We're Having a Baby This Month!

Happy August 1st, everyone. I can not believe I can now say, "We're having a baby this month!!!!!" Where has the time gone? I definitely feel like the first two trimesters just flew by and this third has been draaaaagging on. Probably because we've been pretty much prepared for her arrival since 30 weeks. I finished my baby quilt a couple weeks ago and I've been just twiddling my thumbs since. The days seem to drag on and on but that might also be because it pretty much hurts and exhausts me to do anything. Getting out of bed is the worse! Thanks to pregnancy-induced carpal tunnel, my hands and wrists ache. My feet ache. My belly and back ache. Despite all that, I'm still not ready to be done. I mean I am, but I'm not. I'm going to miss being pregnant. I'm going to miss feeling her move inside me. I'm going to miss having her all to myself.

With that said.....

I can't wait to meet her! I can't wait to smell that intoxicating baby smell on her head. I can't wait to look into her eyes and tell her that I'm her mommy. I can't wait to ignore my messy house because I'm too busy snuggling with my baby girl. I can't wait to see Mike melt into an absolute puddle when he meets his daughter for the first time. I can't wait to nurse her and gaze into her eyes--I think knowing that I'm giving her all the nourishment she needs is going to be one of the most empowering things I'll ever feel. I still can't believe that after 4.5 years of waiting, we are going to meet our daughter this month!

During this pregnancy I have been doing a lot to prepare for her arrival. Besides the obvious shopping for clothes, cloth diapers, baby gear, etc. I have been doing some other things to prepare both physically and mentally. I thought I'd share these things for anyone else who may be interested too.

Ina May's Guide to Childbirth
By far my FAVORITE book that I've read on birth. Birth is not to be feared. Birth is natural. Birth is not a medical condition that needs to be treated. (Unless you're high risk and have medical issues that need to be treated, obviously.) Am I nervous for the pain of childbirth? Yes. I'd be lying if I said I wasn't. However, I know my body was designed to do this and I welcome the natural process. Honestly, the pain and recovery from a c-section scares me more. I remember how awful I felt after my laparoscopy last summer and I remember saying to Mike, "I can't even imagine feeling this way and having to care for a newborn." Even if you're the type of person who wants nothing to do with a midwife or wants an epidural as soon as she gets to the hospital, I still highly suggest you read this book. Did you know that the average American spends more time researching cars or a new computer than they spend on researching childbirth? It's crazy! Like infertility and IVF, I couldn't imagine going into this with no knowledge. It just blows my mind how blindly some people can follow their doctors. If I did that I would probably still be in the shitty clinic on post, trying like hell to get pregnant instead of anticipating the birth of my baby girl but I digress.  Some of it is a little hippy-dippy but it has so much great information and some really wonderful birth stories.

 The Womanly Art of Breastfeeding
I loved this book so much I read it twice! This book far exceeded any other book I read about breastfeeding. It was incredibly informative and got me totally pumped to nurse my baby girl!. I wish every woman who says, "I am going to try to breastfeed...." would read this! I have no doubts that I can and will breastfeed my daughter. It may come with some issues but I now know who to see if I need help and Mike knows that his role in supporting me in my endeavors is just as important as my role as a nursing mom. I read other books about breastfeeding too and this was by far my favorite.

Natural Hospital Birth: The Best of Both Worlds
This book was great! While I already knew about things like c-section statistics, interventions, rooming in, etc. It helped me be more prepared to advocate for myself and our wishes in a hospital setting. I'm not too worried about getting pushed around by doctors or nurses, mostly because I've heard nothing but great things about my hospital being very supportive of natural birth moms, but also because I know Mike won't allow it. He is not to to allow others bully him and he will definitely speak up for us when I can't. Also, I'll have my doula there!

Red Raspberry Leaf Tea
I've been trying to drink at least one cup a day since a couple weeks after I hit my second trimester. Contrary to popular belief, this does not induce labor. It is a uterine toner and can help make contractions during labor more efficient and help prevent postpartum hemorrhaging. It also helps with fertility and menstrual cramps. Luckily, I'm a big tea drinker so I don't mind the taste though a lot of people say it's too bland for them. It's very refreshing iced as well!  For more on the benefits of drinking RRL tea check out this article. You can find RRL tea at Super.Supplements or in a Natural Foods section of your grocery store. Am.azon sells it for a good deal too!

