Prenatal Appointment & Change of Plans!

I had my most recent prenatal appointment on the 19th at just over 27 weeks. I think everyone has heard about the results of this appointment, but I figured I would document it in detail for the sake of keeping up with blogging and looking back on this exciting time later down the road. ;)

Before my midwife Claudine even started the exam, she said she had something to talk to us about. This birth center is fairly new, only opened in February of this year. She has her state accreditation but has been working on getting a national accreditation since August. The national certificate is not required, it just looks better for the birth center and also enables more insurance companies to contract with the center. However Claudine was just informed - despite having several VBAC patients on record since the summer, like me - that the center won't be approved if she serves VBAC patients there. This is silly for a number of reasons, including the fact that *after* she is certified she could apply and be approved for an exception to the rule, based on their most recent guidelines (http://www.birthcenteraccreditation.org/2011/07/cabc-vbac-policy-adopted-june-2008/). But she has to get the certificate first, and then apply for exception, and this process won't be complete until after our baby is due.

So she said we have several options. I can transfer care; she can hide my file and essentially lie and still let me birth at the center; OR, she can simply attend my birth at my home. She does attend home births and as a CNM is legally able to attend a VBAC at home. Previously she did not wish to go so far to attend a birth, but she would rather do this than drop me as a patient or fudge her paperwork.

When I first became pregnant with this baby - even before - I looked into the home birth option. The more educated I became about my different options and best chance for a successful VBAC, the more I wanted a home birth. The problem was finding a provider; there are only three CNMs in Arizona who do home births (most CNMs work in hospitals, while LMs - licensed midwives - attend home births, but cannot legally attend VBACs). Out of the three CNMs, one is in Tucson but chooses not to do VBACs. The other two are in Phoenix; I contacted one and her schedule was full. So I contacted Claudine. She is running a birth center as well as doing home births in the Phoenix area, so she did not wish to commit to a home birth out of town. But she was also running the only birth center in the state that would accept VBACs, so we chose that as our next best option as it seemed we just couldn't make a home birth happen.

So needless to say when she offered to attend our birth at home, Sean and I jumped at the option. (Sean, incidentally, is almost more adamant than I am about staying out of the hospital for this birth!) I know it is less convenient for her, but I am so grateful she offered to do this rather than just telling us we had to transfer care, as she could have done.

I've already done all of my "homework" she requested: I verified that our insurance will cover the home birth, I collected the pertinent phone numbers for the hospital we will use in the event of an emergency transfer, and I spoke with the fire department about response times and helicopter availability just in case. (This is all "just in case" really, she wants us to be prepared for the worst although none of us have any reason to anticipate anything going wrong.) Most women who end up transferring their home birth to a hospital do so by choice, rather than it being a true emergency. The reality is, pregnancy and birth are not nearly as dangerous as tales of western medicine can make them out to be! ;)

So, that was long winded. And we are having a home birth, possibly a home water birth as we will rent a birthing tub in case I want to use it. We are thrilled to say the least - after wanting a home birth from the beginning I had given up on the idea. But I still felt cranky and grumbled about it every time we had to make the hour and a half drive. ;) Speaking of, this also puts my mind at ease as far as logistics of the birth center being an hour and a half away and how to handle that while in labor, finding child care for Ari possible in the middle of the night, etc.

Oh, and the actual exam went fine! Mama and baby are healthy. Baby was head down, we'll see if he stays put or flips a few more times, and his heart rate was good. :)

Halloween

We realized we never did a Halloween post so I am back dating this and sliding it in. ;)

A couple days before Halloween we carved pumpkins. Or, I carved pumpkins while Ari watched. He wanted very little to do with scooping seeds out or the general messiness.

On Halloween we took him trick or treating for the first time. He did so well, I wasn't sure if he would really participate since it involved talking to strangers, but he said "trick or treat" and "thank you" at every house! He was a monkey aka Curious George and Sean was the Man in the Yellow Hat. :) He had a really good time and wanted to go trick or treating again the next night. We let him have one piece of candy after dinner for about three nights afterwards then he pretty much forgot about it and the candy, uh, mysteriously disappeared.

Proud of his pumpkins.

Mad because he wanted to GO trick or treating already, not pose for pictures!