Monday, March 8, 2010

A day in the life...

We had our 20 week prenatal appointment today. I actually thought this might be a good opportunity to show what a typical Midwifery appointment is like. This is something that I get a lot of questions about. I used to think it was an odd question but I guess I have come to realize that the whole concept of homebirth is so foreign to most people that it naturally elicits a certain curiosity.

I have become aware in conversations that there are many people who imagine that Midwifery care means that I meet with a Wiccan who is dressed in a broomstick skirt and Birkenstocks so that she can burn sage around me and rub herbs on my belly to bless my baby. This kind of notion always just makes me laugh but in an effort to dispel this and other crazy ideas about prenatal care from a Midwife I am posting these pictures and a real description of a typical appointment.

For those who find this odd...keep in mind that I have a lot of clients and friends whose curiosity about---all things birth related---is borderline obsessive. We call ourselves 'birth junkies' and this kind of thing fascinates us so if you aren't a birth junkie feel free to pass on this post. :)


This is a shot of the exterior of Nurturing Hearts Birth Services or NHBS. In my previous pregnancies I was fortunate to have the luxury of 'home visits' wherein my Midwife came to my home for prenatals. The home visit is becoming increasingly less common as the "valley" has spread making the travel time for Midwives ridiculous. It does make sense for us to come to them whenever possible and if I have to have an appointment that isn't in my home then at least it gets to be in the lovely home-like atmosphere of Nurturing Hearts.


This is the waiting room outside the offices of NHBS. My kids love it here and they are always welcomed graciously by Stephanie and Kate since the Midwifery Model of care sees pregnancy and birth as a family affair.

When Stephanie steps out to get us from the waiting room we move into her office where there is a little couch for me and a toy area for the kids. The beginning of the appointment starts with a casual chat on the couch about how I have been feeling in the last few weeks; do I have any concerns or ailments bothering me; questions I might have for my Midwives or questions they have for me about my nutrition and general health.

Today we went over my ultrasound results which was nice because I found out from Kate that the report showed that my placenta is anterior (this means at the front of my uterus) which likely explains why I have yet to feel the baby's movement. It puts a little 'pillow' between me and the moving baby so it finally makes a little sense and puts me at ease about the fact that this is the longest I have ever gone before feeling the baby move.


After we chat for a bit I move over to this little cot where Kate checks my blood pressure (as seen here---Notice Hayden's fascination with the process) and measures my fundal height (how far up the uterus has grown in the last month) and in this particular appointment also drew some more blood for another panel to check out my anemia---which; unfortunately; I am still battling.

Notice anything missing from this "exam table"? That's right...stirrups. That's because V.E.s are rarely performed prenatally by midwives. There is really no medical benefit to V. examinations at this point and most pregnant women find them---and the narrow, cold exam tables to which they are attached---very uncomfortable. Even when/if a V.E. is necessary such as when a GBS (Group B Strep) culture is performed there is really no benefit to the use of stirrups---that archaic contraption (torture device?) which was invented by a man and does not account for the comfort of a pregnant woman in any way shape or form.


After all that "boring" clinical stuff we get to listen to the baby's heartbeat with the doppler. (This actually has clinical benefits too but the kids and I just like to hear her heartbeat! This is Nate's favorite part of the appointment---he is on the left in this picture.)



Finally we wrap up the appointment with more questions and conversation. I never feel rushed and always enjoy our chats since I feel like all of my concerns are addressed and we are also building a great rapport which helps a lot when you consider that at the end of this ride I am going to be spending hours with these ladies in my home waiting for the baby to make her appearance. Pictured here are Stephanie Soderblum, my Midwife (in brown) and Kate Cunningham, her student (in green).



All in all the appointment takes about an hour and I can honestly say it is one of the best hours of my month. I look forward to it which is such an enormous juxtaposition to the dread I used to feel when I went for my OB appointments in Caleb's pregnancy. And THAT is a day in the life.

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