Friday, May 17, 2013

Drinking the Koolaid

First of all, thank you all for your kind responses about Indy. With everything we have been going through with both of our pets, I have marveled at the caring in this community toward animals. My posts about my pets have gotten so many kind comments, it just goes to show how important pets are to all of us.

But this post is not about a sad story relating to pets - I promise! Instead, it is a follow up to my post about hospital birth versus a birthing center. This morning was our appointment with the Midwife. Going into it, I was feeling fairly certain that my goal was to find a way to have that "middle road" that so many people recommended. Namely, in this case, having the midwifery model of prenatal care, but still having my hospital birth plus doula. Read on to see if I wavered in that goal...

Let me start with walking through the door of the clinic. If you remember my first post about my OB's office, I was disappointed with the lack of art on the walls, baby-centered items, and just general sense of "pretty office for pregnant women." Well, this place is ALL of that and more. First of all, the reception area is a big store filled with items for babies and pregnant women. Picture brightly colored wooden toys, adorable baby bottles, colorful cloth diapers, nursing wraps, and a plethora of nipple-related items that do god-knows-what. Not to mention artful black and white photos of women (and men!) and their babies. The walls are papered with announcements about prenatal yoga, prenatal massage, and just general prenatal wellness.

Then we walk into the "exam room." Yeah right. Exam room? More like a therapy office. We sank into a plush, comfortable couch and the midwife handed me my glass of water and my husband his coffee (with agave, ha!). I took in the exam table that looked more like an aromatherapy massage table. The plants, the artwork, and oh-yeah, a few medical items discretely tucked into the cabinet. When she went to get us our drinks, my husband literally teared up a little (don't tell him I told you this!) from suddenly being in such a warm environment after the shock we've been through in the last two days with our cat. And trust me, he is a big, tough, manly-man. Well, normally he is a big, tough, manly man. In this appointment he was holding my hand, rubbing my neck and earnestly discussing the merits of a true "birth experience." Uhhh...who is this guy??

So what did we learn? Basically more of what I already knew about the positives of a natural birth, the negatives of a hospital birth, yadda yadda, thanks for the recap of a Business of Being Born. But we also heard about their contingency plan for hospital trips, the way in which they make those decisions (hyper cautious, planning ahead), and their statistics regarding transfers to hospitals (less than 1% emergency trips, 15% non-emergency transfers). Typical reasons to transfer would be if the woman decides no way in HELL can I do this shit without medicine, or more serious issues such as the baby's heartrate is weak/irregular, the baby's position is not conducive to vaginal labor, or the woman has been laboring for too long. The midwife spent an hour talking with us. She validated our dissatisfaction with OB care and offered to help us find an OB more open to natural birth if we decide to stay with a doctor. She listened about how sick I have been and then said, "I just really want to validate how hard it can be to be sick during pregnancy. You want to be happy and positive, but all you can do is barely make it through the day. That comes with guilt and confusion. It's hard." Thank you, I agree!! She also listened about the recent "bleeding episode." She approached it with such a calming, normalizing way that I can see why the "pregnancy is not a disease" model goes over so well. She scoffed at "no sex for the rest of the pregnancy" and wondered what the impact on our relationship would be of "no sex." Of course, she explained she had not examined me and all of these decisions would be based on my pregnancy, risk factors, type of bleeding, etc. Good to know she's not ALL touchy-feely.

Their prenatal appointments are one hour long (first appt is 1.5 hours) and include therapy-like discussions about transitioning into parenthood, your own experiences with your parents, your relationship, and your current experiences. Her words, "having a baby is not just about giving birth. It is an entire experience," really hit home with me. It seems to be a nice confluence of medical and emotional care. They DO do all of the same tests you would find in a doctor's office (gestational diabetes, blood work, etc, etc), which I liked. They do have a doctor who works with them and is able to meet them at a hospital in case of transfer (don't you like the way they use the word "transfer" instead of "emergency"?). Basically, they seem to have a thriving group practice with a dedication to quality, holistic care.

