday a week or so ago.

I'm an awesome happy birthday wisher. I was lamenting our increasing age, and how my perceptions are changing. The Cat Daddy and I think all the newscasters in our city are about 19, straight out of high school, and I've seen so many really, really young-looking moms over the past week or so that I was thinking, "Holy smokes, is teen pregnancy really that big of a problem here in Cheyenne?" But no, every one of these moms had a wedding ring on. They were probably early-20's at the youngest. Heck, the way I'm guessing these days they could've been my age and I wouldn't know the difference.

So the "problem" is that I'm getting older. When did this start to happen? The Cat Daddy and I realized we were heading in that direction a year or so ago, when it dawned on us that we were no longer part of the "target demographic" (young, hip 20-somethings) of the type of churches we gravitate toward. Since we still gravitate toward them it gives us hope that we're not total sticks in the mud...but it is still a little unnerving to see ourselves fading toward the "older" crowd.

The change in visual perception, however, has been sudden and startling to me. Seriously, I didn't notice it until we got to Cheyenne. This along with the memories of growing up, and remembering when my parents were the ages we are right now, and thinking "Oh my goodness, we are there. We are them." Am I headed for the PTA, destined to become a "room mother" at the elementary school? Do I need to accumulate some nifty large Tupperware containers (via nifty large Tupperware parties, of course) for toting yearly rounds of classroom cupcakes with tiny sugary shapes sprinkled on top? Do I have to take a hiaitus on burping at the table, and making occasional inappropriate comments? Or, worse, do I have to discourage my kids from doing the same? **shudder**

I would just like to say that there are lots of things I will consent to, for now I understand better the plight of the parent. I do enjoy the baking, so I'll make cupcakes. I will tone down the cussing around children, especially those who are not my own. I will watch Sprout when I'd rather watch something grownup, and eat at McDonalds if for no other reason than the playland. I will continue to burst into Raffi songs at random times.

...and his name was Aikendrum...

I will draw the line, however. The mom-mobile I have is the one I'm sticking with. No minivan, even if you can haul all sorts of equipment & stuff in them. I will consciously fight against becoming a total stick in the mud, and/or saying things like "This is what you call entertainment/music? I can't even understand the words," but I will still keep enjoying my favorite music from back when everyone was on drugs all the time...which was really even before my time but my dad always listened to it so I picked up on his tastes. The 60's & 70's were good years for music, you know...

Mar 22, 2009

Home Birth Questions Answered--Logistics, Etc...

Part I; Part II; Part III; Part IV; Safety

At long last, the Q/A on the logistics of home birth (including, of course, a photo of His Highness cavorting with the cheerful aquatic sea creatures during the test inflation of the kiddie pool)...

Q-- What about His Highness?
A--He will be shuttled off with a friend.

Q--What if you wanted him to be at the birth?
A--Then we would do that. We get to choose who we want present.

Q--Who do you want present?
A--Our plan is for the midwife, her assistant (who will also function as a doula), the Cat Daddy, and myself to be there.

Q--What, are you trying to shut everyone else out?
A--Yes. It’s labor, not a garden party. I concentrate best with a minimal audience.

Q--Isn’t it messy?
A--Yes & no. Birth is pretty messy no matter how you do it, but we prepare things ahead of time to minimize the mess—with help from a supply list the midwife gave us. And then the midwife & her assistant do the clean-up, laundry included—nice!

Q--When will you set up the pool? Won’t it take forever to fill?
A--Early in labor. I’m guessing it’ll take an hour or two to inflate it, fill it, and get it to temperature.

Q--How will you get the pool warm and keep it there?
A--A combination of hot water from the washing machine hookup (via a brand new drinking-water-safe garden hose) and water boiled the old fashioned way (on the stove). As it cools we'll bail some cool water & add more hot. And we'll cover it when I'm not using it to hold in the heat better.

Q--What if the weight of all the water makes the pool fall through the floor to the basement?
A--I’m nerdy enough to have done the calculations, and confident that won’t happen.

