Project Pollywog: 34 Weeks, 3 Days

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Sorry... posted late. From Thursday, 30 August, 2007.

Project Pollywog: 34 Weeks, 3 days

Yesterday was our 34 week Midwife appointment. The topic of the day was home birth. As the reader knows, we have been reconsidering this possibility and leaning strongly towards it since discovering that our new insurance will not cover birth by midwife. Yesterday we discussed more in depth the logistics of it, some more details and addressed Stephen’s concerns of safety. Included below are the answers to our questions and hopefully many of yours as well.
Our big hang up has simply related to which hospital we’d rather be closer to. Both hospital options for the birthing center and being at home are not optimal, but it’s hard to know if one is worse than the other. If there is a life in question who can we trust? I think that in the end we’re taking a leap of faith that should we need it, Cascade Valley Hospital will not kill us. Home birth it is.

Home Birth FAQ

1. Is it safe?
   Despite what we are taught to believe, home birth under the supervision of a trained professional, like a midwife is safe. If there is a problem, we will be transferred to a hospital (see below).


2. What equipment is brought to the home?
   Everything that would be present at the birthing center (other than the tub, of course) is brought to the home by the midwife. This includes any IV equipment, meds, oxygen and resuscitation equipment, the scale, etc.


3. What scenarios are considered an emergency or require transfer to the hospital?
   Causes for transfer are broken into two categories: emergent and non-emergent. Non-emergent causes for transfer include breech presentation (which is nearly impossible at this point) and not progressing in labour. Darlene’s rate of transfer for this reason is 17%. It is a joint decision between us and her, namely falling on how patient we want to be and whether we feel we want to stick it out, so to speak. In this event, an ambulance is not necessary.
   Emergent (potentially life threatening) situations include hemorrhaging, baby unresponsive to resuscitation efforts, blood pressure, and fetal distress. In Darlene’s 9 years of practice, there have only been 2 Emergent transfers. She constant assures us that she is very conservative and will not let anything go to the point where an emergent transfer could be necessary if there is any evidence that this may be the case.


4. Where would we be taken if we need to be transferred to the hospital?
   Non-Emergent: Seattle or Anacortes. Emergent: Cascade Valley Hospital (unfortunately, that is nearest to us).


5. At what point does the midwife arrive?
   The midwife will come once we are in active labour: Contractions are 4 minutes apart for 60 second durations, for two hours. This is the same point we would have gone to the birthing center.


6. What are the post birth procedures?
   Post birth the baby will be lifted directly to Raine’s chest, skin to skin, with blankets on top of the baby for warmth. The baby will be latched and nursing as soon as possible. During the first hour, Darlene will listen to the baby’s heart and lungs and do APGAR Scoring. During the last half hour before the midwife leaves, the baby’s weight will be measured.
   We all believe that the first two hours after birth are very important for bonding and to the success of nursing. The baby will be with us, skin to skin, constantly (other than a mandatory trip to the loo for mom).
   There will be no pokey of the baby. We have shown no risk factors and therefore there is no need.


7. What are the differences between a birth center birth and a home birth?
   Logistically nothing. The main differences (as listed in a previous post) are location, closest hospital and relative ease of comfort and acquisition of food. All the same equipment will be present. There is no built in tub in which to labour, but we’re in the process of looking into a rental for that.


8. Who will be in attendance at the birth?
   Besides the parents-to-be, Darlene (midwife) and her assistant/apprentice, Rebecca, and Raine’s mother, Tamara. Tamara will be in charge of downstairs, cooking for everyone, fielding phone calls, and generally being on hand for household issues so that Stephen and Raine can be relaxed and together throughout labor and birth.


9. Isn’t it messy?
   This is Stephen’s largest concern, but it will be no messier at home than it would be anywhere else. Darlene and Rebecca will be handling any mess that there is. Laundry will be put in before they leave and anything with blood or otherwise will leave in a biohazard bag with which we have no contact. I may also point out that plastic is a wonderful thing in such situations.


10. How long does the midwife stay in the home?
    Average length of stay is three hours past the birth.


11. Will visitors be allowed?
    First of all, we have never done this before so everything I say regarding this matter is conjecture at best. However, we are asking at this point that people at the very least call ahead before coming over. We are imagining that we may be open to visitors at or around the time that the midwife leaves (so at least three hours post birth). This gives us out bonding time and some recovery time… as well as some time to adjust being a new little family. After that we’re likely to be more open to having people over to meet the baby, but we’ll have to see what happens.


