So I reluctantly met with a new OB. She was my friend’s OB – we were pregnant at the same time. The new OB was nice and I felt comfortable enough with her in our first appointment that I decided to continue going back to her.
But I wasn't giving up hope! The insurance fight continued.
In the meantime, I was learning even more about home birth midwifery and natural childbirth, too. It seemed like the resources were never-ending! I now knew there were different types of midwives, which I didn't know from the start. The childbirth ed teacher said this to me during one chat: “just make sure your midwife is certified.” So I knew there were at least certified midwives and non-certified midwives out there for home births. But as I dove deeper into learning about home birth, I learned there were more than just two different types. I learned there were CPMs, LMs and CNMs. There are more, actually, that I learned about after the birth of our first child. Anyway. At one point the insurance company was starting to bend the rules for us a bit by allowing the home birth but only if we had a nurse midwife from our network. I asked yoga teacher if she was a nurse midwife as well, because I knew someone could be both a nurse midwife and a CPM or LM. She told me she was not but wrote me a text message saying that if I wasn’t able to have a home birth with her but instead had a home birth with a nurse midwife it would be “the next best thing.”
Turns out we didn't have any nurse midwives in our network.
At that point in time, I wasn’t fully aware of the differences in education and training between Certified Nurse Midwives, Certified Professional Midwives, and Licensed Midwives - not as I am now. I also was not aware of the differences between our midwives here versus midwives in other first world countries, like the Netherlands. I made the assumption that the process to be called a licensed professional meant something… surely, not just anyone can be called a licensed professional and be able to “oversee” a woman in labor and a newborn baby. I trusted that a Licensed Midwife would be capable, that the certification meant a certain level of competency… I don’t mean the midwives we knew specifically, I mean the title in general. The certification. It’s a national certification. Surely it is a thorough process. It is birth, after all. As much as I believed in birth so much and the beauty of it and simplicity of the physiological process… so simple yet different every time… I knew it also was important to have a skilled care giver present, as birth can “rarely” mean life or death… and a skilled care giver can make that difference. Complications can necessitate someone trained in resolving them.
I had read about childbirth complications. Midwives are trained to handle them at home, though. And chances of experiencing them at home, without intervention, were less. If all else fails, you go to the hospital. Another film I watched at the time, I remember hearing the midwife say that midwives will know ahead of time, before it becomes an emergency. The film echoed what I had heard and read. And plus, we had the proof. We had the studies to show that home birth was just as safe, as far as numbers were concerned.
There’s no guarantee anywhere you give birth. This I knew. This I had read and been told. Safety was a huge priority to us. Pardon me, it was the priority for us. It’s why we were having a home birth. The USA doesn’t compare well at all to other countries for infant mortality. Our maternal mortality… yikes. Our obstetric system is flawed. Big time. That’s why hospitals aren’t a safe place for having babies. Home is.
These are things I believed.
I had faith... I had my trust in birth, my low risk pregnancy, my impeccable diet (I learned so much about nutrition from the home birth midwives – especially the one teaching our childbirth ed class)… I knew the chances that anything would go wrong for us and our birth were so, so slim. We just needed to be home. If our baby was going to die at home, our baby was going to die at the hospital. It would be a rare situation, if that were the case.
These are things I believed.
These are things I believed.
(Neurological and physical injury were not things I looked into much. I will be honest. I was trying hard to learn as much as I could but it’s a lot to take in in a short amount of time (9 months))
Back to my OB…
I’d have visits with her and she was lovely. I was, ummmm, a pain in the butt, to put it mildly. I didn’t think so at the time but looking back… yikes. I had so many assumptions and just this sour attitude because of my now fairly strong fear of OBs and hospitals. I distinctly remember discussing with her cutting the cord after birth and Pitocin after birth. I wanted delayed clamping and did not want Pitocin. As far as I was concerned, Pitocin was the Devil. I didn’t want it anywhere near me! Not even after the baby was born, unless I truly needed it. Delayed clamping was no big deal, though she was skeptical of its benefits. I told the childbirth ed midwife about what the OB said when she expressed her skepticism of delayed cord clamping and midwife replied “well your OB just doesn’t know. She just doesn’t know.”