Q--How will you empty the pool?
A--We’ll siphon it (to the back yard, toilet, or bathtub) with a hose. We even bought a $7 drill pump thingy so no one has to risk a mouthful of water to get it started.

A--I know. That’s why we bought the little thingy.

Q--If your labor slows or stalls will your midwife use herbal remedies to try to help it along?
A--I think so. She’s familiar with a lot of herbal stuff used throughout pregnancy and is all for herbal remedies that have been shown to be safe & effective.

Q--What about your baby’s vital stats, birth certificate, etc.?
A--The midwife brings everything she needs to take his measurements and so on, and sends in the paperwork for the birth certificate.

Q--Do you think placentas are totally beautiful now?
A--No. Not really at all. My midwife will properly dispose of the placenta for us. We won’t be saving it, or burying it under a freshly-planted tree, or anything like that.

Q--Um, people do that?
A--Some do. We won’t.

Q--I still wouldn't want to do a home birth.
A--That's cool, as long as you know what's available. Only you can decide how & where you prefer to give birth. Empowerment, and all that.

Q--This is the most fascinating series of posts I’ve ever read. Where can I find out more?
A--A good place to start is the Citizens for Midwifery FAQ’s page. For info specifically on waterbirth, start at Waterbirth International.

Then check out my midwife’s page of links and other stuff. Lotsa really good info there.

Well kids, this concludes my planned sharing on home birth. Thanks for all the positive feedback, and feel free to dialogue and ask questions. As you can probably tell, I will talk about it endlessly if provoked.

God-willing, I'll be posting in a few weeks to tell you that everything went great and it was all I dreamed and more. Here's hoping...

Mar 16, 2009

Well Maybe...

The Cat Daddy thinks I should publish a retraction of my earlier post on President Obama, specifically this paragraph--

"...While I don't think he'll turn the US into a socialist nation in 4 years, I do think that under him we will pay more taxes and there will be little snippets of socialism popping up. Which could lead to increasing socialistic patterns, which in some ways sounds really good, but in the end I don't think it's the right path for the US."

Now that I've gone back & read it, I still stand by it. Not that there's much to stand by. I don't know a whole lot about national policy so I haven't exactly made any strong statements either way. Still, I don't think the US will be a socialist nation by 2012. I must admit, though, that the changes being made in these few months are bigger than I expected.

Our discussion was started by an
article I skimmed about the president vowing to block bonuses for AIG execs. I thought it was pretty brazen of AIG to use bailout money on executive bonuses, but the Cat Daddy brought up an interesting point that the bonuses were contractual, so to not pay the bonuses could be considered breaking a contract. And then we both talked in circles a bit about whether a contractual bonus is truly a bonus, and why don't they just include it in the salary, and so on (Taxes? Anyone know?). I had to agree that I'd be pretty torqued if I'd been promised a certain amount of pay, only to have it taken away...but then this is government bailout money, so maybe the government does have more of a say in how the company spends it.

Oh but THEN that leads to a whole other crop of issues. To start with, lots of businesses get government money in some form. And how much control should the government have over the money it gives out in federal programs & whatnot? Should it be allowed to go in & set limits on bonuses, or even salaries? And if so, who would determine what reasonable limits would be, and how would they go about it?

That's all to say that the more the government gets involved, the more the boundaries get blurred, and in the Cat Daddy's words, it becomes a "slippery slope." It's hard for me to reconcile helping needy people with government involvement. But does a big company fall under the umbrella of "needy?" I wouldn't think so...but then if a giant company tanked, the employees might then become needy, so do you bail out the company to prevent the massive job-losses? Apparently this time, yes. And anyway, I'm all for helping people who need it, but I think it's really, really important to give them the kind of help that is really helpful, instead of the kind of help that helps them to stay in their rut. You know, teaching a man to fish and all that.

