Choosing the Right Caregiver

Day: 27 28+1

I never really gave it too much thought on choosing the right caregiver until probably 5 or 6 months into the pregnancy. The OB/GYN office I went to was the one I’ve been visiting, which is super close to us. Even though I never really had any previous experiences, instinctively I haven’t been comfortable getting 10 minutes each month with the obstetricians, each time I see a different OB, and there’s no way to really know who will be on shift because the time of the delivery is unpredictable. I would hope that I can establish some sort of personal relationship with whoever will be in the labor room, but apparently this is how most OB practices work. The biggest problems I have with the OBs, in general, are: a) seems like OBs are not trained to coach pregnant women on diet, which is essential to a good pregnancy, they are trained to deal with medical problems; b) they have to carry one of the highest liability insurance, so their priority is to get the babies out and not getting sued (even though the rational is for the safety of the mother and the baby), the care and emotional support during pregnancy is clearly missing, at least from my experience compared to my 1~2 hr exclusive visit time with Dr. Gil who is a naturopathic doctor; c) all the great technologies and tests aren’t in my mind, producing great results, for example, amniocentesis is a pretty painful procedure that carries risks of decision of abortion and miscarriage; d) I simply feel that they expect me to just take their standard procedure, such as getting induced or having a C-section at 38 weeks. When Michael came into the picture seeing the OBs with me, he just couldn’t deal with the fact that they simply deny the physics (gravity has nothing to do with birthing). As to me, I just want to have answers but we got “it’s unknown” when it comes to causes for gestational diabetes or stillbirth.

Most of us probably won’t believe that that United States has the highest infant mortality rate and maternal death among the developed counties. And we definitely have restricted the practices of midwives. Take Germany for example, the federal law requires a midwife be present at birth. After reading about Cesarean section, Pitocin, epidural, and all kinds of medication and procedures, I am really shocked that the risks and complications that could arise from these intervention, a couple of documentaries that we watched such as ‘Business of Being Born‘, ‘Orgasmic Birth‘, which explore the psychological effects on both mother and baby, I do believe babies are fully aware of their feelings including pain, its just they can’t communicate with us other than crying. And these risks and complications were never communicated to me during my visits even when I asked about it.The answer was, ‘we do it all the time, you don’t need to worry about it’. The fact is though, I am the one who is giving birth, not the OBs!

I  know very few physicians are willing to accept patients who want to try for a VBAC, because of the .5~1% chance of uterus rupture, yet I didn’t expect it would be nearly impossible to deliver the twins in an L&D room, they all REQUIRE me to go into the operating room when its time to push, even though 50% of the twins are born vaginally! I may have found a lead today that they will agree to having me deliver at the L&D, if all the conditions are prefect – at least the first baby is head down, and I reach full term (37 weeks) so we will see, the benefits of staying in the L&D room is to avoid sudden interruptions which could stall the labor, and I don’t have to make a decision to choose which one, Michael or the doula/midwife, should be with me in the operating room, since only one support person is allowed in the OR.

Basically my options are: birthing center, home or hospital.

Home birth is such an enticing idea – however, NC bans the practice of the lay midwives so I am not sure if any CPM will be willing to do a twin delivery at home. And I have about 4 minutes in case of placenta rupture to get the second baby out so that is a big concern for me.

Birthing Center: I actually contacted the Farm in Tennessee (FMC), and the birthing center in Chapel Hill, they don’t take twin pregnancy, the doctors working with FMC aren’t okay with it, same stories with the birthing center in Chapel Hill. UNC hospital, which has a division of midwifery (they have Certified Nurse-Midwives on staff) but they do not attend twin birth either.

That pretty much leaves me with the hospital and I am hoping to find a midwife as a doula and she will be able to stay with me throughout the labor and delivery, since neither Michael and I will be in a position to have the energy to fight for what we want in case problems arise. Don’t get me wrong, we were very pleased with the setting at the hospital – WakeMed Cary (see picture) is only 5 minutes away and the labor room looks like a hotel suite, with Jacuzzi, birthing ball and squatting bar. But we just want to make sure we can trust and feel comfortable with everyone in there.

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