Evening Primrose Oil
Again, contrary to popular belief this does not directly induce labor.  Evening Primrose Oil contains an essential fatty acid that is converted into a prostaglandin by our bodies, which is what softens our cervix during pregnancy and labor.  Semen also contains naturally prostaglandins and can help your cervix ripen. However, sex can be quite uncomfortable and difficult at this point in pregnancy so needless to say I figured the EPO wouldn't hurt as well. At my 37 week appointment my midwife gave me the green light to start using EPO to help prepare my cervix for birth. I insert two gel caps into my vagina every night before bed (make sure to use a pad or pantyliner as this can get messy!) Starting next week I will up the dosage to 3. The gel caps are dissolved by morning and hopefully the EPO is doing it's thing overnight! It does not work right away, of course. It takes a few weeks to ripen and soften the cervix. I could have started it at 36 weeks but I didn't have an appointment then and I wanted to talk with my midwife to make sure it was okay to start it. It's always a good idea to talk to your care provider before starting any kind of herbal or medicinal regiment.

Big Bouncy Ball
I wish I would have bought one ages ago! This is the only thing that brings me instant relief for back pain. I bounce on it whenever my back feels tight and try to spend at least an hour a day on it. I sit on while I'm watching the Olympics and pretend I'm a lot more than just a huge pregnant lady bouncing on a ball. Sitting on the ball is *almost* as good as the squatting position but much, much easier. Have you ever tried to squat when you're 40 pounds heavier and your center of gravity is totally off? It's not pretty. This position opens the pelvis and helps baby get in prime position for birth! It also feels really, really good on my back and hips. And your animals look at you like you're crazy:

Bailey wondering what I'm doing.

Zero and the bump out for a walk

Walking
I always said that I wasn't going to be lazy during pregnancy and except for those first few months where I didn't feel like doing ANYTHING--I've been pretty good about staying somewhat active. Plus those first few months were winter in the Pacific NW aka cold and rainy season--so I had an excuse, right? ;) Now that my swelling is gone for the most part, I have been going on walks with Mike when he gets home from work. Thankfully it doesn't take too much pleading on my part to get him to go with me because he knows it's good for me and the baby (and the doggies!) We don't go far, mostly because my back gets really tight and painful, but we try to do at least a mile. Most days we do about 1.25-1.5 miles, which seems amazingly far when you are waddling the entire way. I get a lot of stares from people passing by. Haha.  I normally feel some cervical pressure by the end of the walk so I hope it's doing something to help the progress along.


I know I've already said this but we're having a baby this month! Only 16 days until my due date but I won't be surprised if I go post date. I hope that doesn't happen since we're moving so soon but if it comes to that Mike and I have decided to wait until 40 weeks to talk about eviction. Mike and I both guessed that she'll make her arrival on the 14th so I guess we'll see! Have you put in your guess yet?

Oh and I had to share this funny picture! Mike and I went up to Seattle last weekend to hang out with my brother and sister-in-law one last time before the babies start arriving. My SIL now has over 14 pounds of babies in her! She's due August 19 and so far they've shown no signs of coming any time soon. I know she's as ready to meet her babies as I am!

Mike's magical floating head

I am Pumped to Birth this Baby!

There's an epidemic in America right now. We have an unnecessarily high c-section rate and birth is no longer seen as a natural, physiological process, but rather as a medical ailment and something that needs to be treated or cured.  For anyone who is pregnant or trying to become pregnant, I highly suggest you watch Pregnant in America and The Business of Being Born. They are both extremely eye opening. Ina May's Guide to Childbirth and The Thinking Woman's Guide to a Better Birth are really great resources as well.

My goal is a natural, un-medicated water birth. My hospital is the only one in the state that allows water births! I know some of you are probably thinking I'm crazy. "What? Natural?! We'll see...."  "Why not just get an epidural?" "Why put yourself through that?" And my favorite, "It's not like you get a medal for going natural..." You know what? Women may not get a medal for going natural but they sure as hell deserve them! You get medals for running a marathon. Marathons are mentally and physically challenging, just like birth. Why not give credit where credit is due?!

