At my 36/37 week appointment yesterday, I was 1-2 cm dilated and 70% effaced. This was only my second vaginal exam this pregnancy, and since I was getting the Group B strep test anyway, I said sure when the midwife asked if I’d like her to check how things were looking down there. I’ve been so happy with my care and preparation this time around, and having my provider ask if I want a check done is representative of the autonomy and confidence I feel in approaching the actual birth.
In some ways I’m still doing things conventionally — like having the Group B test at all, but a) I’d like to know if I am positive, and b) at least this time I did a couple homeopathic things to reduce my chance of getting a positive (I took Vitamin C and acidophilus supplements every four waking hours in the two weeks leading up to the test; you can be a lot more aggressive in preventing/treating Group B, but I had both of those on hand, and they’re good to take anyway, especially for, uh, digestive tract health, if you know what I mean). I don’t think I was ever positive before my three other births, but as an example of how much I relinquished responsibility, it’s possible that I was positive but wasn’t told or didn’t give it any thought because I had epidurals with each, and so always had IVs through which the antibiotics could be given without any disruption to my plans.
My appointment was with one of the midwives I hadn’t met yet, which isn’t ideal of course; ideally I’d fly to The Farm this week and give birth in Ina May’s shadow next week, but all things considered I’m happy with this group of midwives and I don’t begrudge them the life-convenience of sharing call, especially since it is their habit to stay with the mother for the entire labor. I reviewed my plans and hopes and fears with this new midwife, and after telling her how quick Lucy’s birth was (6 hours) even with an induction and epidural at 39 weeks, she supported me in staying home as long as possible but encouraged me to be prepared for things to go quickly and to maybe go from hanging out one minute to being ready to hop in the car the next (it’s a 30-minute-plus ride). Of course, anything could happen; I could be in labor for three days two weeks after my due date, but hopefully not.
Either way, it’s probably time to start getting ready. I have a lot on my To-Do List:
1. Write my birth plan (mostly a list of stuff I don’t want done, like an IV (I’ll sign a waiver to forgo the hep-lock the hospital requires in case of emergency; given my low-risk history my midwives are comfortable with this), taking the baby out of my arms (much less to the nursery) before I’ve had an hour to bond and breastfeed, cord clamping before it’s stopped pulsing, continuous electronic fetal monitoring (I’ve agreed to the initial twenty-minute baseline by telemetry which allows movement, then 90-second checks at 30-minute intervals).
I’m still researching the eye ointment and Vitamin K shot business; since Tom and I are life-long monogamists there should be no need for the eye ointment and since I’ll be producing tons of colostrum for a full-term baby the Vitamin K should be unnecessary too. On the other hand, these are relatively minor things (I think) and I don’t know how strongly I feel about them. Things like enemas, shaves, and episiotomies aren’t routine, but maybe I’ll include them just in case. 50% of the women who see my midwives have an epidural, and I plan not to — what I need instead is praise and encouragement, offerings of physical and emotional support, NOT of drugs (I know what’s available and can ask for it if I need to; Tom knows it’s his job, if that happens, to remind me that I want to wait 15 more minutes and see how I feel then, repeatedly, if necessary). Things I do want to have happen are harder to write down. I want things to go how they go; I want to feel comfortable in vocalizing (loudly if I feel like it), moving, bathing, drinking (I probably won’t want to eat if I arrive in active labor/close to transition), squatting, etc).
2. Pack a bag (with my own nightgowns, music on the iPod, a birth ball, juices and light snacks, a note for the door and maybe some cue cards for Tom and Chrysanthemum from Birthing From Within, stuff for the kid, 3 or 4 versions of Pride and Prejudice to watch (you know, the usual); Mockingjay if it’s after August 24th).
3. Wash some onesies and blankets, buy some diapers and a nursing bra or three (any recommendations? I was never very happy with my previous ones, and I’m bigger this time around — 38DD and not looking forward to engorgement).
4. Arrange babysitting, though Avery (9 /12) has expressed a lot of interest in being present. I’d like to have her there, but a lot will depend on the timing (and how I’m coping; I’d love her to see a natural birth, but not if I would scare her).
5. Finish reading the books and watching the dvds Rixa sent me (The Business of Being Born is available for instant play on Netflix,and I think Tom was surprised how interesting it was). Right now I’m practicing the stuff in Birthing From Within; it seems more helpful and realistic than Hypnobirthing, though I’m sure they could be complementary.
6. Finish cleaning and organizing the house. I’m not overdoing things; I nap most days and my blood pressure was a nice 107/67 yesterday. I mostly want things clean and organized because I feel so much calmer when they are. If I’m lost in reading or writing, I can ignore clutter or dirt for weeks. But if I want a soothing, comfortable environment for early labor, I know I’ll want things pretty clean and minimally distracting. This will be just as important in the sleep-deprived newborn months, especially with school starting for Avery and Callie just five days after my due date. Part of my organizing is a chore-training campaign with the girls. They’ve always helped in the kitchen and in caring for their personal space and belongings (though not terribly consistently), but now they’re old enough to do more, and more independently. Mom, if I whined as much as these hooligans do sometimes, all I can say is, I’m being sufficiently punished for that.
7. Get a priesthood blessing from my husband and maybe my father too. I read this call for stories about spirituality in birth, and realized, again and anew, how inadequately I prepared for birth previously. One of the tenderest moments of my life was when I asked for a blessing from Tom in Cairo before my first miscarriage, but I did not even think about asking for a blessing before my three deliveries. I hope this doesn’t mean that I’m not a very spiritual or faithful person, but the alternative, that I viewed childbirth as something that would just happen to me, something that would be “done” by my doctor and therefore not anything I needed help in “doing” is just as incompatible with my vision of who I am.
There are two things I’m worried about as the birth gets closer. I’m worried about the pain, and I’m worried about feeling inhibited in acting instinctively/naturally and asking for/receiving comfort measures for the pain other than a socially-acceptable epidural. Despite the numerous reassurances I’ve received from almost every single woman I’ve spoken to who has some experience (as a laboring women, nurse, or midwife) with the hospital I’ll be at — that it is a natural-birth-friendly institution, I can’t forget the things I’ve heard and read about the significance of the fundamental decision I’ve made to give birth in a hospital, despite being pretty convinced after extensive reading and research that both the baby and I would be more comfortable and just as safe at home.
Still, that’s the decision I’ve made based on Tom’s and my feelings/perspective/experience, and other circumstances such as what our health insurance covers and our distance from a hospital in case of true emergency, etc. It’s a bit disconcerting (in a cognitive dissonance sort of way) to read (and believe) a book like Birth as An American Rite of Passage and still plan to give birth in a hospital, but no other compromise presents itself to me as more reasonable given all the specific factors of my present life and understanding.
I feel lucky to not be worried about my body’s ability to give birth vaginally. Especially after reading Birthing the Easy Way and talking to my cousin who’s had two c-sections and three homebirths, it’s clear that many natural-childbirthers have more logical reason for concern; I admire their courage. I got lucky three times: despite welcoming any and all interventions, things went as well as possible. So it’s not my body I’m worried about, but my brain’s ability to turn off, surrender, relinquish control not to an institution or authority figure but to my own body’s natural wisdom and design.