A Labor of Labor.

18 06 2010

So, I’d been waiting to post until I had something really great to update you on. Specifically, that I’d found a wonderful midwife and my plans for a homebirth were moving along smoothly. But that’s not what’s happening thus far. I’m going a little crazy, though, so I thought I’d take this opportunity to vent. And also, if I’m typing here, I can’t be obsessively checking my email, looking for a reply to one of the sixty-two emails I’ve got floating around out there to various midwives/doulas/birth class instructors, to which I’ve had NO REPLIES THUS FAR!

I thought I had the whole thing wrapped up. As soon as I found out I’m pregnant, I contacted a homebirthing midwifery duo, and explained my situation (porphyria and all,) and asked for a consultation. After our initial appointment, they said they felt comfortable enough with the situation, and trusted my instincts, and trusted that I would keep track of things during my pregnancy with my hematologist. Eric and I discussed whether or not we wanted to even meet with any other midwives. We agreed that we liked them, they seemed willing to take me on, and we just knew they were the right ones for us. So no, we would not even bother interviewing anyone else.

The following week was when I got sick, so I weathered that storm, and when I came out just fine and we knew Babo was fine, we decided we’d contact the midwives and tell them we’d like to sign a contract with them. The only thing holding us back was the price. Homebirthing midwifery care is NOT covered by insurance, (because if we all had our babies at home, how would the hospitals make their money,) so we’d have to come up with the money on our own. Compared to a hospital birth, homebirth is FRACTIONS of the cost, but it’s still a hefty chunk. Their particular rate, which seems to be the going rate around here, is $3000. That covers all prenatal care, the birth, and postnatal care. (Compare that to a hospital birth, with the national average cost being something like $15,000-20,000, JUST for the birth itself.)

So three grand isn’t much, relatively, but it has to be paid in full by the 35th week of pregnancy, and that was going to be a strain on us. So when I emailed them to say we’d like to hire them, I also explained our dire financial situation, in the hopes that perhaps they offered an (unadvertised) sliding scale. I also told them that I’d had a brief attack, but that everything was fine, and now I knew that the worst possible scenario wasn’t as horrible as I thought it’d be.

So, about eight days after I sent that email, I got one back saying that, in light of the recent attack, they were now feeling uncomfortable and hesitant about taking me on. They’d have to discuss it and get back to me. I was crushed. I’d already gone over and over with them how important it is to me to stay out of the hospital, and how my pregnancy is not a “high risk” pregnancy, the way it is for someone, with, say, insulin-dependent diabetes, or someone with, I dunno, a heroin addiction. Really, there’s no risk posed to the pregnancy at all, which I’ve had confirmed by a couple of different hematologists.

I don’t think I have the energy right now to explain all the reasons I believe in homebirth. I just do. It’s safer. It’s better for mom and baby. It’s statistically proven. If you don’t believe me, research it yourself. And don’t believe what your favorite OB says on the matter, because OBs are surgeons, and have been trained that all births are potential emergencies and that babies need to be rescued from the uterus.

For these and many other basic, fundamental reasons, I believe that healthy mothers should be having their babies at home, away from the risk of dangerous interventions and infections that come with hospitals. And I believe that I, in particular, must stay out of the hospital.

Let’s review my triggers: Stress. Medications. Infection. Chemicals. Bleach. Reduced caloric intake.

Let’s look at a hospital: A staff that is not properly prepared to handle natural childbirth, nor is prepared to handle porphyria, which certainly would be STRESS-inducing for me. A staff that is trained that all things should be treated with MEDICATION, especially childbirth. Hospitals are hotbeds of INFECTIONS. The rooms are cleaned with harsh CHEMICALS, and the sheets are BLEACHED til there’s no tomorrow, and there’s no avoiding these two things, no matter what. And in a hospital, women are strictly FORBIDDEN TO EAT while laboring, so that when they have to heroically cut you open and rescue that baby, there’s no food in your stomach to pose a risk of aspiration.

Need I say more?

Now, if there’s some real, true, medical emergency while I’m in labor, I won’t hesitate to transfer to a hospital, if my or my baby’s health or life is in danger. Otherwise, my butt does not belong in a hospital.

After I got that email from the midwives, I twiddled my thumbs, awaiting their decision. After about 12 days of not hearing anything, I finally sent another email, making my case once more, but telling them that if they were at all uncomfortable with me, then we’re not a good fit. I certainly don’t want a midwife around who’s paranoid about treating me.

After another FIVE days or so, I finally got the word from them that would not be taking me on. They only specialize in “low risk” pregnancies. Oh. My. Lord.

How many times do I have to explain this??? I’m NOT HIGH RISK, PEOPLE! Just because I have a disease with a name doesn’t mean something bad will happen. The worse thing that porphyria brings is an attack, right? I feel attacks coming on for days. If I were to have an attack while pregnant, I’d get with my hematologist, and we’d treat it and stop it. Done. It’s not like an attack can come out of absolutely nowhere, and send me in to anaphylactic shock. If something about labor brought on an attack, I’d have plenty of time to deal with it. It’s not going to make me seize up and foam at the mouth all of the sudden. It just doesn’t happen for me that way. Besides, I’m being super careful about carb intake and getting glucose treatments every other week, and my hematologist is seeing me monthly to monitor me.

I really can’t help but think that this is the issue: I am having a homebirth, and something goes “wrong,”… Let’s say the baby turns breach all of the sudden, which is rare but could happen, right? So we decide to transfer to the hospital. Of course, baby being breach has nothing to do with porphyria at all. But we get there, and I tell the OB on call that I’m transferring from a planned homebirth (already a strike against me, since OBs and hospitals are not known for being friendly to HB transfers,) and that I have porphyria, so we’ll have to take a lot of consideration in administering any drugs that may be necessary. Then the medical community has a really good reason to give the midwives all sorts of guff, right? “How dare you take on a patient with porphyria! You never should have taken a high-risk patient!” Then the midwives come under scrutiny just because, and they have to deal with that fallout.

There was a midwife in the area recently who made a couple of decisions differently than the medical community would have liked, and she came under such fire that she decided to stop practicing. On the one hand, I get where these midwives are coming from. If they sense any chance of the medical community being able to give them crap, they back off, in order to preserve their practice and offer homebirthing midwifery care to as many women as possible. But on the other hand, in doing so, plenty of deserving women are robbed of the choice to have their babies at home. AND, we’re subjected to the same big-medicine/insurance/liability game that we’re trying to avoid in the first place.

I’m trying to take this in stride, and just calmly move on to the next option. The problem with that is that there aren’t but so many options around here. So I’ve literally sent emails to every midwife I can find in the area in the last week, and I’ve heard nothing. Not a freaking thing. It’s like I’ve been black-listed or something.

And now I’m 15 weeks pregnant without a practitioner, and I’m not sure what my next move should be. I need some sleep, and I’m certainly not getting any these days.

Keep your fingers crossed for me that someone will A) write me back, and B) trust me. I’m tired of begging people to trust me when it comes to my health and my body. Really, really tired. But I guess I just have to keep on speaking loudly and clearly, until someone stops and listens.