Why I want a natural birth:

• I think that women in America are given far too little credit for their abilities to birth babies. We are made to do this; I am made to do this.
• After everything it's taken me to get to this point (See: New? Start here.) I would really like to experience the natural birth process.
• I want to experience that total rush of oxytocin, the baby high, when I birth my baby. Drugs can interfere with this natural occurence. 
• Every drug given during the birthing process will cross the placenta to the baby. I want to see an awake, alert baby when I meet her for the first time. AND since I'm encapsulating my placenta (maybe I need to do another post on this topic?!) I would rather not have any of that stuff in there.
• A natural birth will lessen the  chance of a cascade of interventions, decreasing my risk of needing a c-section. 

 Of course all this goes out the window if mine or baby's safety is jeopardized. The ultimate goal is obviously to have a healthy baby safely but due to my low risk pregnancy there is absolutely no reason to think that my birth plan can't become a reality. Mike is totally on board with my birth plans and has been so caring and inquisitive. Yesterday, when we were taking a walk with our girls, he asked me what kinds of things I would like him to say to me during labor and which words I would find comforting and motivating. I know he's going to be a great sense of support for me during labor! However, last week we decided to hire a doula to also assist and support us during birth. Why? Well, we're first time parents and have no clue what to expect. I'm more afraid of the unknown than I am of labor pains.  Back in the day, women often labored with the support of other experienced women or  attentive midwives who were able to help them through the pain and all the scary unknowns. This is where a doula comes in. With her help, I am more likely to be successful in my natural birth hopes! She will not take Mike's place in the delivery room. She will, however, be an additional support person for me as well as for Mike.

What is a doula?

The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.
Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.
A Birth Doula

• Recognizes birth as a key experience the mother will remember all her life
• Understands the physiology of birth and the emotional needs of a woman in labor
• Assists the woman in preparing for and carrying out her plans for birth
• Stays with the woman throughout the labor
• Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decision
• Facilitates communication between the laboring woman, her partner and her clinical care providers
• Perceives her role as nurturing and protecting the woman's memory of the birth experience
• Allows the woman's partner to participate at his/her comfort level

A birth doula certified by DONA International is designated by the initials CD(DONA).
Research evidence shows that the quality services of a postpartum doula can ease the transition that comes with the addition of a baby to a family, improve parental satisfaction and reduce the risk of mood disorders.

Why use a doula?

Women have complex needs during childbirth and the weeks that follow. In addition to medical care and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualized care based on their circumstances and preferences.
DONA International doulas are educated and experienced in childbirth and the postpartum period. We are prepared to provide physical (non-medical), emotional and informational support to women and their partners during labor and birth, as well as to families in the weeks following childbirth. We offer a loving touch, positioning and comfort measures that make childbearing women and families feel nurtured and cared for.

Numerous clinical studies have found that a doula’s presence at birth

• tends to result in shorter labors with fewer complications
• reduces negative feelings about one’s childbirth experience
• reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans
• reduces the mother’s request for pain medication and/or epidurals

Research shows parents who receive support can:

• Feel more secure and cared for
• Are more successful in adapting to new family dynamics
• Have greater success with breastfeeding
• Have greater self-confidence
• Have less postpartum depression
• Have lower incidence of abuse

                                                                                                                                                                                          

I met with my doula yesterday to go over my hopes for birth and what I expect from her.  I chose her based on a number of factors--she's a friend, she's experienced but not yet certified (so we can actually afford her!) and she has a history of infertility, which makes it much easier to talk to her about our journey so far. We went over my birth plan, discussed my fears and anxieties, she explained her role in the delivery room and shared some stories about the hospital were I'll be delivering. I am so pumped to birth this baby now! I can't wait to meet her, to nurse her and I know my family and friends are very excited to learn her name! I can't believe that I will be full term tomorrow. We are so close to meeting our little miracle! I hope that I get the birth experience I'm dreaming of. If I end up needing help with the pain I hope it will be only after I have tried everything else first.

In other news...Mike's orders came through yesterday so it's finally official--we were moving to Fort Rucker! By 10 October we will be officially be southerners. Okay, not really...I can't imagine ever considering myself a southerner (I'm actually very nervous to live down south!) but we can pretend. :)

Don't Drink The Kool-aid

I recently stumbled across this awesome blog Banned from Baby Showers and loved everything this article had to say.

Monday, July 23, 2012

Don't Drink the Kool-Aid!

