Well, sometimes the best laid plans… *sigh
So I have anemia. All the time. Don’t know how long I’ve had it, probably most of my life, but it gets a lot worse when I’m pregnant. In the past, I’ve been able to keep my levels up just enough with Iron Supplements. I’ve also delivered every baby in the hospital, which has different requirements for iron levels at time of delivery. I worked hard to get my iron levels up and at the check a couple weeks ago, I was doing pretty good at a 10.6. The legal minimum requirements for iron levels is 10.1 or higher, so I was fine. Then at last weekend’s appointment, we took blood for a check again and my levels had dropped nearly a whole point. Down to below the legal requirement for home birth. My midwife called me on Monday and delivered the bad news. I had “risked out” of having a home birth. I was devastated. I got a recommendation from my midwife for an awesome nurse-midwife who could take me on and deliver me at the hospital. I went over to her office that afternoon and met with her. They want to induce me on Monday. That word freaked me out. I’m not sure my body could handle more pitocin than what I’ve already had in the past. My uterus could rupture, and seeing as how I’m anemic, my chances of bleeding out are pretty high in a scenario like that. That was part of the reason I had wanted to go the natural route in the first place. I was pleasantly surprised and relieved to hear that the nurse-midwife Tiffany was very pro-natural birth and she sat and thing she said was, “What do YOU want from this birth? How do YOU want this to go?” I told her what I wanted. I expressed how torn I was about having an induction. On one hand, if my iron levels are dropping despite my best efforts, I wanted to give birth ASAP. On the other hand…I wanted to birth my way on my time and terms. We came up with a birth plan that I was comfortable with.
Here it is:
If I go into labor on my own before Saturday, I will deliver under the care of a nurse-midwife at Mercy Gilbert. I will get to walk around and not be confined to bed, hooked to monitors. They will do intermittent monitoring and I can labor in the tub. (YAY!) They will let me do skin-to-skin as long as I want after she is born and will delay cord clamping. They will ask before administering any tests or medications to either baby or myself. My midwives who have been on this journey with me the whole way, will be there acting as doulas, guiding and encouraging me the whole way.
If I get to Saturday, my midwife Jude will retest my iron levels that morning and run the lab stat so that I will get the results that evening. If I’m back up to over the minimum requirements, I can transfer care back to her and birth at home as originally planned. The chances of me getting my iron levels up that quickly isn’t great, but it is sure worth a try.
If I get to Saturday and my iron levels have not come up to where they need to be, I will be induced on Monday. Here’s the plan for that…
Monday morning, I’ll report to the hospital and start an “outpatient induction”. This means that I will be getting prostaglandin gel (up to three treatments) to try to kickstart my labor. This is the least invasive method of induction and I’m very comfortable with it. I’ll be laying down the first hour after the first treatment to give it a chance to work and then I get up and walk for an hour. I can do this up to three times that day. If it doesn’t work, they will send me home and I can try again in a few more days. Hence the “outpatient procedure” status. If it does put me into labor, then they will admit me and I’ll do a natural hospital birth like I described above.
This is not the original plan, but things happen and I am feeling very comfortable about it. Of course, I’m still hoping to have a home birth, but if that doesn’t happen,… it’s going to be okay. For the safety of myself and Miss E, this is what I feel is the best and safest course of action.
So prayers, positive thoughts and encouragement are all welcome as I finish out this pregnancy.
Till Next Time,