This is the third post in the Edwards Family Road to Homebirth series. Read about how we decided to grow our family and how we got pregnant here. And read about how we came to the midwife model of care and to planning a homebirth here.
The process of planning our homebirth:
We had our first appointment with our midwife when I was about six weeks along. It was exciting to get to sit and talk about how we felt about being pregnant and planning a home birth, and to talk about how I was feeling overall. I don’t think the nausea had set in at that point, so I was feeling pretty great. After talking for about 45 minutes, I went to the bathroom to collect my urine sample and to test it for all kinds of things. Then she weighed me and took my blood pressure. It was way too early to try to catch the heart beat on the Doppler, and I think it was too early for her to start measuring my fundal height. But that’s essentially what every appointment has looked like since-45 minutes of talking about my pregnancy and birth plans and 15 minutes or so of checking my urine, my weight, my blood pressure, the baby’s heart beat, my fundal height, and the baby’s position (once it was big enough to tell). I saw her monthly until I reached 28 weeks; now I see her every other week, and I’ll see her weekly starting at 36 weeks.
An important thing to know is that homebirth is not for everyone from a physical standpoint (there are other reasons, of course). Due to licensing rules and regulations, licensed midwives in Arkansas may only provide care for women who are deemed low-risk. In order to determine this, I have to have two risk screenings to make sure that I don’t have any conditions that would preclude me from a homebirth with a licensed midwife (the regs list a ton of different conditions). One was done at 10 weeks, and the other will be done at 36 weeks, with a gestational diabetes screening at 27 weeks. So far, I’m fit as a fiddle for our homebirth. If anything on their list comes up between now and when my baby is born (that includes during labor and delivery), I will be transferred into the care of a physician at a hospital. Also important to note is that I can only have a homebirth attended by a midwife between 36 and 42 weeks. So if the baby wants to come tomorrow, it’s off to the hospital I go.
Early on in the pregnancy, I had two major worries. One was that the baby’s organs would be on the outside, which was calmed by our ultrasound at 21 weeks. The other was that I was going to “risk out” late in my pregnancy and not have a clue as to what doctor I might want to transfer to. The thing is, I’d never been to the same OB/GYN more than once, so I didn’t have a doctor with whom I had any sort of relationship. This was a somewhat more difficult worry to get over. I mean, what if I found out halfway through that I wasn’t low-risk and couldn’t have a homebirth? Where would I go? I had heard good things about the doctors at Cornerstone Clinic for Women, so I made myself an appointment with one of their doctors. To be perfectly honest, I did not tell him when I made the appointment that I was planning a homebirth. I knew that if I did, I could be kicked right out of the office without a second glance (yes, turns out doctors can fire patients). After that appointment-which worked out to cover my first risk screening (which I DID pay for), I called and told his office that I would be planning a homebirth with a midwife, and they confirmed that the doctor would no longer see me. But I felt better-I had met an OB with a good reputation that I liked just fine. Granted, I’m sure there’s a good chance that if I had-or even if I were to now-risked out of midwife care, that this doctor would refuse to see me. And that’s fine, because I’m just not worried about that now. I see that the chances of my risking out are so slim, and even if I do, I’ll just cross that bridge when I come to it.
Another major part of my preparing for the homebirth has been educating myself about birth. Trevor and I have been attending homebirth classes, I’ve been reading a number of books, and we’ve watched some videos of various types of births. Being the nerd that I am, this has been one of my favorite parts of the preparation (which I would have done even if I had been planning a hospital birth, to be sure). Learning about what my body is going to be doing during labor actually has me excited about going through it. Women’s bodies are so amazing-we conceive a life, carry it with us for nine months, and then bring it to the outside world. I daydream about how to handle contractions and how my body will be serving its ultimate purpose (of course, trying to avoid any concrete expectations).
Our next step in the planning process is to have our home visit with our midwife, Kim, and another midwife, Mary, who will assist Kim at our birth. Mary has been the instructor of our classes, so we’ve already gotten to know and like her. We’ve had to order our “homebirth kit” from a place online, and we’ve had to collect other assorted supplies (for example, pull-up diapers…for me…fun!). We’re trying to get the house as ready as possible for the baby by the time we have our home visit, but I’m not so sure how close we’ll get to that goal. One thing I’ve forgotten to mention is that we’re going to be set up to have a water birth. I’m not making any advanced-decisions about whether or not I’ll actually deliver the baby in the pool (Kim has one that we’ll use), but I want to have it available to labor in and to deliver in if I want to when the time comes.