American women have drank the Kool-aid and have been completely brainwashed!  You know the Kool-aid I'm talking about:  The purple Kool-aid says that if the baby doesn't come out in 24 hours, it won't fit and the mom should be sectioned.  The red one says that if a woman is 40 weeks, she is overdue and the baby will die if she isn't induced.  The green Kool-aid says that an epidural is just an epidural.  And the orange one says that a cesarean is safer for mom and baby.  We won't even get to the Kool-aid that tells you that your baby can manipulate you!  The list goes on and on.  I just picked a few from some common American birth myths that I've heard repeated lately.

DON'T DRINK THE KOOL-AI

I just heard this story last night and I have permission to relay it here.  I am appalled that with such great birth choices, women are being sectioned 60% of the time not 20 minutes up the road from me.  Here's the story from the lactation consultant:

Saw another "victim" of Dr. Seligman & MCA (Medical Center of Arlington) today. At 38.5 weeks, her baby hadn't dropped so Dr. S told her they needed to induce on Tuesday and she would probably need a c/s at 39 weeks. After 10 hours on pitocin, baby still hadn't moved down so Dr. S. told her that the baby probably wouldn't fit through her pelvis anyway, so they needed to do a c/s. Baby was born weighing 7lb 4oz, still covered in lanugo and has very little suck reflex. :-( Mom is starting the make the connection that baby was NOT ready to come yet. Said her mom delivered all of her babies at 42 weeks. Oh, and she said that Dr. Seligman's parting comment to her was "Next time we'll just schedule the c/s for 39 weeks and avoid all of this other nonsense." 

This story really touched a nerve with me.  Frankly, her doctor is a complete idiot.  I feel horrible for the mom.  This is some bad Kool-aid she drank, but she trusted her doctor.  Very few don't trust their doctor and end up in the same situation.  He should not be practicing medicine.

What about the woman that labors "too long"?  "It's barbaric to expect a woman to labor for 24 hours without drugs.  Put her out of her misery!  If she's labored that long, surely something is wrong.  She should just have a c-section."  There is another OB at the Medical Center of Arlington in Arlington, TX, Dr. Udell, that tells her "patients" that the only humane way to have a baby is via cesarean.  She laughs if a woman tells her she wants to have an unmedicated birth.  Yes, this OB is a woman, and no, she does not have children.  I only know one woman who has had a vaginal birth with her, and frankly, it's because the labor was so fast, the OB didn't have time to intervene.  Although she did find a way to get her flat on her back despite the mom wanting to be on hands and knees...

I know of another OB in Mansfield, TX that routinely tells her "patients" that "nothing good happens after 40 weeks" and insists on induction at that time.  The baby must have a sticky note with the date circled in red ink on the side of the uterus so it knows just when it is expected.  It will be evicted by 40 weeks if mom is with Dr. W.  It is dangerous to stay pregnant another day!  Induce, induce, induce! 

"An epidural is safe and you are crazy if you don't sign up for one." This Kool-aid tastes so good, mostly because we want it to.  It's just an epidural.  Nevermind the cascading interventions when a mom says she wants "her epidural".  IV fluids, catheterization, blood pressure cuff, continuous electronic fetal monitoring, possible internal fetal monitoring (which includes breaking water - I'll come back to this one in a minute), fever reducer, pitocin, is more likely to have an episiotomy and assisted delivery (forceps/vacuum), and ultimately, she is more likely to have a cesarean.

I just want to mention briefly that I am hearing less and less about internal monitoring.  I honestly believe that we have become too blase about c-sections that everyone is just comfortable with going straight for the cesarean rather than use a more accurate form of monitoring.  Just an observation.

And the cesarean Kool-aid... This is the biggest lie of them all.  "Cesareans are safe -- even safer -- for mom and baby than a vaginal birth."  Shame on anyone who believes this to be an acceptable -- and even preferred -- way to get the baby out.  Women are going in for surgery and have no idea how this will impact them or their baby for the rest of their lives.  Someone always has to jump in and tell me why they had to have a cesarean.  Yes, folks, I am very aware that a cesarean does sometimes save a life and sometimes the baby really can't get out on his/her own.  Very aware.  What is the rate where you live?  What is the cesarean rate at your closest hospital?  You should know these things.  What can you do about it?  We're getting to that.

So many women (and men) feel defeated when it comes to the Kool-aid.  Everyone has drank it.  I think two things have to happen.  We can scream the truth from the rooftops, but that may or may not work.