Oh and we saw the Birthing Suite. Hello, 5-star, baby-welcoming accommodations. The suite is a two bedroom apartment with 20-foot ceilings and floor to ceiling glass wall that can be retracted into the ceiling to let in the fresh air. Uhh nice? The living room is complete with comfortable couches and a full dining room/kitchen so your family can make you food while you labor. The bedroom has another couch (for hubby to sleep?), a queen size bed, and of course, the gorgeous, deep birthing pool. Oh, then a normal bathroom with tub and shower. Again, discretely tucked away you will see medical equipment including oxygen for mom and baby, resuscitation equipment for mom and baby, and who knows (I don't want to??) what else. The Birthing Suite is yours for as long as you labor until about six hours afterwards when they help you to transition home. Two days later they visit you at home to check in.



So what did I decide? Well first of all, let me tell you, after his first misty-eyed moment, I knew my husband had drank the Koolaid. At breakfast after our appointment he said, "This is the most excited about our pregnancy I've been yet!" So cute. Me? Well I felt completely torn between two sides of myself. I don't know if I've explained this before (skim ahead if I have), but I grew up feeling like a creative, hippie-esque, open-minded, artistic person. THAT person would have dived in (no pun intended) to the birthing suite. That person wrote creative writing, studied philosophy, did water color, and wore Birkenstocks. Oh and makeup, what's that? Then I went to graduate school. They made me get grown-up clothes. They slashed through my reports to get rid of "creative writing" and leave scientific formatting. They made me believe in evidence, sciences and assessment of your effectiveness. So, sitting their at breakfast, both sides of me were at odds. My heart wanted to take the plunge and go with what feels oh-so-right and my brain kept thinking of risks and complications.

So what did I do? I jumped.

We have our first appointment in two weeks. I feel good about this. It feels right. Do I feel scared? Hell yes. But, ultimately, as my husband put it, it's really just delaying when you go to the hospital. When I want to go, we'll go. Until then, we'll stay committed to something we both feel is just "right." Also, if I decide two weeks before the delivery that I need to be in a hospital, then I'll be able to be in a hospital. In the meantime, I will move away from the care of a doctor that never really "fit" what I had hoped for. And I will give myself the nurturing, decadent care I feel I (and my baby...AND my husband) deserve.

After I made the appointment, the director called to assure me that I was now "under their care" and I could call 24/7 with any questions. In case of an emergency they will - listen close here people - come to my home if needed to check me out. They also sent me initial paperwork to fill out. At my doctor's office I filled out absolutely nothing. She asked me NO questions except, "Are there any serious diseases in your family history?" and "When was your last pap? June? Oh good, I don't need to do one then." In contrast, these forms are like a book. To me, as a therapist, they seem to be taking a family-systems approach to care. In addition to the extensive medical history for me AND my husband, they ask multiple questions about my mother, about her births, about her views on births and about my sister's views on birth (really??). They then ask about relationship history, whether parents are still married, my family's views on birthing outside of the hospital, my goals about my birth, etc, etc, etc....I can't remember it all. And what is really cool? My husband ALSO fills out a form about his views on natural birth, how he sees his role in the birth, his family's view on natural birth, etc, etc, etc. This is not just prenatal care here guys. If you are uncomfortable with self-disclosure, step back onto the paper-covered exam table.

So that's that. We're taking the plunge. And now that the decision is made? I feel giddy. In dialectical therapy, they say the best way to know if you are making a decision with your Wise Mind (as opposed to your Emotional Mind or Rational Mind), is to make the decision, give it time, and see if it still feels right. Well, it's only been about 8 hours, but I'm feeling pretty good so far :)

Please weigh in here. Thoughts? Concerns? Questions about what I didn't cover? Things I should follow up on? Cheerleading? Would you like a glass of the Koolaid??

16 comments:

  1. I think your birth center sounds wonderful! My husband similarly "drank the Koolaid" (lol) after meeting with our midwife the first time. Birth isn't an illness, and it doesn't have to be managed. I'm so excited to keep reading about your journey!!

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    1. Haha, so funny about your husband too! I will definitely keep you posted with more stories :)

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  2. I am so excited for you! Even in the midst of the pain of our loss, our meeting with our midwife was very similar to yours. It was a 180 from the care we had been recieving and that was so refreshing! My midwife sounds a lot like yours--committed to her model of care but also has a healthy respect for doctors and hospitals. But I'm glad that you feel so comfortable with her!!

