The Swamp Witch

Welcome to the World, Flynn!

When I look down at my belly, there is a lump on the left side.

This little guy has been hanging out in a great position: head down, facing my right butt cheek. However, the bulk of his back and butt are making me look lopsided!

37 weeks, 3 days…I’m betting this guy comes right on time or a smidgen late. Please let him not come early…the house is such a wreck!

Oh, $*#&$!

That was my first reaction to seeing the positive pregnancy test at the end of February this year. My husband and I had decided to go off birth control so that we could conceivably conceive later in the year. I guess we’re both more fertile than we realized! A mere one week after removing the last Nuvaring (a hormonal birth control method that I highly recommend!), we were pregnant. Of course, I didn’t know that until six weeks later, at which time I thought I had the flu.

Off I went to see my doctor, a family practice that I trust and whole-heartedly endorse for western medical attention. Yep, their pregnancy test also came back positive.

“What? You’ve got to be kidding me?! I’ve not done any research on pregnancy or child rearing or…geesh! Ack! Why, god, why? Why me? What were we thinking?!”

Okay, that’s not what I really said in the doctor’s office. What really happened is that I burst into tears, at which point the nurse asked me if this was bad news. No, I explained, just a little sudden and unexpected…but definitely not bad.

All the fears of bearing a child, becoming a mother, and – most profoundly – giving birth came rushing out, front and center. I had a lot of learning to do, and I had exactly 34 weeks in which to do it (give or take, we’ll see when he decides to show up).

The first order of business was to find an OB. Assuming that childbirth was going to be the most excruciating pain of my life and that of course I would want an epidural, I spent very little time researching my options. I went with the recommendation of my doctor, whom I trust, and began my prenatal care at a large practice of all women doctors. I wasn’t terribly impressed, but I am rarely impressed with doctors, especially doctors in large practices.

What I like most about my family doc is that I don’t feel like I’m on a timer when she walks in; if I have questions or need to talk through her recommendations I never feel rushed to hurry up so she can get to the next patient. Not so at this OB practice. Oh, well, at least they were all women, I told myself.

In June my husband and I began childbirth classes in the Bradley Method. I signed up for them primarily to learn more about what would happen to my body during labor and delivery, not due to any strong desire to have a natural childbirth; I thought the people who wanted to do a homebirth were just kooky. As the classes progressed, I gained more and more confidence in my body’s ability to birth this child. After all, women birthed naturally for a millennia before childbirth was made a medical event and moved from the home into the hospitals (thanks, insurance companies…way to go…real brilliant work, there). I also began to realize that the OB practice I was seeing was not going to be as supportive of my newfound “girl power” as I would want them to be. I simply did not trust that they would support my desire for a natural childbirth. So we starting looking at our other options.

In our area and with our insurance, we were left with two options: one a certified nurse midwife (CNM) and the other an OB who is in practice by herself and who was a lay, or direct entry, midwife for several years before getting her MD. We interviewed both of them and clicked really well with the OB, so at the beginning of July I switched my prenatal care to this new doc.

At this juncture I won’t go into the financial implications of the switch, but let’s just say that we are pretty sure the previous OB practice is trying to swindle us out of money we don’t owe them. It’s funny how I now owe more than if I had delivered with them. Hmmm, sounds fishy to me. But back to the topic at hand, my smugness.

After the Bradley classes and reading Ina May Gaskin’s book Ina May’s Guide to Childbirth, I feel so confident about natural childbirth that I would be planning a homebirth if it didn’t freak out my husband so much.

Tangent: Did you know that in many states it is illegal to give birth at home, including here in Kentucky. I should clarify, it is not illegal for the mother to birth at home unassisted, but if she is assisted by a midwife (or other “pseudo-medical personnel”) that person can be charged with a crime. I think the real crime is in making a perfectly natural event criminal! But I digress…

A large part of the Bradley training is understanding that the medical establishment is just as much a consumer good as your groceries. You have rights, you have choices, and you have final say. Sometimes that final say can have unpleasant implications, for example your insurance may decide to not pay their part of your bill if you sign out of the hospital against medical advice (AMA). But in large part, every woman has more options than she realizes, and more power to take control of her birth experience, than the medical establishment would have you believe.

