Friday, October 19, 2007

Midwife Appointment

I was so wrapped up in the anticipation of hearing the heartbeat (and the incredible migraine that I was suffering from) that I forgot about the other aspect of our visit: the attendance of my mother-in-law and her inquisition of the midwife.

That ... was something else.

I warned Lillian (the midwife) ahead of time, and she was quite prepared, even happy, to answer all of Karen's questions. It was even somewhat amusing to see Karen's inner struggle between her desire to be polite and make a good impression, and her desire to ask any ugly question she has to in order to feel heard.

She started off with:
How many babies have you delivered?
How long have you been a midwife?
How long have you been a midwife in Nanaimo, and how many babies have you delivered here?Then came the first tricky one: being aware of people's privacy issues, can you get one of your clients to call me and talk about their experiences with you? Basically asking for a reference. This is *so* the way Karen thinks - I think Chris was a little surprised that his mom actually went that far, but I could see where she was going as she led up to that!

The next round of questions got a little tougher, and they weren't really 'questions' so much as, I guess, 'discussion points'. For example, after telling me she hoped I wouldn't get offended - which I didn't - she asked Lillian how my advanced age (32) affected her expectation and care surrounding my pregnancy and birth. She also asked about Lillian's preference for home or hospital births, which I thought was a little beside the point, since Lillian will catch the baby wherever we decide to do it, it's not really up to her. But it was really just a way for Lillian to open the discussion about home births, what they're like compared to hospital births, and what her rules are - both those governed by the college of midwives, and her own personal guidelines - for turning a home birth into a hospital one. I really felt that we were having this whole discussion about 5 months too early, but at the same time it was really interesting to have a passionate, well-informed discussion about all the aspects of home/hospital birth. It was at this stage of conversation that Chris and I really started to get involved and ask some of our own questions surrounding the issue, and that was great.

For example, I was reassured that many of the worries I had about hospital births - primarily, the "cascade of interventions" - is much less likely to take place when you are there under midwifery care instead of obstetrical management. "Midwives just aren't trained that way," Lillian assured me. "We aren't going to turn on all the machines just because they're there." I also commented on what I'd learned from Rhea about the hospitals having certain rules and guidelines that *any* caregiver has to abide by when attending a birth. "The way I understand it, as soon as we enter the hospital, even though I am under your care, you and I are no longer the bottom-line in decision making: there are certain rules we have to obey, simply because we are in their hospital." Lillian agreed that this was true, but commented that there weren't any rules at NRGH that she personally disagreed with. "One of their rules states that if the meconium is really thick and the baby's heartrate is going down, that a pediatrician gets called in." She raised her hands in the air in a "hands off" gesture. "That's something I'd do anyway, so it doesn't bother me that they have that rule."

In any case, I was really happy with the way Lillian handled Karen's questions, and I hope Karen was too. I don't really know if anything got put to rest - I think we have a ways to go before we get to that point - but I can honestly say that I think we're on the right track.
As for home birth vs. hospital birth, Karen is sure selling hard on the hospital birth, and I am wavering a bit. One sentence I read in "The Midwifery Option" has stuck with me: [paraphrased] "The fact is that if anything goes wrong with your baby during or after birth, those around you will find it easier to accept if the baby was in a hospital, regardless of the outcome." That is to say, the baby may have died no matter where it was, but family and friends will feel more at peace about that death if it took place in a hospital. Fair or not, it rings true to me - and obviously I don't expect our baby to die (nobody does, I guess), but this holds true for a million other things as well. The baby gets sick, the baby's lung collapses, the baby's at a low birth weight, the baby has a heart murmur, whatever. Everyone's going to feel better about that baby's chances if s/he was born in a hospital. It's not necessarily accurate, but it's true.

So hospital birth feels to me like a good way to compromise. If I could extract a tacit agreement that everyone would get off my back about having a midwife if only I'd agree to have a hospital birth, well, that sounds okay to me. Especially now that the new maternity wing is built and it sounds absolutely awesome: a pullout bed for Dad, great deep tubs for labouring in the water, and each private, family-oriented room is self-contained, that is, the room where you labour is the room where you deliver is the room where you recover.

On the other hand, there's this niggling doubt in the back of my mind that asks what will happen if I prove this much of a pushover, right at the start of my parenting journey - will The Grandparents think they can push me around on everything? So I think the best route to take would be for Chris and I to truly find peace and acceptance in our decision, and make it clear that it was OUR decision. The thing is, it's way too early to make that decision now, so I'm kind of aggravated that we're all fighting - or at least, "passionately discussing" - five months early. I've never said to either set of grandparents "I want a home birth." All I've said is "I haven't decided yet." And I think I have a long time until I have to decide.

Anyway, after all that I lay down on the bed and we tried to hear the heartbeat. We didn't find it, but we did hear kicking, which was amusing: the kicks were very distinct "click" noises, much more satisfying than the "whooshing" sounds we heard last time. After a few minutes and a few kicks, Lillian concluded that the baby's feet must be up against my belly, rather than his/her torso, so we wouldn't get to hear the heart. Too bad, but there's always next time.

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