1)  We have to start with the younger generation.  Don't be afraid to talk about birth with them.  Talk to your sons and daughters.  Just casual conversations.  Tell them about the day they were born, how their birth was amazing and special.  Just hearing different words associated with birth makes the Kool-aid not taste so good when they do hear it in our culture. 

2)  Get involved in making change happen.  You have to open your mouth, or at least get involved and help the people who are opening their mouths!  There is a rally being formed all across the country right now to take place on Labor Day, September 3, 2012.  Go to Improving Birth for details.  There may already be organizers putting a rally together in your community.  If not, YOU DO IT!  Change has to start with someone.  Why not YOU? 

What to Reject When You're Expecting

Thanks to Consumer Reports for publishing this excellent article on the top 10 Pregnancy Procedures to avoid unless medically necessary. 


1. A C-section with a low-risk first birth.
2. An automatic second c-section.
3. An elective early delivery.
4. Inducing labor without a medical reason.
5. Ultrasounds after 24 weeks.
6. Continuous electronic fetal monitoring.
7. Early epidurals.
8. Routinely rupturing the amniotic membranes.
9. Routine episiotomies.
10. Sending your newborn to the nursery.

Fighting the Fear

I won't lie--I'm scared of the pain that will inevitably come with natural labor and delivery. I have always combated extreme menstrual cramps and some of the procedures I had during my infertility journey were down right painful and I hope I never have to repeat.  Yes, labor will hurt. A lot. But I have been assured by many different woman that the pain experienced during child birth is so unlike anything else that I will be in a completely different mindset. Through my reading I've learned that fear can only increase the pain I experience so I have been trying to read positive natural birth stories and watch videos such as this. I'm also registered for a natural child birth class with a doula who is kind of famous amongst natural birthers in the area. I'm just waiting to receive confirmation for the dates that I selected.

Absolutely beautiful. I was cringing at first, listening to the immense amount of pain she was obviously in, but her pure joy and excitement had me in tears. THIS is the type of thing that I need to focus on. Whatever pain I may experience during birth will be overridden by sheer joy. I need to just keep reminding myself of this. The Intensity of the Pain Matches the Intensity of the Joy.

For those of you who are planning a natural birth, what are you doing to prepare?

My Natural Birth Plan

My birth plan has been submitted to and discussed with my midwife. She's totally on board with everything and most things are already standard procedure in her practice, which means the on call midwife who delivers me will be too.  I'd be lying if I said I wasn't scared about labor and delivery but Mike and I plan to attend a natural child birth preparation class next month, which will hopefully help put my fears and anxiety to rest. I'm currently reading Natural Hospital Birth and Ina May Gaskin's Guide to Natural Childbirth, which have been incredibly informative and eye opening.

Birth Plan for Megan H                                                              Estimated Due Date: 17 August 2012

Michael H, Husband                                                                   Christina M, ARNP, CNM

• We are attempting to have a natural, un-medicated birth without medical or chemical interventions.
• I plan on not being induced until after 42 weeks, in accordance with ACOG’s recommendations.

During labor, we would like:

• To have minimal monitoring and limited vaginal exams.
• To eat and drink as desired.
• To have a saline lock instead of an IV.
• To move around as much as possible.

During labor, we would like to avoid:

• Artificial rupture of membranes.
• Suggestions of chemical interventions, to include anesthetics or analgesics.
• Any references to “things moving along”, “pain”, “hurt”, etc.

During delivery, we would like:

• To push at my own pace (Mother-directed pushing).
• To birth in any position, especially standing or squatting.
• To use warm compresses, food-grade oils, and perineal support to help prevent tearing.
• To lower the bright lights at the moment of birth.

During delivery, we would like to avoid:

• Loud coaching or counting during pushing.
• Pushing while lying on my back.
• The use of vacuum or forceps.
• An episiotomy; I prefer to tear naturally.

Following birth, we would like:

• To delay the cord clamping as long as possible, until it stops pulsating at the least.
• My husband to cut the cord.
• To have baby placed on Mother’s abdomen immediately.
• The APGAR to be tested while the baby is on my chest.
• To delay any non-emergent newborn procedures, including the vitamin K shot, the PKU heel stick, eye prophylaxis, bathing, measuring, weighing, and foot printing until after our bonding period.
• To bathe her ourselves.
• To breastfeed exclusively. (No bottles, pacifiers, syringes, formula, etc.)To meet with an IBCLC or a local La Leche League Leader as soon as possible.
• To retain my placenta for encapsulation.