As a woman gets closer to her due date, she goes to her CNM or OB more frequently. At the beginning of her pregnancy, she sees her provider once a month. At around 7 months she starts going twice a month. About one month out from her due date, she goes for a weekly check up. Nothing terribly exciting happens at these appointments. It is mostly an opportunity to check her vital signs and measure the baby and listen for the heartbeat to make sure that mother and baby are progressing well for a smooth labor. Many OBs start doing internal exams as the mother gets closer to her due date. This is useless and can be potentially harmful for numerous reasons.

First, the baby is about to enter the world through the mother’s birth canal. The baby is already exposed to and acclimated to the mother’s womb and all that has been a part of his environment for nearly ten months (yes, it is ten months…a woman is pregnant for forty weeks). That includes all her cooties and all her partner’s cooties. What the baby is not acclimated to is the doctors’ and nurses’ cooties and the cooties on the gloves they are using. Anything introduced into the vagina can potentially introduce germs or infections that would not have occurred otherwise.

Secondly, an internal exam is usually done to check for cervical effacement and dilation. Effacement is how much the cervix has thinned and dilation is how much the cervix is open. A woman must be 100% effaced and 10cm dilated for a baby to descend into the birth canal from the uterus. Basically, you go from having a cervix that looks like a large marshmallow (the kind you roast for s’mores) to having a cervix that looks like the rubber sealer on a mason jar (the thing you put on top of the glass before screwing the top on). Here’s the kicker: your effacement and dilation tell you ab-sol-ute-ly nada about when you might go into labor. You can walk around 2, 3, even 4 cm dilated for days – even weeks! Knowing that I’m 20% effaced and 3 cm dilated only means that I am closer to birth than I was nine months ago. That’s about as significant as it gets.

Consequently, dealing with this knowledge becomes a mind game. And I can vouch for the fact that a woman needs no more mind games to deal with than she has already. Labor and delivery are largely impacted by a woman’s psychological readiness for the event and for becoming a mother. So why would I add insult to injury and let someone give me false hope that I might go into labor a little early? And who really cares? I want this kid to finish baking before he comes out, and I trust that he’ll know when the right time is.

In addition to these useless internal exams, many OBs will try to encourage you in your late stage of pregnancy by claiming that they can induce and take the baby if you are just too tired of being pregnant. First of all, I hate that phrase “take the baby,” you’ll not be taking my baby anywhere, thank you very much! Secondly, many inductions done in the United States are done for the convenience of the doctor or the parents. Since when did needing to make a tee time qualify as a good reason to bring a child into this world? Thirdly, many inductions end up with more medical intervention than would have been necessary if labor had been allowed to start on its own. Fourthly, many women are put on a time table for labor and delivery. This is done in part because of the number of people using epidurals. An epidural takes away your feeling from the injection site down, and so women with epidurals must rely on the computer monitors to which they are connected to let them know when they are having a contraction. Epidurals pretty much take the power in birth away from woman. She cannot be as cognizant a participant in the birth because she can’t feel what is happening during the birth her baby.

DISCLAIMER: There are exceptions to every rule, I agree. But on average, the US has a too high percentage of inductions and c-sections. And giving birth in a gravity neutral position (in stirrups, for example) is the least helpful way of getting the baby out into the world.

Okay, so now that you’ve tolerated my lecture on natural childbirth, why am I so smug? There is another woman at work who is pregnant. She is due next week, actually. She is going to the OB I started with, the large practice I mentioned earlier. She has been coming in each week exclaiming how far effaced and dilated she is. Today she even said that her doctor told her that she will probably go into labor in the next 48 hours. If she does not go into labor by Tuesday, the doctor will induce. Good grief! I’m sick of being pregnant, but I also want to give this child the best start at life that I can. After all, he’s already starting out with a bad history of heart conditions with the male side of his genes, the least I can do is make it a little easier to get started in life.

So I’m feeling pretty smug about the decisions we’ve made and the knowledge I’ve gained. I love being swamp witch-y!

A funny thing is happening to my body as my belly gets bigger and JoJo’s due date creeps closer: I look like a special effect on a sci-fi B-movie. It’s really funny to sit on the couch, minding my own business, and suddenly feel this movement in my abdomen. I look down to see my belly visably moving! Sometimes he’ll push out in one spot, bulging out one side of my belly, then pull back. Then push out, again. It really does look – and feel – like a special effect on a sci-fi movie. I’ll be sure to post if an alien bursts out of my belly.