10th Midwife Appointment

July 11th 2013

36 weeks 6 days 

Today Jamie, myself, and my doula met with the midwife to talk about complications in labor. 

The midwife discussed the major complications, such as shoulder dsytocia, haemorrhaging, episitomys and tearing, breech babies, and infant CPR. 

Because shoulder dsytocia (where the baby's shoulder gets caught on the mom's pubic bone and has to be broken in order to get the baby out) was something I was really concerned about, the midwife showed me a model of a woman's pelvis and showed me exactly how the baby moves down the pelvis and how they would get stuck. More importantly, she showed me how they can easily slip their hands inside and gently turn the baby to get him out. Actually seeing that really allowed me to relax, as now it doesn't seem like such a dire situation. Also, I tend to do well with visuals so I can fully understand what's going on. 

The midwife also talked about the small chance of haemorrhaging after delivery, or if the placenta gets stuck. In that case, I would have a lot of people tending to me, making sure I get meds and blood if needed. There is only like a 5% chance of this happening so I'm not going to worry about it. Usually, this can be dealt with extremely fast and the mom recovers fine. If the placenta isn't coming out, the midwife will give me some pitocin to cause my uterus to contract and expel the after birth. 

About 40% of women experience some minor tearing, and not very many women need episitomys. What is amazing about the human body is that the perineum heals faster than any other area in the body and has an incredible ability to stretch. I know the midwife will try and prevent tearing and will only cut me if absolutely needed so there is a chance that I could deliver this baby vaginally and come out unscathed so to say. 

Another possible complication is that the baby would be bum or feet first. Thankfully, my baby's head has been down in my pelvis since at least 28 weeks and there is little chance he will suddenly flip and become breech. Because he is lying on my right side, the midwife wants me to try some exercises to get him to move to the right side, as it will make labor easier and reduce my chances of back labor. 

Finally, the midwife talked about infant resuscitation  If babies are born and they are not crying, the midwife will rub them down with a towel, which usually gets the baby to cry. If not, the midwife will rub the baby down more vigorously. About 1% of the time, the infant will need CPR. 

The midwife also checked my blood pressure, which was good, and measured my uterus. This particular midwife always measures smaller so I only measured at one week ahead at 37 weeks instead of two weeks ahead, which is my norm. She listened to the baby's heart rate which was 130. The heart rate is not usually that low, but the baby was lazy or sleeping at that moment. Later he proceeded to give me a few good kicks to reassure me he was okay! 

I expressed my frustrations at being given different information by so many different people, which has made it difficult for me to think about what kind of labor I want and what I can expect. The midwife expressed that she hates giving growth ultrasounds, because they can be so inaccurate. The results are based on the quality of the equipment being used, the skill of the technician  the baby's position, and the mother's body. The mere fact that the ultrasound results changed so much in just two weeks proves this point. Also, there is a good chance that the baby isn't as big or weigh as much as they estimate! Also, because I have a short torso, there is less space for the baby so he may appear larger than he is. 

I was reassured to know that the midwives will be monitoring me closely, and if my labor is not progressing or they think the baby is not going to fit, they can order a C section and avoid unnecessary problems and complications. 

Overall, after discussing my fears and concerns, and by getting more information, I have decided to try for a vaginal delivery and to just go with the flow. I am trying not to worry about all the potential what-ifs and just take it as it comes. It's great to know that I don't have to have a C section and that it is now a choice. Because both mothers and babies do better with a vaginal delivery I am hoping that my labor will progress and I will have a normal delivery. 

Since 36 weeks, I am drinking three cups of red raspberry leaf tea a day and taking 1000 mg of evening primrose oil orally. I'm also trying to get in a couple of walks-which is difficult due to pain. At 37 weeks, I will be upping my dosage of evening primrose oil in an attempt to encourage the baby to come by or before his due date.