Saturday, July 31, 2010

MW dilemma & pre-UC fears

i have been having mixed feelings about my upcoming birth (november). very excited and liberated about UC'ing, but scared, too, as it seems that each of my pgcys has come with some sort of minor complications that for the most part, in a medical setting, are not really a big deal. like GD (which i don't have this least yet), getting rx's for infections and other issues (UTI and sinus probs are common for me while pg, and i had severe bronchitis last time toward the end which almost landed me in the hospital). i don't have a problem self-treating most things, either naturally or with rx's that i already have on hand if natural stuff isn't cutting it after a while (but it usually does). this time around i'm having kidney issues (treating with D-mannose, cranberry, and vit c, but it's taking a looong time to resolve) and what seems like arrhythmia/tachycardia (which my father has had, but may be normal due to increased blood volume, but my lack of "medical care" makes it more noticeable and worrisome, because i am SO not looking forward to having to go see the awful back-up OB again - see why below). but i am afraid if i mention my concerns to my HB MWs that they will insist on it, and maybe i have a real, serious heart problem that will truly "risk" me out of their care altogether. so now i'm all paranoid about my kidneys shutting down :roll: or having a heart attack :yeah: :roll: *SIGH* yeah, i'm paranoid.

i'm starting to feel like i should go ahead and "get in" with the hospital MWs for these things, and just not show up for the birth ;) but i'm already 24 wks and i don't want to insult my HB MWs (i love them, whereas my fave hosp MW who is very traditional has since retired from midwifery in favor of teaching obstetrics at the teaching hospital <---THAT will be a very good thing for up-coming OBs and L&D RNs in this area!! :D but i don't really know and/or like the remaining MWs at that hosp)'s just that they are CPMs and can't prescribe treatments, so if i need any "medical attention" i have to go to their back-up OB, who works alone and has a TON of patients (he is the only HB MW back-up in town, and the only OB left in town that accepts medicaid without being a pre-existing patient -- which i am for the hosp MWs, btw). so, anyway, the wait in his office is RIDICULOUS. i have been there twice, once for a consult and 20wk u/s, and then again for a colposcopy/biopsy (i know!!) and repeat gender u/s ("she" keeps crossing her legs :mad: ). i was there for 4 hrs the first time and 9 hrs the second time. both visits brought me to tears for various reasons. not to mention that his practicing rights exist only at our town's teaching hospital, which is a HORRIBLE place to have a baby, for the impersonal, over-reactive, intervention-happy, traditional-hospital medical atmosphere so....i do NOT want to go back to him, which is why i am contemplating going to the hosp MWs for certain things.

so my dilemma is that i don't think medicaid will allow me to have more than one set of caretakers for my pregnancy...??? i know if i were to completely SWITCH from the HB MWs to hosp MWs it would be okay, but the fact that the back-up OB has STILL not decided whether to sign off on my HB, and if not, then whether to "allow" my HB MWs to continue with my prenatal and PP care. I really want to do a "sneaky" UC where i call the MWs AFTER baby is out (or at least hubby calls while i'm pushing, giving them no time to get there "in time" :D ) so they can come check us out after (for my own peace of mind). e.g. if babe is "slow to start" it would be nice to have the MWs show up with their deep-suction and oxygen if necessary, just to make sure things are okay (my first born had juicy lungs and was transferred to NICU for 2 days :( ). if i am with hosp MWs, i'd have to go to the hospital for a relatively immediate PP check, and i'd be afraid they'd want to admit us "for observation". that's another problem for medicaid pts around here. AMA = medicaid refuses the bill. :mad: and if i wait until 24 hrs later or whatever, then it's pointless to go anyway.

i don't mind just taking babe to ped asap for an assessment (depending on the time of day of delivery -- i've had 3 "after hours" babies and 1 "lunch hour" one :lol: ). it's ME i'm worried about...i have a history of blood-loss (PPH after the twins that caused me to nearly faint when i tried to go for a walk a few hours later -- but then again i was pumped full of fluids and pitocin during labor AND my uterus was double-stretched; and borderline PPH after my last babe), and although i have not torn since my first born (nuchal arm), i am concerned that without "proper" perineal/urethral support during delivery (i think i will be squeamish about feeling the stretching from the outside), i might end up with a tear that requires more than just rest to fix...unlikely, i know, but i have a SERIOUS aversion to hospital admission, which is what i'm afraid they'd try to force on me...or maybe they can take care of all this in the office if it's daytime? is it true that if the baby is not born under their care that it is not their "right" to demand to assess and "treat" her post birth? even if it's <24hrs later? i just don't need another AMA on my "record". they assigned a social worker to us last time, when i took my 2yo home from the ER AMA last month...

so, i have a history of, um, let's say "obstacles" with my labors, births, and newborns, so i would like the reassurance of a quasi-medical PP assessment without having to leave home, if at all possible.

i know these are probably all normal first-time UC'er fears.  btw, i do have an affirmation that i am repeating constantly, and i truly believe it (okay, so maybe 99% ;) ). "i believe that this labor will be quick and easy and uncomplicated, and that baby and i will be healthy." it's just all the "what ifs" that are dragging me down. :ooer:

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