It's kind of like the parents whose kid keeps getting into trouble, but they keep bailing him out, so he has no motivation to stop getting in trouble. Or, one of my favorite Cloud & Townsend illustrations--the guy who doesn't water his lawn, but the water from the neighbor's sprinkler falls on it & keeps it nice & green, so he looks out and thinks "My yard is doing fine." Meanwhile, despite running the sprinkler faithfully the neighbor's yard is dying because he's watering everywhere but his own yard. I wonder, had the government not given AIG a bailout package, if the execs would still be getting the big bonuses. Not that simple, I know. Believe me, I know...

Snippets From an Ordinary Day...

--The one redeeming quality of this year's "spring forward" is that His Highness is, for the most part, sleeping until 7 on his own. It won't last, but it's nice to have a slightly more gradual transition than usual.

--The Cat Daddy was doing some work out on the deck this weekend and left a 5' or so length of PVC pipe, and a 1" x 1" (?) stick o' lumber out there. His Highness likes to bring outdoor things indoors and vice versa, so I had to explain that these things of Daddy's are outdoor things, and that the couch pillows and our new crocheted blanket (courtesy of my aunt, a fantastic crocheter) are indoor things. He's a smart boy, I know he understands, but of course being the kid it's his job to test the limits. So while I was taking care of business in the executive office (bathroom. I was going to the bathroom), in he walks with the PVC pipe. Very proudly, I might add.

Being the grownup it's my job to enforce the limits, so I said "Outside with that, now please. The pipe is an outdoor thing, remember?" So out he went, leaving me with the toilet paper still poised, ready for action. Before kids I was never one to conduct business from the potty, but what struck me as weird is that no aspect of the exchange struck me as weird. And I thought, again, "Yes, here I am, in that stage of life. I am that person." This is not bad; it's just the way it is, and I happen to be quite aware of it.

--I once had really good sunglasses--Oakleys. I wore them everywhere, but they were especially good for jogging because they were very gentle on my head. No squeezing headaches. I don't buy good sunglasses anymore because I have a penchant for losing them. I don't do the cheapest cheapies, mostly because I'm very fussy about having amber-colored lenses. I found ones I really like at Target so I've been buying those lately. I bought the most recent ones a couple months ago; I'd managed to lose yet another pair, yadda yadda yadda. I caught some ribbing from the Cat Daddy over it. I catch some ribbing from the Cat Daddy a lot.

Oh but wait--this time it wasn't my fault. Today while I was doing the dishes, trying to keep His Highness from eating all the Chapstick we own, he meandered over to a kitchen cabinet--one that is as yet unoccupied--and peered in. I looked to see what we'd put in there and yes, there were my old sunglasses. So now I have two of the same pair...

Mar 14, 2009

Home Birth Questions Answered--Safety, Etc...

Part I; Part II; Part III; Part IV; Logistics

I think this is the fun part--the hows, what-ifs, and whatnot of natural and/or home birth. In my pre-childbearing days the only thing I envisioned about home birth was crunchy hippy-types with flowers in their hair, talking about the beauty of placentas & stuff. There was no way I'd do anything that freaky-deaky. The thing is, once you know more about home birth, it loses most of the freaky-deaky and often sounds completely reasonable, even if it's not something you'd want to do.

Q--Are you nuts?
A--No, just a little outside the mainstream when it comes to the birthing.

Q--What's the deal with midwives? What's their "thing"?
A--The midwives model of care is based on the assumption that normal, low-risk pregnancy & birth are not medical events, and the majority of the time they will go just fine when allowed to proceed on their own. The goal is to empower women to trust their instincts and believe in their bodies' abilities to do what what they were designed to do--birth babies.

Q--Who delivers the baby?
A--Ah, a distinction in terminology here. The mother delivers the baby. Birth attendants, such as doctors and midwives, catch babies. Or depending on their wishes, sometimes moms & dads catch the babies.

Q--Really? People care that much about semantics?
A--Some do, some don’t. Depends on what helps them feel empowered.