12. What about the stairs?
    We are planning on dividing the house somewhat with Raine and all birth related activities staying upstairs with Tamara running the downstairs (this also allows for the making and delivery of food). We’re also expecting that Raine will be upstairs and staying away from the stairs for as much as the first couple of days depending on how she feels.


13. Is it expensive?
    Babies are a big expense, but this is actually the least expensive method, short of heading into the woods and catching the baby in a bucket. This is expensive for us in the way that we are getting no insurance help and having to come up with everything quickly in one lump sum. However, the total cost of the home birth will still be less than our 20% portion of a hospital birth would have been.

General FAQ

1. If the baby is a boy, will he get the snip?
   No. There will be no snipping. There is no evidence/research to support the need for a circumcision.


2. Who will be the baby’s doctor?
   The baby will be taken care of by our GP and Naturopath, Dr. Mark Monwai of Cornerstone Family Health Clinic in Kirkland. Coincidentally, his third child is due about the same time as our baby.


3. Will there be a back up pediatrician?
   Dr. Mark works with Children’s Hospital on matters regarding infection, fever, serious illness, injury, or anything that seems to necessitate care outside of his own practice. Therefore, there is no need for a back up pediatrician. If there is some problem, we go straight to the top of the care chain for this area.


4. To Vaccinate or not to Vaccinate?
   We will vaccinate, but we will do so using preservative and mercury free vaccinations which are stocked by Dr. Mark and covered by insurance. We do not plan to vaccinate for anything and everything indiscriminately. We believe in a naturally healthy, strong immune system supported through nutrition.


5. Do you know what it is?
   Yes, it’s still a baby. No, we do not know the chromosomal configuration, testosterone levels or resulting genitalia sported by the baby. And even then, gender is anyone’s guess.


6. Too big, too small?
   Even though people are constantly commenting to Raine that she is “not that big for being so close!” the growth of the baby is right on target. And even though Raine has actually lost a little weight in the last few weeks, the baby is still fine. Please remember that Raine is 5’9” and there is a lot of room for baby to hide in her torso. But believe us; the baby is getting bigger, heavier, stronger and just as curious and rambunctious as ever. We’re pretty sure it’s going to be healthy and fine.


7. What names do you have picked out?
   If the baby is a girl, which we’re still leaning towards, then it shall be an Ellie and we shall call her Ellie. Ellie Belly Jelly Bean. Or… Elisabeth Lorraine Terhune. If it turns out to be a boy then we will have to meet him and find out who he is. That’s the long answer for “we have no idea.”


8. How are the birthing classes going?
   Birth classes are trucking right along. This week we are attending class 8 of 12- that’s 2/3rds done! Despite the fact that Stephen doesn’t dig the group reading thing, and we aren’t terribly fond of everyone in the class, we still feel this was the best choice for us. We are learning more about what to expect from labor and delivery. And though Stephen doesn’t think he’s learned anything, he’s really demonstrated a fantastic aptitude for comforting Raine through practice contractions and even some of the real pains of late pregnancy (for which she is very thankful).


9. Will the baby be a veggie or a carnivore?
   This is an excellent question for which we do not have an excellent answer. A lot of the nutrition issues regarding baby will rely largely on baby’s blood type. Right now the only thing that has been decided is that junk food is out, low sugar is in, and breast feeding is in. We’re shooting for good nutrition, organic foods and that sort of thing. That means no Happy Meals and fries, people.


10. Who will be the God Parents?
    A God parent is a thing of a religion we do not practice. It also seems to be a sure fire way to never see those named as such again. Therefore, there shall be none.


11. How much time will you take off from work?
    Raine seems to be a workaholic these days and is trying to get her little photography business off the ground. So, on the downside, there is no formal maternity leave and everything relies on her. On the plus side, she works from home and therefore will still be spending as much baby time as possible. Whatever ends p happening will depend on how things go and what the baby needs.
    Stephen, who also works from home, has a fairly flexible work situation with regards to paternity leave. However, since he is the primary bread winner, and works for a small company, we will be doing what we can to allow him to work as much as possible. But we’re hoping for a couple of days as a new family.

Other things we’ve discovered:

1. Some people freeze the placenta for one year and then bury it under a tree or flowering bush to signify growth.


2. The Arboretum in Seattle is full of Hippie Placentas.


3. Stephen is turning into quite the softy and is quite fascinated by little kids.


4. Stephen is also fascinated and quite enjoys the "bring things and take it away and then bring it back" game often played by toddlers. Maya, being such a toddler now, is quite fond of this game and likes to play it with imaginary objects.


5. Food items do not count in the above game. A piece of popcorn once taken is not given back... but toddlers will come back for more.