You are 17 weeks old today in my belly. You're Daddy and I love you very much. We know you will give us all the love in your heart too when you are born, but right now I wanted to thank you for the things you have given me already:
Thank you for the little tickles inside my belly and the few kicks I have already felt that kinda feel like a nerve twitch (you know? Like the ones you get under your eyes).
Thank you for the round ligament pain I feel whenever I blow my nose and cough. I have now found that I like to have one knee up to my chest whenever I have to do those things.
Thank you for letting me get more sleep on the couch than in bed. I'm sure your Daddy thanks you too when he tries to sleep on the ottoman over the weekends just to spend the night with me.
Thank you for giving me cleavage! And bouncy boobs. I have never been so pleasantly surprised when looking down at my chest. Your Daddy definitely thanks you too!
Thank you for the back pain when I try to wash the dishes so that I cannot finish them.
Thank you for the waddle when I walk. I'm sure it will get more noticeable when you get bigger inside of me.
Thank you for the weight gain and tiny stretch marks. I now get to buy something called Tummy Honey!
Thank you for the headaches I get at night. Your Daddy appreciates it too because he gets to rub my feet when I get them, which helps a lot!
Thank you for the poor vision. I now where my glasses most of the time.
Thank you for giving me gas. I can now burp like an old man after meals.
Thank you for the hot flashes. I can now leave the apartment without wearing all those layers of clothes that your Daddy hated because I was always chilly.
Thank you for giving me the strength I need to stand up for what's best for both of us.
Thank you for allowing me to drink a lot of water when I hardly ever drank anything at all.
Thank you for my middle-of-the-night feedings so I'm prepared when you arrive and need them too.
Thank you for posing so well for all of your ultrasounds. Especially the 3D one at 8 weeks 5 days.
Thank you for waiving at me and your Daddy at the 12 week ultrasound.
Thank you for all the cute giraffe stuff I get to buy you, even if you end up not liking giraffes.
Thank you for the ability to use all the baby product knowledge I learned when working at Buy Buy Baby to assure that I will get you the safest and best stuff out there.
Thank you for that strong heartbeat we heard on Tuesday. You sounded amazing!
Thank you for allowing me to find a semi-comfortable position to cut my toe nails yesterday.
Thank you for allowing me to keep my sense of humor so far throughout this pregnancy.
I'm sure there is more, but you have also given me Pregnancy Brain. Your Daddy says I have a hard enough time remembering things and now, with Pregnancy Brain, it's a lot worse. That's OK though, I come from a long line of people who suffer from CRAFT so I'm used to it!
Your Daddy and I cannot wait to see you again. We will be able to do that on September 13th when we find out if you are a boy or a girl. Once we find out, we will be able to call you by your name, which is very exciting! Hope you waive to us again. In the meantime, I will still have those tiny conversations with you throughout the day so you know that I am thinking about you.
Now that I'm in my second trimester at 16 weeks along, I am feeling a lot better. I don't feel sick 24 hours a day anymore and only on a rare occasion now will I throw up. I have a lot more energy and feel up to doing more activities. The only thing I have a problem with is standing for too long. It kills my back. I feel it the most when I'm doing the dishes and cooking so I have to take a lot of breaks. My belly is some-what big, I mean, I look pregnant, and it makes me wonder if I weren't pregnant, but put on some extra weight, would I still have back pain? Do big bellied people suffer from the same pain pregnant women do? Maybe I'll take a survey…or not.
I weigh the most I have ever weighed, in my life! Every time I step on the scale it amazes me. And week by week I see a pound more. I know that I need to gain weight for my baby. I was eating more in the first trimester, but that has gone back to normal now that I'm feeling better. Also, I'm not sure how much of the weight is from pregnancy and how much is from lymphedema. I have been really bad about wearing my compression garments because I was feeling so sick. Because of that my legs have gotten more swollen than usual. I'll start wearing my garments on a regular basis now that I'm feeling better so I'll be keeping an eye on my weight to see if that goes down any once the swelling goes down in my legs.
A weird side effect of my belly growing is the change in my belly button. I guess you could say that I have an innie, although my belly button was so tightly tied when I was a baby, I really only had a slit. It looked as though someone drew a J on my stomach and called it my belly button. Now that my belly is bigger, my belly button has opened up. It's weird to look at. I can actually see in it, like an innie is supposed to be. I wonder if my belly button will pop out? While pregnant with her 5th child (I think, she had 8 all together), my Mommom's (grandma) belly button disappeared and never returned. She would tell us she was from Mars because she had no belly button. Strange enough, any kid would've believed her with her lack of a belly button and being able to take out her entire row of teeth! Not to mention that at 4 feet 11 inches, she gave birth to 8 children - none of which are shorter than 5 foot 4, and raised them on her own. She definitely was a super-human alien from Mars!