Q--What about prenatal care?
A--I have all the same appointments as I would with an OB, and all the same screenings and such are available to me. My blood is Rh-negative, so I need an extra shot or two, and in my case the midwife gives them to me.

Q--Where do you have your prenatal care?
A--Some midwives, even home birth ones, have offices. Mine comes to my house. She brings all her necessary supplies with her. It's fantastic!

Q--Did she do an ultrasound?
A--She referred me to the hospital to have it done.

Q--What if something goes wrong?
A--Totally depends on the situation.

Q--Nice one, Snarky McSnark. What if the baby is breech?
A--Depends on the parents' & midwife's comfort level with a breech birth. In my case if we tried all the 'tricks' and the baby just wouldn't turn, I would go to the hospital & have a c-section.

Q--Would the midwife do the c-section?
A--No, an OB would.

Q--What if you have a failure to progress?
A--As long as the baby and I were both fine we would let the labor progress at its own pace. I would probably do a combination of different things, such as changing positions, walking around, and the like. Or if I were tired I might rest for a while to conserve my energy for when things picked up again. I would also eat (lightly) and drink to keep my energy up.

A--Probably not. If things were going so long that I was becoming exhausted, or if the midwife recommended transfer, I would go to the hospital. Most likely though, the baby will come on his own when he's ready.

Q--What else might send you to the hospital?
A--To name a few: premature labor, problems with the placenta (abruption, previa, etc), signs of distress in the baby, signs of shock in me, thick meconium (poop) stained fluid, cord prolapse, or pretty much anything where we or the midwife feel it’s necessary.

Q--Who decides if you go to the hospital?
A--In most cases, the midwife would consult with the doctor on call at the hospital first. If at all possible it would be a joint decision between us, her, and the docs, but there are some cases where she & the doc would make an executive decision, regardless of what we think. Knowing that she’s going to do her best to help us have an intervention-free birth, if she thinks we should go, I’d likely be quite inclined to agree.

Q--How closely does the midwife watch you during labor?
A--Once the midwife and her assistant are here, it's pretty much continuous support. She takes my vital signs every so often, and keeps an eye on me in general to make sure I'm staying healthy throughout labor. There's a protocol she follows, but I don't remember what it is.

Q--What about fetal monitoring?
A--The midwife brings the doppler-thingy and listens to the baby's heartbeat, according to a specific protocol. If I remember right it's every hour during early-active labor, every half hour during active labor/transition, and every 15 minutes during pushing. As with me, she keeps an eye on the baby to make sure all is well.

Logistics next time! Any more questions, put them in comments or email me: skerri_bATyahooDOTcom...

Mar 13, 2009

Home Birth Manifesto IV--Denouement...

Part I; Part II; Part III; Safety; Logistics

In Part III, I mentioned that, in this post, I would talk about our experiences since deciding to plan a home birth, finding our midwife, getting the insurance in order, etc.

But as I look back over the past six months or so I am finding that things have really been pretty boring since then. Boring in a good way, mind you--I've had all my regular appointments and most of the screenings that they usually do for pregnant ladies, and the little kiddo has been growing & growing, getting ready for mid-April. My first-trimester queasies lasted way longer than the first trimester, but everything has been well within the norms for pregnancy and these days I'm feeling pretty good, as long as I remember to eat regularly, steer clear of a few key foods depending on the day, and drink lots of water. Funny how that works.

I guess I'll toss out some snippets, then...

--As far as the labor goes, I'm expecting pretty much the same as with the last time, except I won't be going anywhere. I'm hoping that feeling more relaxed in my own space, along with this being my second kiddo, will help the whole process go faster than the first time. I know there are no guarantees there, but I'm still pretty hopeful about it.

--I'm not necessarily planning a waterbirth, but I do plan to sit in the water for at least part of the labor--buoyancy is an excellent alternative to drugs for managing pain. I don't know how I'll feel in the moment, so I want the option to stay in the tub for the birth if I want. But I'm cheap, so instead of buying or renting a tub built specifically for labor/birth, I bought the inflatable kiddie pool my midwife recommended, for less than $40 including shipping. It has an inflatable bottom for added comfort, and cheerful aquatic creatures printed on the sides. That last part just strikes me as funny. I keep thinking, "Must get pictures of the cheerful sea creatures."