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    1. I know...I keep thinking of your experience as I go through this. And I agree 180 degree difference.

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  3. Wow, this place sounds absolutely amazing!! I say if you have access to that kind of care then you should absolutely take advantage of it! You deserve to be pampered and treated like a special woman during a very special time in her life, and it sounds like you will not be disappointed at the birthing centre. To keep your scientific mind in check, you can just remind yourself that you can easily be "transferred" and many women all over the world deliver healthy babies in many different birthing scenarios.

    I also like your advice at the end about decision making, I think it will come in handy at this time in my life.

    I am so happy for you! I hope you can post more pics of the centre.

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    1. Yes, it definitely feels like pampering and it is definitely amazing. I feel lucky that we are able to have it. I'm glad the decision making advice stuck with you.

      Here's a good article with more info about DBT Wise Mind:
      http://en.wikibooks.org/wiki/Dialectical_Behavioral_Therapy/Core_Mindfulness_Skills/Wise_Mind/Experiencing_Integration_and_Intuition

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  4. Wow, that's a GREAT place. Sounds expensive ;) And you're absolutely right, if you change your mind, the hospital is still an option. The other way around probably isn't possible, or that easy. I really think you made the right choice for you! That's great!

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    1. Ha! I forgot to mention the cost! It IS expensive. But not when you compare it to the cost of giving birth in a hospital. The whole package, including prenatal care, delivery in the birthing suite, birthing classes, baby care classes, lactation classes, post natal care, and some extra stuff (a few sessions of yoga, etc) costs under $7000. They have a more basic package as well. Then, your insurance can cover up to 50-75%. So really, it could end up being LESS expensive than a hospital birth, depending on your insurance.

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  5. Yup, this sounds great, specially about the holistic care, the fact that they care of the medical + the personal, because you are much more than just, well a bunch of complex cells arranged to work together.
    The fact that they work with a doctor, and that, at any point you can decide to go towards a more medical / clinical way of care if you feel safer then or if something arises is also reassuring.

    BTW: we just had an appointment with a new hospital / clinic and what a difference, the intake appointment lasted 1 hr and a half, they answered all kinds of questions, the place was plastered with both photos of embryos, babies, and posters of scientific articles they have presented and we also had to fill a whole questionnaire including both of our family histories, so I was nodding along when you described that part.

    Wishing and hoping you will feel better the rest of the time.

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    1. Yes, it is definitely holistic care, which I really appreciate. And yes, there is medical backup which makes me feel better.

      Hey! I'm so glad you found a new clinic. That sounds wonderful and just like YOU deserve. I know you don't post about your appointments and such, but I'd love to hear more about it. Keep me posted.

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  6. I was just at the OBs office for my NINE MINUTE appointment and I spent the whole drive home thinking of your last post and being so jealous that I didn't have the option of even looking at a birthing center. If I could drink the Koolaid I definitely would. Unfortunately my HMO only has orange drink and so that is what I have to be okay with. Yet again, money stands between me and the what I want. A familiar theme in my life.

    I think it's awesome you're using the birthing center. I can't wait to hear more about it.

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    1. Awww...I'm sorry about the HMO orange drink. We splurged on the PPO this year only because we were hoping it would be the year we'd get pregnant. Lucky for us. I will say though, depending on what your HMO covers and how much you end up owing, it sometimes wouldn't be that much more to pay the birth center out of pocket. Their bare minimum package (prenatal care + birth) may end up being similar to the out of pocket pay with an HMO.

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  7. Wow, I think it all sounds great!! I would have drank the kool-aid, too. :-) You seem like a very reasonable, responsible person and I can tell you've made the right choice. Plus, I think it's awesome that you can decide to go with a more medical route if you need to! This all sounds very positive, and I'm happy for you!!

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    1. Thank you!! It means a lot to hear your support, especially since you're a nurse. :)

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  8. Whoa, that birthing suite looks INTENSE! It's nicer than most hotel rooms I stay in, that's for sure. I think this place sounds totally legit and qualified; they really seem to fulfill both sides of the coin in terms of both emotional and physical help through this journey. Always trust your instinct!

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    1. The suite IS intense! The living room area actually has a floor to ceiling glass wall that slides up into the ceiling to open the whole room into open air. I am actually excited to give birth. How crazy is that?

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