So I need to start exercising, not only for my health, but the health of our baby. I don't like to exercise, not even a little. I did yoga in the past and never thought of it as exercise so I tried to find a prenatal yoga routine that I would enjoy doing. Instead of paying hundreds of dollars a month going to a class, I decided to look up some videos on You Tube. I found a couple of prenatal yoga clips but none that would really work for me. Having lymphedema in both legs doesn't make it easy for me to squat or lunge so I needed to find something that would assist me. After a semi-long search, not only did I find a prenatal yoga video, I found one that is a full class and works with an assist from a chair. Score!!
Now that people know Dan and I have a midwife to get me through my pregnancy and labor, it has come to my attention that many people have a lot of misconceptions about what a midwife is. So many people have said:
"Be careful."
"Make sure you also have an obstetrician because a lot of things can go wrong with a midwife."
"You should ask for references."
"You're doing a home-birth?"
"You should have an OB because you're high risk due to your history."
"It's dangerous to have a midwife."
I've realized that many people are misinformed about what a midwife does compared to an obstetrician. I want to shed some light on those differences. First, though, let me answer the questions from above.
I am being careful. I've done a lot of research in the area of what is best for me and my baby. A midwife can perform all gynecological and obstetrical needs as an OB/GYN. The only thing they cannot do is perform a cesarean section.
Our midwife, as all midwives, work with obstetricians in the event that intervention is needed.
I'm not going to ask for references and am sure I would not get any as patient/Dr. privacy would not allow. You would not ask your regular obstetrician or any Dr. for that matter for references. I met with the midwife, I liked what she had to offer, and I will be using her. A friend of ours has also known women who have used her in the past and are using her now as their midwife, so word of mouth is considered here. Our midwife has done over 750+ births so experience is not an issue.
We are not having a home-birth. Our midwife will do both home-births and hospital births. We are opting for a hospital birth with the midwife and are going to a hospital that supports the midwifery model of care.
I want to clarify that even though I have had two miscarriages, I am not high risk with this pregnancy. The problems that I faced which caused my miscarriages have been taken care of with medication and surgery.
It is more dangerous to have an obstetrician help deliver your baby because they are surgeons. Obstetricians are not trained to do normal births. Normal, meaning natural, little to no intervention. Unless you are a high risk pregnancy, a midwife is better and safer.
Now let's take a look at the Midwifery Model of Care: Midwifery Model of Care by Judy Edmunds, Certified Professional Midwife
OBSTETRICALMIDWIFERY
Focus on pathology, illness -------------------- Normal, developmental, social
Elevates "authorities" as experts ------------- Women's knowledge is valued
Woman is low in hierarchy -------------------- Egalitarian, peer relationship
Must enter doctor's territory ------------------- Midwife is a guest in her home (if home-birth)
Lack of familiar surroundings ---------------- Remains in familiar environment (if home-birth)
Strangers perform procedures ---------------- Midwife has become her friend
Women's positions restricted ----------------- Freedom to move as desired
Brisk, depersonalized schedule -------------- Ample time for relaxed visits
Awkward, brief communication ------------- Open, intimate two-way sharing
Unfamiliar language used often -------------- Simple, common vocabulary
Professional distance maintained ------------ Close relationship is forged
Spiritual, emotional neutrality ----------------- Honors her personal feelings
Training emphasis: intervention -------------- Trained to preserve normality
Drugs offered for pain relief ------------------- Pain accepted, comfort offered
Some facts every soon-to-be parent should know:
The United States has the second worst newborn death rate in the developed world
Midwives attend over 70% of all births in Europe and Japan
Midwives attend less than 8% of all births in the United States
The United States has one of the highest maternal mortality rates among all industrialized countries
In the early 1900's in the U.S. inexperienced obstetricians began doing smear campaigns against midwives
In 1900, 95% of births in the United States took place at home
In 1938, half of all births in the U.S took place at home
By 1955, less than 1% of births took place at home and remains that number today
Induction in labor (pitocin and other drugs) increases the rate of cesarean section births
Lying on your back to give birth makes it harder for the mother to use her stomach muscles to push which will increase the chances of an episiotomy, forceps, or vacuum to get the baby out
Obstetricians are not trained in normal childbirth, they are trained as surgeons
New York hospitals have some of the highest cesarean section rates in the country
The cesarean section rate in the U.S. went from 4% to 23% in the 1970's
Since 1996 the cesarean section rate in the U.S. has risen 46%
In 2005 the cesarean section rate was one out of every three births
Ok, so here's an interesting clip from The Business of Being Born:
Why are doctors giving Pitocin to speed up the delivery when it clearly states on the warning label not to do so unless there is a medical necessity?
