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Tuesday, April 01, 2008I have never wished harder for the ability to see into the future in all my life. Or yearned more for some sort of guarantee... good or bad. "You will have no complications whatsoever and your babies will be absolutely healthy; go for the home birth," or "There will be trouble; birth in the hospital." Really, either one would be completely fine with me. I just wish there were some way to know, without a doubt, that I am 100% making the right decision either way. Alas, life doesn't come with guarantees.
Why am I considering a home birth? You can read the back-story here, in my personal blog (warning: it's my personal blog, so sometimes I use bad words). The short version is, because there are two in there, I'm automatically "high risk." The fact that I've had three completely healthy, normal, uncomplicated births doesn't figure into the equation. I'm high risk, and therefore there are a whole lot of interventions that are going to be recommended (I use that word lightly) the second I set foot in the hospital.
Quite a few things have happened since I made that post...
First, Lee and I met with Kathy Mitchell, the midwife that was recommended to us by several people. One friend described her perfectly: "She's not crunchy-granola, she's sort of motherly, the kind of person you wish was your mom." That's exactly how I felt as we talked with her. She was very reassuring, and given my health, history, and the fact that both babies are currently head-down, she didn't see any reason that we couldn't try for a home birth. We left feeling really good. Even Lee liked her, and that's saying a lot!
Next up, we had our consultation with the midwives at CHOICE. Lee was supposed to go with me, but Levi altered his nap schedule that day, so we opted for me going on my own, rather than contend with a very crabby boy for the entire appointment. I met with Abby and Kelly, and I adored them both. Abby is older, and very similar to Kathy. I guessed Kelly to be around my age, but she's been practicing since 1987, so she has to be at least a little older. Overall, they were both incredibly realistic. While genuinely supportive of birthing these babies at home, they also carefully outlined the possible risks associated with twins, and how the various scenarios would be handled. At one point Abby said, "I want you to understand that we are NOT 'home birth or bust.' There are times when being in the hospital is the safest option." I found that perspective to be very comforting. While I absolutely believe in my body's ability to birth twins, the bottom line is that there is more potential for risk than with a singleton. If we go with home birth, I would prefer the attendant(s) err on the side of caution. Abby and Kelly felt like a perfect fit. Before I left, I set up the next appointment, where they will do my full history. Lee will come with me to that one, so that he has a chance to get to know them as well.
Finally, I had my appointment with Dr. Jenkins yesterday. Lee was with me, which I think was really good, as we presented a united front. The discussion went... as well as it could, I suppose. I think I offended him a little bit, although I was trying to put things as delicately as possible, while still getting my point across. Going in, what I really wanted was his support of a home birth (even reluctant support would be ok), and his willingness to be a backup should a hospital delivery become necessary. I have a wonderful history with this doctor, and losing him to a home birth would disappoint me greatly.
In response to whether he would be a backup, he said "I won't like it, but I'll certainly do it." I guess I couldn't really ask for more there. We talked about the various things Dr. Ruedrich had said, and he assured me again and again: "This is your picnic... no matter what doctor is on call when you go into labor, no one will do anything to you or the babies that you don't want." He encouraged us to write down the things that are important to us, and bring it to the next appointment. Ultimately, he actually did seem glad that I was open about everything, and that we were having the discussion NOW, as opposed to when we walked into the hospital (or didn't walk into the hospital, because we'd chosen a home birth and didn't tell him). Overall, it appears there is lots of room for negotiation with Dr. Jenkins, and that's encouraging.
So now the questions tumbling around in my brain are...
- If I stay with Dr. Jenkins, how much do I trust that our wishes will be honored no matter who is on call that day/night? How much do I trust that we won't have to spend my entire labor warding off interventions?
- If we choose a home birth, will I be confident that the midwives will recognize potential problems early enough to transport safely to the hospital?
And the really big ones...
- If we birth in the hospital, and something goes horribly wrong, would the the outcome have been different if I were at home?
- If we birth at home, and something goes horribly wrong, would the outcome have been different if I were at the hospital?
If I had a guarantee that NO interventions would take place, or even be suggested, unless/until there was specific evidence to warrant it, I would absolutely give birth in the hospital.
If I had a guarantee that I would definitely get to the hospital in time if trouble should arise, I would absolutely opt for a home birth.
Unfortunately, no one is going to give me either guarantee, and I'm back to wishing for a crystal ball.
Labels: Childbirth Issues