--Support people--Since the birth of His Highness, both the Cat Daddy and I are pretty vocal about encouraging people to have a doula or other person for added support during labor. I appreciated having a couple other women present who knew lots of different ways that I might like to be supported and encouraged during the hard parts, and the Cat Daddy appreciated that he didn't have to read my mind to know what I wanted. He was able to support me well, without worrying whether or not he was supporting me well, if that makes any sense. As he says, "birthing really is women's work," and I tend to agree. For me that additional support made all the difference.

Let me harp on this one just a little bit longer. It irks me when I hear people say "trust me, just do such-and-such," or some other condescending phrase based only on their experiences, because it causes women to question their own experiences and strength and think "gosh, maybe I really can't do this." There's a big difference between "I had to..." and "I chose to..." When it comes to normal and uncomplicated birth, the truth of the matter is that you absolutely can do it the way you want to. Knowing all your options and having supportive people around you saying "You CAN do this" makes all the difference in being confident about whatever choices you make in the process. Then you are powerful and in charge of your own birth, which I think is the only acceptable way to do it. Rather than saying "trust me, get a doula," (!) I'll leave it at "consider carefully who you want to have supporting you, and do what you want for your birth."

--My favorite questions I learned to ask are "Am I OK? Is my baby OK? Why are we doing such-and-such?" I like it because it makes the doc/nurse/midwife articulate their reasoning for you. Sometimes there is a legitimate need for an intervention, but sometimes it's just what they "always do." Knowing this helps you decide whether or not you want to go ahead with whatever they are suggesting.

My other favorite is "I do not consent to that." I did not use that one, but I have heard stories from other women who felt strongarmed into procedures that were unnecessary. It's easy to feel like the doctor is "the boss," but in reality they need consent to proceed with a procedure. I think a good doc/nurse/midwife will include you in the decision-making process whenever possible. You are the one doing the work and the recipient of whatever treatments you decide upon, after all.

...That about concludes my manifesto. I think. I could ramble on forever, but I think I've pretty well captured the gist of things. Obviously I'm geared more toward natural & such, but my big thing is that people know about all their options, and hear that they are capable of doing labor & birth the way they choose. I feel grateful to have learned about this kind of stuff, & to have been able to make very different choices than I might have otherwise. And one side-effect of this is that I feel more confident & powerful in other of areas of life. It's a beautiful thing.

The Q/A is in process, so that'll be next...

Mar 11, 2009

Home Birth Questions...

Hey folks, I'm working on a Q/A list for common questions people have about safety & logistics of home birth. If you have one that keeps you awake at night, put it in the comments or email it to me--skerri_bATyahooDOTcom (but put in appropriate symbols in the address).

Won't that be fun!!

Mar 9, 2009

Home Birth Manifesto III--Kiddo #2...

Part I; Part II; Part IV; Safety; Logistics

So to recap thus far, His Highness was born in a hospital, I went natural, and in the process I learned a few things that I wanted to do differently for subsequent kids. Boom; done.

Fast forward to August of '08, when we found we were expecting another baby. Yay us! The immediate issue was that we were no longer living in Massachusetts. We were in Lompoc CA at the time, but were rapidly approaching our relocation to lovely Cheyenne, so we needed to make some decisions as far as where to go for the maternity care.

Had we still been in Massachusetts, I actually would've been less likely to go with a homebirth. I had been happy enough with the results the first time through, and I was confident that I could go with the same docs & hospital and still make the changes I wanted. I haven't even mentioned the Cat Daddy in all of this yet, have I. He was with me the whole way, and entirely supportive & cool, and also very happy with our experiences with His Highness. For him staying with the same docs would've been a no-brainer.

