33 week home visit

In the wee hours of the morning last Friday I got a call from my doula inviting me to the birth of one of her clients who at the time was in the pushing stage of labor and headed for the hospital. The baby was born 4 hours later and my original plan to drive to Maryland for my 32 week prenatal visit was abandoned in favor of a reschedule.

Susan arrived yesterday afternoon with perfect timing--my work day was practically over, and I had just put Roscoe down for his afternoon snooze.

Little Sears is still positioned head down, with his body along my right side. His heart rate was in the 130's. My fundal height is back on track at 33 weeks. I've now gained close to 30 pounds.

We spent most of the visit discussing the birth I attended last week. While in many ways it affirmed my belief that I am best birthing at home, the abrupt nature of the experience had left me feeling apprehensive about unexpected emergencies. In short, the laboring mother received an epidural, the baby's heart rate dipped (as is a common side effect), and eventually plummeted to 70 beats per minute. Within 90 seconds the room was emptied--mother, father, and nursing staff evacuated to the operating room for a c-section.

Intermittent fetal monitoring (as practiced by my midwife) has been shown to be as effective as continuous fetal monitoring--with far fewer reactive interventions. There's also the consideration that an epidural inherently alters the course of natural labor because it restricts the mother's mobility (and her ability to facilitate the baby's descent, or react to situations like a drop in heart rate, with a change in position). Interestingly, my midwife said that in her experience the vast majority of hospital transfers are for first time mothers who get tired and want/need an epidural. A hospital transfer for a safety related emergency is very rare.

At each visit we reiterate the plan that I will alert Susan at my first inclination of labor. Of course there's no way to know how quickly my labor will progress, but it seems that 2-3 hours is the current estimate. I have no interest in free-birthing, however, our conversation today made me feel more confident in the event that the baby is born before she arrives--even though I still don't want to think of the possibility. The good news is that naturally fast labors tend to be efficient and inherently complication-free.

So what's next? I'll be making one last trip to Maryland in 2 weeks (at 35 weeks), our doula/birth assistant will visit us at 37 weeks, and Susan will make another home visit at 38.5 weeks. Whee! Despite the downtrodden mood of Monday's post regarding the amount of time left in this pregnancy, if Little Sears is born around the time that Roscoe was born, I have only 5 weeks to go! While I don't want to give myself false hope, it may be just the thing I need to get through the next few weeks.