I saw my OB this morning. He is a very pleasant guy, UK-trained and personable, and he seems to be convinced that I'm going to have a catastrophic hemorrhage when this baby is born. My two younger sons were born at home, one with a family practitioner and one with a CNM. While I would go back to the hospital in a flash if this pregnancy turned high-risk, I plan to stay home this time too. We've had an HMO for a couple of years now, and along with prenatal visits to my midwife I'm seeing an in-network OB so I can have my tests covered. I was up-front with him about my plans to stay home as long as I stay low-risk.
He has spent a fair amount of time telling me I could bleed out and die.
When my second son was born in an Edinburgh hospital, I was quite anemic going into the delivery and the third stage was actively managed (i.e., more tugging on that cord than I was comfortable with). I lost an estimated 850 ml of blood, but the hemorrhage was easily controlled -- one shot of methergine and that was that. I have no wish to repeat the experience, since the recovery was rather grim, but I also don't think it's an enormous red flag in my obstetric history. I have since had two perfectly normal births with utterly unremarkable third stages, and while I accept that I could hemorrhage again, I'm not losing sleep over it.
When I met my midwife during my pregnancy with Pete, the first question I asked her was what she carried to manage PPH; she said she always had pitocin, methergine, Cytotec, and IV fluids. I live half a mile from the hospital. I will pre-register there, just in case. I will transfer in a heartbeat if there is a problem. My midwife is licensed and legal; she would accompany me, chart in hand.
It doesn't seem very likely to me that I'm going to exsanguinate under those circumstances. Hemorrhage, maybe; lose my uterus, remotely possible; die, improbable. Call me an optimist.
I spent some time this morning trying to respond to the doctor's concerns: I didn't have even a hint of uterine atony after Pete's birth. I'll reconsider my plans if I'm anemic in the third trimester. My midwife can take the same first steps to intervene at home that she can in the hospital. I think, though, he has it burned in his brain: Homebirth = Too Risky. (Oddly, he has focused exclusively on the risks to me, not the risks to the baby.) But I believe I have read every paper published in English on homebirth safety in the past 15 years, and the results are clear: planned attended homebirth is a safe option for low-risk women carrying full-term vertex singletons. (Don't even get me started on Amy Tuteur, who should serve as a caution to any would-be amateur epidemiologists.)
I am feeling a little cranky today because I threw up my breakfast (at 16w5d! on Unisom! enough already!) immediately before going to the doctor to hear about my impending demise. But I will end on a happy note: I am grateful for this baby, whose kicks and flutters are making me smile every day now, grateful for a thus-far low-risk pregnancy, grateful for my midwife. My first visit with her was such a welcome contrast to my first OB visit. Afterward I told my husband, "I wish every pregnant woman could see someone like her." I'm glad I can.
Recent Comments