Following birth, we would like to avoid:

• Clamping or cutting the cord before the cord stops pulsating.
• The Hepatitis B shot and eye ointment.
• Pitocin during the birth of the placenta.
• Wiping or rubbing off of the vernix.

Back-up Birth Plan (for a Cesarean Delivery)
Instead of a cesarean, I would like to return home or remain in the hospital for monitoring if my labor fails to progress. I do not consent to a cesarean delivery based on fears of what might happen to my baby if we don't. I only consent to a cesarean delivery if my baby is showing distress on the monitors and if there is a time-sensitive emergency. If there is time for me to wait for an operating suite, watch a consent video, or wait for my personal doctor to arrive to do the surgery, then it is not a time-sensitive emergency.  I would like to obtain a second opinion if my physician recommends a c-section.

During the prep, I would like:

• To have my husband present.
• To be introduced to everyone in the OR and have their roles explained.
• To be kept informed of what is taking place.
• I do not consent to tying down my arms unless I am unable to control them.
• I do not consent to tranquilizers, sedatives, or amnesiac drugs.

During the procedure, I would like:

• To have only necessary staff present
• For the atmosphere to be as gentle and unhurried as possible.
• To delay the cord clamping as long as possible, until it stops pulsating at the least, so that my baby gets all of its cord blood and so that my baby will not need oxygen from a different source.
• To have the baby be immediately placed skin-to-skin with an uncut umbilical cord on my bare chest and covered with blankets for warmth, unless there is an unusual situation.

During the repair, I would like:

• To keep the baby skin-to-skin on my chest or in my arms instead of using a warmer, even throughout suturing, recovery, etc.

• The APGAR to be tested while the baby is on my chest.
• To keep the vernix on my baby’s skin so that I can rub it in myself.
• My husband to cut the cord.
• To delay any non-emergent newborn procedures, including the vitamin K shot, the PKU heel stick, eye prophylaxis, bathing, measuring, weighing, and foot printing.
  The opportunity to breastfeed the baby immediately, even while the surgeons are finishing their work.
• To retain my placenta for encapsulation.

In recovery, I would like:

• To be visited by an IBCLC or a local La Leche League Leader as soon as possible.
• To keep the baby with me at all times.
• To delay the baby’s bath, weight, and other measurements until after our bonding period.
  
  
  
  
  
  And a big congratulations to Jessica, whose twins made their very early appearance last Saturday!

Fort Rucker Bound

So it's semi-official. We are heading to Fort Rucker! Mike's reenlistment paperwork was turned in yesterday and we should get the "official" word from Uncle Sam in the next several days. His estimated report date is 10 July, so about 5 weeks before my due date. Eek! We are so excited about this new adventure in Army life. I am looking forward to warm weather and being back within driving distance of more family members.  I'm even more excited that Mike won't be deploying for a long time! We've waited so long for this little girl and it will be so special to keep our family so Mike can witness all her big firsts.  What I am a little (a lot) apprehensive about is not only traveling 2,800 miles at 33 weeks pregnant but also giving birth in a very anti-natural birth climate.


Throughout this entire pregnancy I have had a pretty specific vision of how I hope my labor and delivery to go. This is very likely going to be our only child and I would really love to experience everything that labor brings. I know some people will call me naive or even ridiculous for having such a long list of goals and wishes but I am determined to do my best to make it happen. I am not totally opposed to the use of drugs or interventions, especially if my baby's in danger, but I would definitely like to try to labor naturally first. This wasn't going to be an issue with my current midwife--she will allow me to walk around during labor, eat, use the tub for pain management and push in whatever position feels comfortable to me rather than what is convenient for her.  I have had some incredibly painful tests during my infertility journey and it was so hard to be still while I was in such pain. I can't imagine being in that much pain for hours and being required to lay flat on my back.  In Alabama, midwives are illegal. Yes, you read that right. Midwives are not allowed to attend hospital births and can be prosecuted for attending out-of-hospital births. While I'm not interested in a home birth, I think it should be a choice left up to the parents and not a choice forced on them by state legislation. There is not a single free standing birth center in the entire state of Alabama.