The warning on the Pitocin bag states: WARNING: This medication is recommended to be used only in pregnancies that have a medical reason for inducing labor (e.g., eclampsia). It is not recommended for elective (voluntary) procedures or to make the birthing process more convenient. For additional information, consult your doctor.
I'm going on a rant here so I do apologize in advance. After so much research on this matter I have very strong feelings about the whole birthing process in the U.S. and I need to share my thoughts, especially when a lot of people have been making me feel like I'm doing something wrong for having a midwife instead of an obstetrician. Thank you to all of you who have not judged me and my decision, but have been supportive and want to learn about the differences. I appreciate it.
It's a very stressful place for women to be in, because we are taught to trust doctors. How many times do we ever get that second opinion? When it comes to childbirth, women are meant to feel almost helpless. Like we need the interventions of the obstetricians to have a healthy birth. But the fact is, women have been giving birth long before there were obstetricians. So what's changed? Women's bodies are still the same, so why have I heard of doctors saying things like the baby's head is too big to have a vaginal birth? That makes absolutely no sense. These doctors are saying things like this to scare us. To make us get these cesarean sections to save time and speed up the delivery. I watch these baby shows, such as A Birth Story and Bringing Home Baby, and I want to cry. Birthing is portrayed as something scary. Something that we need drugs to get us through. It disgusts me. I get so upset, especially when I see healthy moms-to-be scheduling their cesarean sections for no good health reason. A cesarean section is major surgery and these women are opting for it because their doctors won't let them get past their due date. Or they are having cesarean sections because their doctor is scaring them into thinking that a 12 hour labor is harmful to the baby, when in fact, they just don't want to be there for another 12 hours until you deliver vaginally. The baby will come on it's own. You don't need to schedule it unless there is a medical necessity to do so.
Which brings me to my point, people are just not informed of these facts and what a normal birth is. We are brought up to believe that when you have a baby, you go to an obstetrician and give birth in a hospital on a bed. All the while hooked up to all sorts of machines with an IV in your arm so the doctors can inject you with drugs. Let me say that again: DRUGS!!! Drugs that we do not need and drugs that we may not know the effects of to our unborn babies until it's too late. We are told time and time again, "Do not take any medication while pregnant because it may harm your baby. If you need pain medicine, take nothing stronger than Regular Strength Tylenol." So why is it OK to take a much stronger medication during labor? There is not enough research for me to say, "Yes, give me all the drugs you have for labor because I know for a fact that it will not harm me or my baby." Fact is, if there's the slightest chance of harm, I will not do it. I don't even take headache medicine because I just don't like to take any kind of drug, pregnant or not. I'm not against pain medicine if it is something you absolutely need, especially in labor. But I do want women to know that opting for it right away because of fear that has been drilled into us almost immediately, is wrong. We are told over and over again that labor is the most painful experience we will ever have. I believe that women are going into labor expecting this and not wanting to deal with it so they ask for the epidural as soon as they get to the hospital. They don't wait to experience anything. Once you get that epidural, you will get any drug the doctor tells you that you "need." Why not? If it will make the labor quicker, you should do it, right? Why not wait it out and let your baby be born naturally, on his or her own time line instead of the doctor's? It's something that I will never understand because unless there is a medical need for you to labor quicker (baby in distress, mother in distress) then there is no need to speed it up.
So obstetricians are all about the interventions. Ask any woman who has given birth and I will guarantee that almost all of them, will say that they have had drugs during pregnancy. Then, out of those women, how many have had a cesarean section? The number may astound you. It's getting ridiculous and the only saving grace is having a midwife. For a low risk pregnancy, a midwife will be there to support the mother and get her through the most empowering day of her life: giving birth to her baby. This is not a feminist thing, like many will say. This is a woman's rite of passage, if you want to label it. Birth is an experience that I want to remember, something that I want to feel. I don't want to be dazed from drugs, I want to be aware of my body and what is going on. Most people will call that feminist or call a woman a hippy or out of her mind for wanting to feel the pain. Truth is, life is painful. There is no way around that. But if I can survive this pain and in the end have a beautiful, healthy baby to hold in my arms, the pain of that experience is welcomed and in the end I will be rewarded with a wave of natural oxytocin that will put me in bliss. Unfortunately, many woman don't feel that because of the drugs. The baby feels that bliss as well, but if the baby can't be near the mother's breast right after birth, that experience is lost. Obstetricians will have your baby taken from you almost instantly to be cleaned up and weighed. Midwives will encourage you to hold your baby for a while so you can bond instantly. Why is there a rush to clean and weigh? Oh, that's right, so the room you're in can be cleared faster for that next laboring mother.
