Thursday, February 11, 2010

Switching Care at 29 weeks.

So, basically I am busy and lazy at the same time so I thought the easiest way to tell this story in a timely fashion would be to copy part of an email that I sent to my mother in-law today:


Jerad and I actually had a consult with a new midwife yesterday and are switching care to her. Neither one of us had really ever resonated with the nurse midwives at Creating Harmony and had been having reservations about them and delivering in a hospital all along. So many people love them, but I think their approach/attitude/practice just wasn't a good fit for us. They are so busy (each midwife delivers about 30 babies A MONTH) so they don't really have time to get to know the patients. The appointments were all really short and impersonal and honestly not worth the drive to San Luis. The receptionist is AWFUL. Plus even though French hospital has birth tubs, you can't actually have the baby in them, they're just for use during labor and a waterbirth is something that I had really wanted to do if possible.

The last straw was my last prenatal appointment when the Glucose Tolerance Test came up. She wrote up a script for me to go take the test before my next appointment and was basically like "its time for you to do the GTT test" without discussing it at all. I told her I had a few reservations about it which made her get all snarky because she had to sit back down and talk to me some more :) I told her that I didn't have ANY of the risk factors for gestational diabetes (family history, advanced maternal age, excess weight, PCOS) and at every appointment I have never measured abnormal for sugars or proteins in my urine. I also told her that I felt like the test wouldn't really be accurate for me because normally I do not eat refined carbs or sugar, drink soda, heck, I don't even have juice with breakfast! So waking up and drinking a super sugary high fructose drink and seeing how my body processes it didn't make very much sense to me. If my body can't process a million grams of high fructose corn syrup on an empty stomach.... its not really an issue because that situation is never going to present itself in my day to day life. Even assuming I DID have GD, they would put me on a diet and exercise program that is basically the same as what I'm doing now so... I just wasn't interested in the test at all.

She was not happy and told me that while I could "technically" refuse the test I should know that babies born to mothers with GD can have all sorts of complications including excessive growth or worst case scenario, be a still birth. We went back and forth and I basically told her if I were having any symptoms or issues, or had family history or any other risk factors I would probably be fine with doing the test. Or maybe even if SHE was actually convinced/concerned that I had some type of risk. I also said I was open to measuring my fasting and after meal sugars with a monitor for a week OR possibly eating a high carb more normal breakfast instead of the glucola then having the GTT test done. She wasn't happy, but was willing to work with that and thats sort of how we left it. She dug around the office and found the "alternative" diet sheet for people that can't drink the glucose stuff. Its something like a piece of white bread with butter and jelly, an egg, grape juice, and a few other things.

When I got home I told Jerad how the apt went and he pointed out that if thats how they act about something so trivial then they probably aren't going to be the best advocates of our wishes in the hospital either. Anyways, I didn't really know where to go from there. Jerad suggested that we drive to the bay area and have a midwife attended birth center birth there but driving hours in labor didn't seem very enticing to me so I decided I'd just suck it up and keep trying to like the people we'd already been seeing and maybe lower my expectations a little.

Then, last week while I was looking for pediatricians, I found a naturopathic physician specializing in pediatrics who had just moved to the area. A lot of people were saying really great things about her on message boards. THEN I found out that she is also a licensed home birth midwife. We met with her yesterday for a consult and just to see how we felt about her. The appointment ended up lasting TWO HOURS. She was soooo personable and such a great fit and we all just "clicked." She has so much experience, and since she is also a pediatric physician in the super rare case that a complication did occur with the baby after birth she is more than capable of dealing with it. The only thing that was kind of holding us back was the cost. Home births are usually $2000ish-$7000 depending on the area. Plus its a huge ordeal to get insurance to cover it so they are pretty much all out of pocket. In our county there is NO competition. Prior to her moving here we were down to ONE midwife that would attend homebirths (we had called her when we first found out I was pregnant but she is on vacation when I'm due). Plus, everything in general is expensive here so I just figured it would be on the upper end of the cost spectrum. But, she only charges $4,200 for all of the prenatal appointments, birth, and post natal appointments/baby checks (done at 1 and 3 days, then 1 week, 3 weeks, and 6 weeks). I asked her if since I had already had a lot of my prenatal "care" completed so far if she would be willing to give us a discount, and offered to pay her the whole amount at once. She offered to take off more than we were hoping for. So, yesterday I called Creating Harmony and told them we were switching providers and we officially get our home water birth!

A few weeks ago Jerad and I were talking about our concern/reservations/fears about labor and delivery and switching providers and taking the hospital out of the equation literally wipes out everything we were worried about. So, we're both pretty happy now!


So, that's what's up for now. I have my first appointment with her next Thursday then will see her every 2 weeks until 36 weeks, and every week after that. She does the post natal and baby visits at 1 day, 3 days, then one week at our home, then 3 weeks and 6 weeks in her office. I am SUPER stoked that she is also a family practice doctor because now our family will have a doctor! Jerad and I never go unless there is something really wrong (like when I thought I broke my arm or he got a double ear infection and mono) and then we just go to an Urgent Care. We're both pretty leery of western medicine and usually do natural treatments at home but it would be SO NICE to have a doctor that we had a relationship with and was a naturopath!

Edited to add: I just wanted to say that even though Creating Harmony and French hospital didn't work out for us, I think they are both GREAT options! I know so many people who have used one of both and had the best experiences. I'm not trying to say that a home birth is the "right" way to go, its just so right for us :)


Paige said...

I am so thrilled for you! Let me know if you want a videographer/photographer! (You know me- I am a sucker for anything to do with birth... heck, I'd clean your tub afterwards for you if it meant I got to help!)

We did the "(not at) home birth" for the very same reason you considered the hospital, but we were able to do it at my moms house, which meant that I could down to Ventura and hang out BEFORE I went into labor! But since it was a 2+ hour drive, I did all my prenatal care with Kromhout. I had 2 appointments with the midwives, and knew it was not going to work out.

I knew that if I did end up giving birth in SLO, it would be in a hospital, and if I was in a hospital, I was going to push ALL of the limits. For me that meant seeing the OB, as contrary as that may seem. I knew that in the end, the midwives would need to defer to him for counsel, and I wanted to know (and be known) by the person making the decisions. Besides that, I just really liked the idea of seeing the same person at every appointment. We had a great experience with him. All of our appointments were calm, never rushed, and I felt like he really made it a point to get to know us. (And bonus- his wife had 2 home births, so he seemed "on the level")

In the end, I got the homebirth I really wanted. But I felt that if we had ended up birthing in the hospital with Aaron K, it wouldn't have been THAT bad. I did not feel the same way about the midwives.

Anyway, our next door neighbor has a 9 month old, and just switched to Dietrich as his pediatrician, and she loves her! I am so excited for you guys- it is going to be amazing!

honeywine said...

I don't blame you a bit. It's your body. Stick with someone you like and would want near your lady bits.