Anyway, I've started my research and found out that there are two hospitals that serve the Fort Rucker area. Flowers Hospital and Southeast Alabama Medical Center. Based off the websites alone, I am leaning toward SE Alabama Medical Center because of the way the birthing suites (complete with jacuzzi tubs!) are set up. Flowers doesn't even mention having tubs and that's important to me. When it comes to choosing an OB, I haven't got a clue. I currently know one woman who is living down there and her OB induced her on her due date because she (the OB) was going out of town and my friend was anxious to meet her baby.  Some people might think, "What's wrong with that?" but I personally feel that induction just for the hell of it can lead to potential problems for your baby and that you're almost guaranteed to have a snowball effect of interventions. For this reason, I do not want to be induced unless there is a valid medical reason or baby or I are at risk.
Mike and I had talked about hiring a doula when I first became pregnant. We felt like it would be unnecessary here because my midwife and hospital were so supportive of the type of labor I am hoping for. We thought we'd be able to handle labor and delivery with just the two of us and I liked the idea of Mike being my sole support system during all of it. Now they're we're moving cross country at such a late stage in my pregnancy, with little time to develop a relationship with an OB, we have readdressed the doula issue and have decided to hire one. We feel like she will be a tremendous help in the delivery room when it comes to advocating our wishes to the staff and helping us be successful with our goals. Mike and I won't be able to attend any child birth classes with the timing of our move and upcoming training he has so a doula will be a great resource for relaxation and pain management techniques. She won't take the place of Mike but will be there to guide him to fill the supportive role I will need during labor and delivery. I've already contacted a doula and received a response! She doesn't really care for any of the OBs down there but suggested one that I was actually considering because someone else suggested that he was natural birth friendly. She said he's allowed her clients to eat/drink, walk around, refuse IV meds, use only intermittent fetal monitoring, etc.  Since I won't have a lot of time to "interview" OBs once we get down there I guess I will have to make an informed decision based on the opinions of others. I've made a list of my labor and delivery goals to help me figure out exactly what I'm hoping to find in an OB. Wish me luck!


Home Labor Goals
I would like to labor at home as long as possible, with our doula present, before going to the hospital.

Hospital Labor Goals

• We plan to have myself, my husband and doula present. Please turn away all visitors and unnecessary staff until we have had time alone with our baby.
• We are attempting to have a natural, un-medicated birth without unnecessary medical or chemical intervention.
• We understand that there are procedures which may become necessary.
• Please do not offer me pain medications or ask me to rate my pain.
• Except in the case of an emergency, we ask that we be given the opportunity to accept or refuse any procedure or medication.
• We request that the least invasive or restricting versions of procedures be used.
• I prefer to have minimal monitoring and limited vaginal exams.
• I prefer not to have any unnecessary medications or interventions.
• I would like to the opportunity to be up and moving around as much as possible during labor.

Delivery Goals

• I would like to push at my own pace (Mother-directed pushing.) 
• I do not want an episiotomy unless medically necessary. I prefer to try perineal massage and a warm compress first.
• I would prefer to push in whatever position is comfortable for me, rather than the traditional back and stirrups position. 
• If labor seems to be stalling I would like the option to try different positions to get the baby to come down (hands and knees, squatting, birthing ball, etc.)
• Upon delivery I would like the baby to placed on my chest right away. I would like to have at least 1 hour of skin-to-skin contact before the baby is taken away for measurements.
• I prefer to breastfeed our baby as soon as possible after delivery. I prefer not to be disturbed until after the first feeding.
• We prefer to wait to cut the cord for 1-2 minutes or until it has stopped pulsating. Please offer my husband the opportunity to cut the cord. 
• Please retain my placenta for encapsulation.
• I would like my doula to be allowed to take photos during the entire labor and delivery process.

If a Cesarean Becomes Necessary:

• I would like to be conscious with my husband and doula in the room. I would still like to nurse our baby as soon as possible and for my placenta to be retained.

Recovery Goals

• I would like the baby to room in with us rather than in a centralized nursery.
• I would like either my husband or myself to be present for baby's first bath.
• I would like to establish a strong breastfeeding relationship. Please do not introduce a bottle or pacifier without notifying us of a medical reason. 
• I would like to meet with a lactation consultant to have breastfeeding techniques checked.