Dan and I met with our Nurse-midwife, Dale, yesterday and we were very pleased. When we got to the office we were the only ones in the waiting area. Dale was in a room with another patient so we waited about 15 minutes before we were called in. While in the waiting area, we were greeted with relaxing music and a choice of herbal teas and mineral water. Once called in, Dale was extremely nice and stated that she would answer all of our questions but may be called away due to one of her patients who was in the beginning stages of labor. Even though she was busy, she didn't make us feel rushed. She answered all of our questions thoroughly and seemed really in tune to what we wanted out of our birth experience. Unlike my obstetrician, Dale thought it was a great idea to have a water birth due to my lymphedema. Dan and I were hooked. She's the one!
Dale gave us some reading material and some free samples of baby stuff (like Johnson's baby lotion). She advised us that during our appointments, we would have a full half hour with her to be examined and ask any questions. I love that…a full half hour! Wow, you would never get that with an obstetrician. You would be lucky to get 10 minutes after waiting in the waiting room for an hour! We made an appointment for my 16 week checkup and she gave us a form to send to the obstetrician so they can release my medical records for this pregnancy. I'll also be touring the hospital with her at some point in the near future. She said the hospital was making a birthing center for her midwifery group so they can have their own private wing in the hospital. Although this most likely will not be ready by the time our baby comes in February. That's OK though, at least the hospital will still have that water birth room for us!
So that's it. Now we can move forward and concentrate on the pregnancy without having the stress of not getting the experience we desire. I know that while in labor, things can go differently than planned, but at least I have the initial plan that I hoped for and if things do change, I know it's because it HAD to, not because the obstetrician wanted it to.
Nurse-midwives are registered nurses who have completed accredited midwifery programs. Once certified, they are certified nurse-midwives (CNMs). Nurse-midwives can write prescriptions and provide a variety of care, including:
Care after birth
Disease prevention
Family planning assistance
Gynecological exams
Health maintenance counseling
Labor and delivery care
Menopausal management/li>
Newborn care
Preconception care
Prenatal care
Nurse-midwives collaborate with physicians, especially in problem pregnancies. In general health care, nurse-midwives work with other medical professionals to provide comprehensive health care resources. When additional medical advice or surgical care is needed, they refer women to the appropriate physician.
The philosophy of nurse-midwifery is based on providing health care to women, while acknowledging and respecting their needs. They encourage patient education, active participation, clear communication between the provider and the woman, and an individualized health care experience.
Perhaps the best-known facet of nurse-midwifery is the commitment to facilitating uncomplicated pregnancy. Nurse-midwives provide information about different types of care available and encourage women to enhance their pregnancy by being involved. Nurse-midwives advocate birth education, natural childbirth, and the participation of the entire family. They rely on technology only when it is medically necessary. Thus, cesarean sections and episiotomies are less common when care is provided by a CNM.
Requirements for Certified Nurse-Midwives
The tradition of nurse-midwives has existed since the 1920s and the American College Nurse-Midwives (ACNM) formed in 1955 to oversee the development of the field. The ACNM has defined the criteria for nurse-midwifery. Nurse-midwives receive education and training in nursing and midwifery and must be licensed. The requirements for certification are similar to those for certified midwives.
To become a Certified Nurse-Midwife (CNM), candidates must successfully complete these requirements:
Completion of an accredited nursing program
Licensure as a Registered nurse
Satisfactory completion of a program in nurse-midwifery from an accredited institute
Once a candidate meets these requirements, he or she can take the national certification examination administered by the ACNM Certification Council (ACC). After passing the exam, the candidate receives nurse-midwife certification. Because state licensing laws vary, there may be additional requirements.
The National Center for Health Statistics reports that in 1998, 277,811 births were CNM-attended in the United States. CNMs usually work in private physician practices, hospitals, clinics, free-standing birth centers, and health departments. They may have their own private practices and occasionally attend home births. All states mandate Medicaid reimbursement and most require private insurance reimbursement for nurse-midwifery services.
