Week 1 - Hospital/Birth Updates

A little bit of background...
One of the most difficult transitions for me has been the transition from the birth center in El Paso back to the traditional hospital setting. We began our prenatal care at the baby-friendly hospital in El Paso. Although I know the doctors and staff were kind and capable, I just did not feel comfortable with the philosophy and practices that have become standard in a traditional hospital birth. I am coming into my experience with doctors from my childhood with my dad - who has always been very didactic... taking the time to teach and explain what was happening. The environment in the hospital in El Paso did not support this climate... seeming to prefer patients as compliant recipients of care and expertise of the doctors. I have respect for the knowledge and experience of doctors, but I have always preferred feeling like my thoughts and preferences were valued and considered instead of being brushed aside. 

Around four months into the pregnancy, I began to seek other options and found a fantastic birthing center with a midwife I loved. Every appointment was life-giving and confidence-building. I felt like I was part of the team and my decisions were considered and valued. With my appointments at the birth center and our weekly Hypnobirthing Class, Andre and I were feeling really comfortable and excited about our calm birth and Autumn's gentle entry into the world. 

That, of course, all had to be altered after our last ultrasound in El Paso that altered us to the issues in her heart. (If you haven't read the Autumn's Heart page and are interested in understanding exactly what the cardiologists are seeing, please check out the page on the right of the blog or click here ... I did my best to explain what we understand as of now ). We are at the second best hospital in the country for pediatric cardiology and I know that Autumn's heart will be in some of the best hands in the world.

My initial fears about coming to Houston were mostly linked with the uncertainty of the birthing climate in the hospital. I knew that the Women's Pavilion had the label of being baby-friendly, but I know that a calm/gentle/unmedicated/natural birth is not always received well by doctors and nurses who are coming from a different philosophy of care. In some ways, I feel unsure about my goal to go through this birth using the hypnobirthing/gentle techniques because I know that she will need immediate medical interventions that will not be gentle and calm, but something continues to motivate me to give her this calm time as an entrance into a world that will be stressful and hectic for the first few weeks. I believe in the practices of natural birth and I think it most closely aligns with the type of entrance I want for Autumn in the world.


Our first interactions with the docs...
Andre and I were very impressed and thankful for the excellent care and compassion we felt at our initial appointments with the doctors. Our nurse case manager booked our Monday and Tuesday with appointments all day long - meeting the neonatalogists, obstetricians, cardiologists and counselors. We repeated all of the test from El Paso - a full anatomy screening, echocardiogram on Autumn's heart, and blood draws for gestational diabetes and test for 22q.112 (a genetic condition that can be associated with Tetrology of Fallot). 

Details make an impression on me... for example, all the ultrasound docs and techs made sure to make physical contact with me and speak with me before proceeding with a test. All docs always ask the sex of baby and refer to her as her during procedures - making the experience feel like an authentic human interaction instead of just a procedure. They have spent time to explain and let us ask as many questions as we need. I never feel like I am being rushed out of the room. And most importantly for me, these experts in their field seem to encourage patient investment and participation. They seem to prefer having the patients as part of the team - taking my thoughts and preferences as valid within the context of the team.

Some wins for our gentle/natural birth:
- Unless there is danger for me or baby...
- It looks like they will respect my wishes to not be induced (the docs in El Paso gave me the impression that I wouldn't have the choice).
- I will be able to drink and eat clear liquids during labor. 
- Varied positions and even hydrotherapy will be allowed.
- The doula (recommended by the midwives in El Paso) is excellent and will be an amazing support during the birth...she's participated in over 400 births and specializes in hospital births
- The neonatalogists seem to truly prefer breast milk - when possible for her digestive system and will exclusively feed her breast milk with supplements of IV fluid when needed 


Some compromises:
- Skin to skin contact will probably not be possible. The neonatalogists will need to check her for 30 minutes and start administering prostaglandins right away. I may get the chance to see her for a few minutes before they take her to the NICU (Mom will be following Autumn while Andre waits with me to be cleared to go see her)
- IV - I will definitely need the IV lock placed in my arm, even though I will not necessarily be receiving fluids unless they think it's necessary
- Limited flexibility for final pushing position - it looks like the standard is the back position and no flexibility for squatting or side.


Overall feelings..
I am thankful that we are here so early so I have had the opportunity to meet the docs and feel comfortable with the environment at the hospital. I feel so secure after meeting the doula and feeling her support already with more support to come during the birth. I am comforted to know that Women's Pavilion truly deserves its mother/baby-friendly distinction and that the doctors and staff are compassionate and willing to see me as a part of the team. I am thankful that our OB is flexible and kind - taking seriously my plans and hopes while also concerned about our experience in Houston (He recommended at least 20 restaurants and museum/events we should visit while we are here).

I am able to start picturing the experience and feeling at peace with some of the compromises to my plan of a birth center labor and delivery. One of my favorite affirmations from hypnobirthing is:

"I am prepared to calmly meet whatever turn my birthing journey takes." 

This affirmation has become more important in the light of this detour and any mini-detours that will come up as we continue along this journey.