My OB was concerned that I didn’t want the Pitocin after the birth. She said it was standard procedure at the hospital to do Pitocin after baby was born – an IM shot. No, no. Not unless I needed it. (And I was certain I wouldn’t need it. I was certain I wouldn’t need any interventions.) I could tell it might still be an issue so I wrote on our birth plan that I refuse Pitocin unless I need it and unless I give consent. There. It was in writing. I felt better. :)
The OBs kindness was unexpected for me. I appreciated it but still thought it was… I don’t know… maybe a trap? Maybe it wasn’t real? I sound crazy, I know… but I’d heard too many stories of OBs that seemed on board then it’s a different story at the hospital.
The midwives helped me put together my birth plan. Oh, and I had a doula, too, now! So she double checked the birth plan, too. The childbirth ed midwife said my first draft sounded too harsh. I’m glad she said that. It was too harsh. Thankful that we edited to sound nicer… not so militant in my demands. I should post it sometime on my blog.
Every time I looked at the plan it made me feel a huge mix of emotions: hopeful that I wouldn’t need it because a last minute miracle would come up and we’d have our home birth. Nervous and scared that one of our items would be ignored or purposefully dismissed by hospital staff. Worried that my baby would end up getting swept away after birth and poked with a shot that I didn’t want near my sweet baby. Angry that I needed the plan, that I'd need to fight for our experience... it was my body, my baby, my birth and I didn't need anyone interfering or taking away control of what was mine. And of course, I also felt excited for birth and to meet our baby.
Sometimes I look back and think I was so extreme in my views… like the fringe of the fringe… but then I hop on a childbirth forum geared toward home birth and/or NUCB and nope. I wasn’t extreme. I was right there in the middle.
I was starting to consider becoming a midwife around this time (something I am still set on doing to this day... when our kids are in school so I can be in school, too). I just had so much... I don't know... adoration for the midwives. I think that's the right word. They had an answer for me about everything birth-related and made it all sound so… easy/uncomplicated/normal/beautiful. I heard their stories of even high risk births like twins born at home. I was in awe. Twins run in my family and I was happy to know we could have our twins at home if we ever were pregnant with them. Breech births, too. As they say in the home birth and NUCB communities, just “variations of normal.” The birth stories were amazing. I felt I was on the path to my calling in life (still feel that way).
A letter back from the Department of Managed Healthcare sealed our fate. The fight was officially over. Our insurance company wasn’t budging and there was nothing we could do about it. We were stuck with the hospital and I was devastated.
I had become Facebook friends a while back with yoga midwife - our midwife - and after every birth she attended, she would give a Facebook shout out of congrats about the birth… the strong, empowered mama… the beautiful water birth. Usually a photograph was included, too. I loved seeing them. I remember thinking that I couldn’t wait for our shout out and water birth photo on Facebook! I know it sounds silly but I just felt it was an opportunity to inspire another mother to have a baby born at home… where they should be born. Now that fleeting little thought… that small way of inspiring another… it was lost. With each new birth post she shared, to accompany the awe and excitement I always felt, now came along a bit of jealousy and hopelessness. I was crushed.
I felt comforted that we at least knew what we needed to do going forward. We are fortunate to have other options of health insurance through my husband’s work and we made plans to switch insurance companies during the next open enrollment to one that would cover a home birth (and we did do so). As much as I felt sad about not having our home birth this time, I felt excited and at peace that it would be all squared away for our future births, knowing they’d all be at home.
By the end of the pregnancy, when I hit 39 weeks, I felt OK with the fact that we’d be in the hospital. Not thrilled by any means… but OK. I knew it would help me, actually, going forward as a doula and childbirth educator and midwife. A hospital birth would be good for me to experience. I felt confident with how badly I wanted to avoid interventions. I had my husband on board. We had an awesome doula. I was just ready to meet our baby. If I had to fight for it, I was ready because I knew my birth team would help me stay strong. And hopefully the See’s Candy I bought to take with us to the hospital would help the nurses get on “our side.”
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