But we weren't in Mass; we were headed to Cheyenne. So I started researching the options. I looked up OBs and midwives in the area, including Fort Collins, Greeley, etc. I called what is considered the main OB practice in Cheyenne, and talked to one of the triage nurses. I started out with something like "I'm very crunchy about the childbirth. How easy would it be for me to labor and birth naturally and not have to fight off unnecessary interventions?" Her immediate response was, "Wellll..." which told me everything I needed to know (and I appreciated her honesty). Boiling down her answers to all my other questions, it wouldn't have been a problem in theory, but I got the feeling I'd need to do a lot of self-advocacy, and quite possibly start kicking & swearing to fend off the needles. I also spoke with some ladies who had given birth in Cheyenne and the consensus was "If you really want to give birth naturally, don't give birth in Cheyenne." So that settled that.

By this point I had already broached the topic of home birth with the Cat Daddy. He wasn't really comfortable with the idea, so we talked about his concerns and reservations and all that. I pointed out the advantages for him. We'd have access to our own food, our own TV, internet, and even the PS3. He wouldn't have to go find a waiting room or cafeteria when he wanted a break, and could sleep in his own bed if things were going thru the night (the last time he snoozed on a thick floor pad the Rootses had very kindly brought for him). No driving back & forth to the hospital with His Highness, dinkin' around the hospital room, waiting until time to go home. While this all sounded good, he still preferred the hospital or even a birth center. Fair enough--I promised him I'd keep exploring the options, and he knew I would do the due diligence.

Over the course of the research, my options began to dwindle, and I began to feel nervous. The closest birth center is in Denver, about 2 hours away, and I preferred not to make that trek if I could avoid it. I had looked up hospital midwives and wasn't finding a whole lot of options. I really liked what I saw on the website for this one midwifery practice, but when I called they said they weren't taking any new maternity patients--rats! I was willing to travel the 45 min to Fort Collins, but had no idea what to expect from the practices in that area. Several OB practices include midwives, even the one I spoke with on the phone. But if the midwife isn't on call when you go into labor, you get the doctor on call, same as everyone else, and the doc may or may not be willing to acquiesce to the differences in approach. By this point I really, really wanted to strongly consider home birth.

I started putting out feelers for local home birth midwives. Wyoming has pretty strict midwifery laws. While homebirth isn't all-out illegal like in some states, only certified nurse midwives may legally attend births (as opposed to certified professional midwives or some other variant), and a home birth CNM can be hard to find.

I had also contacted my insurance company to see if they even covered home births, and it turns out they do, but only with a certified nurse midwife. So to have any hope of getting any sort of coverage or reimbursement, I had to go with a CNM anyway. I knew there would still be some finagling involved to get everything set up--that's just how it goes when you want to do something that's different from the norm. But I looked at it this way: I could fight with insurance on this end getting an approval, or anticipate fighting with medical personnel while I was trying to relax and get a baby out. The Cat Daddy was all too prepared to battle docs, and to have great fun doing it, but guess which one I prefer?

Long story short (relatively speaking), I found my certified nurse midwife, who is based in Denver but also has clients in Cheyenne. I contacted her and asked some cursory questions...yes, she'll come up to Cheyenne, yes she takes my insurance, yes she can give me the shots for my Rh-negative blood type, etc. She also referred me to two people: a rep from her billing company who could tell me how they'd dealt with my insurance in the past, and a fellow mil-wife who had recently been a client of hers, who could share with me how she navigated the insurance maze.

Next I asked the Cat Daddy if we could schedule an interview with her, so we could both ask all our questions and see if it was something we wanted to move forward with. His response was along the lines of "I can tell your mind is made up already, so we might as well." He was totally right, but I still give him high praise for being willing to consider it. It meant a lot to me.

So we met with the midwife, discussed her 25 years of experience in both hospital and home settings, asked all our "what-ifs," and talked about our experiences and all things childbirth. It was fabulous. Even the Cat Daddy seemed pretty comfortable with what he was hearing. After she left I asked him, in a very mature manner, "Please please please please please can we do this?!??!?!" and he said "go for it" while I did a little dance and tried to wipe the goofy grin off my face.

The insurance battle then commenced. You would think insurance companies would be all over home birth for normal, low-risk pregnancies, as it means much less overall cost, but that is not the case. In addition to politics and such, home birth is still unusual enough that they balk when people want to do something different, and furthermore want them to pay for it.

Oddly enough, it wasn't so much a battle with the insurance company as it was trying to convince the insurance office on base that they do in fact cover home birth, and to stop telling the doctor they didn't, so he would put in the dang referral for me. All told it took about a month, and was all I dreamed and more with the frustration, but it worked out in the end, mostly due to a very helpful lady who is a something-blah-blah liaison on base. She called on her people and helped me talk the doctor into submitting the referral.

Finally, it was approved. I'm still not sure we'll be reimbursed for the entirety of the cost. In fact I know we won't; there are some out-of-pocket costs we are not even going to attempt submitting because they would be all, "Why on earth do you need a kiddie pool and a garden hose to give birth??" (more on this later) With the referral, however, we know we'll get at least a good chunk of the midwife's fees back, and it's worth it (to me anyway) to pay the difference.

A great side benefit to all this was meeting the mil-wife and hitting it off pretty well. Through her I found the moms group I belong to, and a lady in the group told me about her wonderful experiences with an OB practice in Fort Collins, where they are much more receptive to the natural childbirth (and apparently they treat you like a rockstar in the hospital there. Sounds good to me). While I'd already made the home birth decision, it was good to find this out, because if I end up needing some non-emergent medical care, going there will be my first choice.

Which I believe brings us to the conclusion of how we got here in the way of decision-making. Next I'll talk about our experiences since...

Mar 5, 2009

Home Birth Manifesto II--His Highness...

Part I; Part III; Part IV; Safety; Logistics

The important thing to know about my experience surrounding His Highness's birth is that overall it was really, really good.

I went in planning and hoping for a natural birth, and was able to do just that. All the docs in my OB practice were amenable to the idea (this was Massachusetts, after all--land of the earthy-crunchies), and when I got to the hospital, the nurses were more than willing to support me as well. I'm guessing they ran at least a little bit of interference with the docs for me, because while everything went just fine, it was a long process, and docs sometimes get impatient with the birth when it doesn't go according to averages. I don't know for sure though, and really by now it's a moot point anyway. Regardless, I give all my support folks mad props for helping me do it the way I did.

The good thing about the hospital was that their policies were fairly supportive of letting women choose how they wanted to labor. I had the electronic monitoring, but only about 15 minutes out of every hour. The rest of the time I was able to be up & around, eat lightly and drink, and I walked the entire hospital grounds and more over the course of my labor. I allowed them to put in a hep-lock, but did not have an IV. They had a tub I could have used, but I stuck with just the shower instead. I had a fantastic doula and was able to have friends come visit as well. In fact while the Rootses were there, Roots and the doula and I whooped it up humming and breathing through contractions while the Cat Daddy got to take a break and watch movies with Mr. Roots in what I'm told was a pretty decent waiting room. The room-service-style food was great, and they fed the Cat Daddy as well. And when all was done they sent us home with stuff. A few baby things--thermometer, really good nose-sucker, etc--and even some lotion for me, to help with the dryness due to all the handwashing, I guess. And an umbrella, which I found to be quite random, but I guess one can always use a freebie-umbrella. Everyone I met was kind and encouraging, and seemed glad to help parents & babies start off well.

All that said, and knowing that most of this I couldn't have known except in retrospect, there are some things I felt uneasy about or would change completely...

While my docs were amenable to natural birth, they were also plenty ready to step in and intervene right now. Good if something's wrong or the mother wants to discuss it; bad if everything's fine and they're simply feeling impatient and/or nervous. Over the course of the pregnancy we had extra ultrasounds for a nonexistent problem, and multiple offers of induction because they were estimating His Highness to be a fairly big baby (because they kept doing ultrasounds and, oddly enough, he kept growing). The thing about ultrasounds is that they have a high rate of error, depending on equipment, operator, and just the imprecision of measuring stuff on the inside with equipment on the outside. After the whole thing with finding a potential problem and then ruling it out, we just stopped putting all that much trust in the ultrasounds. In all fairness, their weight estimate was pretty close to his actual birth weight--8 lbs 9 oz--but he came out just fine and there was no reason to think he wouldn't.

At one appointment I mentioned that I would rather just forgo the 35-week ultrasound that was standard in their practice, and the doc nearly hyperventilated while explaining to me that they really needed to make sure there wouldn't be a shoulder dystocia, and to please, please just let them do the ultrasound. I went ahead with it--after all, no needles for me to worry about with an ultrasound--but it bugged me that they put on so much pressure when I was more than willing to take responsibility for waiving the test. I was just tired of the ultrasounds.

Around the time I went into labor they'd done a non-stress test and told me that the amniotic fluid levels were low (based on ultrasound estimates), and that normally they'd just induce me, except they knew it was important to me to avoid induction if possible, so they would "allow" me to wait a bit. This one bugged me because they did not mention that while the fluid levels were on the lower end of things, they were still well within the normal and safe range. They were also taking these estimates first thing in the morning, before I'd drunk the friggin' gallon of water I was taking in daily at the time, which can affect the fluid levels. And again, I could sense the pressure from their end, even though they kept it toned down.

I learned that, while they of course are quite concerned with the safety of moms and babies, the driving concern seems to be one of covering themselves legally. When it comes to litigation, their way of protecting themselves is to err on the side of intervening, and doing so sooner rather than later. On one hand I can certainly understand this. On the other, it annoyed me that they were trying to push medical procedures on me with a basis other than the need for them, thereby making a significant life event more about them than about making the best choices for me and my family.

When I did go into labor (3 days after the due date), I already had a non-stress test scheduled that day, so I kept the appointment, where they found me 5-6 cm dilated. This was fantastic news, and they asked if they could just admit me because anything could happen at any time. I didn't really want to be admitted, but I agreed because I was already so far along.

This is the number one thing I would've changed--I would have gone home. There's no way to have known how it would turn out, but His Highness was not born until over 24 hours later. I suspect part of that time lag was due to the excitement of being admitted, and being in labor, and being watched, and all that. Adrenaline & stuff can slow or stall a labor, and with my being a nervous-type, when I get all ramped up it takes a while for me to relax. My labor never stalled, per se, it just went very, very, very gradually.

Had I gone home it might or might not have taken as long as it did, but either way I'd have passed the time putzing around in my own comfy space, probably baking yummy treats, and I definitely would have done so without a friggin' needle in my arm. True, a hep-lock is not the same as an IV, but it was still a needle, and I hated it. As for all hell breaking loose at any moment, we lived 2.4 miles from the hospital and could've been there in under 10 minutes at any time. I even knew the back roads from jogging the area so many times.

And as for the 48 hours after His Highness was I said, it was good as far as hospital experiences go. It's just that I had never before been in the hospital as a patient, and I was rather unimpressed. The idea was to get some rest, which just didn't happen for me, even during the times when His Highness was off gallivanting in his little roller-bed-thingy. My vitals, his vitals, people checking in, phone calls & visitors (the good distractions), nursing, diapers, charting his nursing & diapers, trying to remember to order lunch, and then to eat it. And being so dang...aware of the fact that I had a brand new kiddo. Who had been in my belly, but definitely wasn't in there anymore, but the belly was still there in a somewhat smaller and squishy form. Trippy, I tell you.

While I felt a little weird leaving the 24-hour support of the hospital, it was a big relief to get home and get on with figuring out how our new little family worked. And to sleep--sporadically, but comfortably in my own bed.

Next time, how all of this transitioned into a decision for home birth...