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Group Appointments and Interventions

Mr. Handsome and I have taken the group appointments route for maternity care. We see a midwife along with five to seven other couples in one visit. It sounds a little strange, and we had some reservations at first, but now that we’ve had three appointments I’ve started to really enjoy and even look forward to them.

There are pros and cons to this style of care, of course. The biggest con is that the appointments take two hours (or more) where regular non-group appointments can be as short as 20 minutes. We can’t bring Kiddo1 with us so we have to ask someone to watch him for about three hours (with travel time).

However, a lot gets discussed during those two hours. Every session has had a focus. During the second session we focused a lot on nutrition. I learned a little too much about how many calories and carbs are in my favorite foods. We were all advised to keep our carbs to 30 grams per meal (three meals a day) and 15 per snack (two snacks a day) – that’s only 120 grams of carbs per day which may sound like a lot but when you realize your favorite bagel has 65 grams of carbs… it’s sobering. Even to a person who is stone-cold sober, like the pregnant.

Another con would be that there isn’t a lot of privacy when it comes to discussions (the part during which the belly is measured, heart rate monitored, etc is done in privacy). But, honestly, the fact is that we (the couples) don’t know each other and don’t know each others’ friends so what are we going to say about each other? We might as well commiserate on the what’s what. Plus, once we get going, things start to come out and we begin identifying with each other really well. It just takes a bit to get comfortable and get things rolling.

So other than great discussion and comradery, the main pro is that you don’t have to go through the same crap that you do during an OB appointment. I hear ladies in my mom’s group complain about how their OBs spend more time reading their chart than listening to them, that there isn’t time to bring up their questions or really get to the root of their concerns, that they analyze their urine sample more than their simple “symptoms” like leg cramps, indigestion, etc, which I’ve learned in my group appointments can be indicative of or adjusted by diet, exercise or vitamins. Simple fixes to annoying problems, which an OB usually doesn’t bring up.

I don’t mean to bad-mouth OBs at all. There are a lot of good ones out there. I’m simply reacting to feedback from fellow pregnants. The OB I had with my first pregnancy was great and a good listener, but this experience with the midwives is SO much more fulfilling.

I wanted to write about these group appointments today because during last night’s session we talked a little about our fears about childbirth (which I’ll write about more specifically in a later post). Our questions, however, led to a much larger discussion/overview of hospital policies.

I admit, after reading Natural Hospital Birth I started to focus my fears a lot on how the hospital could screw up my birth experience… After last night’s appointment I feel a lot better. The policies of the midwives very much align with my expectations and desires for this birth. This is why I chose this hospital and group of midwives, after all, so I shouldn’t be surprised!

The “24-hour countdown” of labor-to-delivery isn’t nearly as rigid with the midwives. They’ll pretty much let you take your time, but they say do yourself a favor and labor as much as you can at home (which won’t count on the clock). They only want to see you if your water breaks early AND there’s a risk factor (such as colored fluid or you tested positive for Group B Strep, the latter will cause a need for antibiotics via IV). Also, eating and drinking during labor is encouraged by the midwives but the OB-side of the hospital strictly prohibits it (the midwives will cut you off if you have Pitocin or an Epidural, though). Speaking of Pitocin, the midwives discourage it, which I am delighted to hear! Fetal monitoring is done via a doppler-like device and it is not constant, so it’s as non-invasive as possible. It still has to be done, but intermittently. As soon as you arrive at the hospital you are monitored for 30 minutes continuously so they can get a good idea of how the baby is doing. Then doppler monitoring will occur for about a minute every 30 minutes or so. For a hospital, that’s really not so bad.

We also talked about all the post-birth procedures that are generally required at most hospitals but are elective at the university. First off, as soon as baby is born she is placed on your chest and you are encouraged to breast feed within the first hour. All baby check-ups can take place right there on your chest. They even prefer to administer the vitamin K shot while you’re breast feeding (it distracts the baby from the shot). You can forgo the baby’s vitamin K if you want, or choose a gradual method instead of the shot (I think we’ll just get it over with with the shot though). You can decline the eye ointment if there’s no risk of infection. If your pediatrician is not affiliated with the hospital you can choose from a pediatric or family practice consult – the midwives recommend the family practice because they are “a lot more flexible” than the peds and will require a lot less monitoring if the birth was healthy and there’s no risk of infection. All this sounds great to me!

I got some great news on my stats, too:

  • I only gained three pounds since the last visit, which is consistent with my home-based weight check-ins. The midwife is happy with my weight gain, diet and exercise.
  • My fundal height (uterus size) is 32 cm which is also right on target. Baby’s heartbeat is an excellent 140 bpm.
  • My blood pressure is 118/70, most excellent. Apparently I am quite calm.
  • My glucose test (which I really tried to reject but apparently this midwife’s study focus is gestational diabetes so there was no getting out of it) showed my blood sugar level at 53 which the student midwife said is the lowest she’s ever seen. Not dangerously low, but low enough that – get this, GET THIS – the midwife says I have (basically) free reign on eating carbs and sugar. I CAN EAT CARBS AND SUGAR! I will still keep this manageable but I won’t be as restrictive as I have been. For example, that night I ate a sensible chicken dinner. And a cheese roll. … And some ice cream.
  • Baby is positioned the same as our last appointment – head down, butt on the right and feet to the left. She is awesome. Stay in that position baby! The midwife says it’s the best position for an easy, quick birth. Fingers crossed!

We have only two more appointments left until the due date! One in late June and one in early July. Unless a complication arises that’s all we’ll have to do! No weekly appointments, no constant check-ins. I’m loving the midwives at my hospital!

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One response »

  1. We’re doing the group visits with our birth center also. I’ve got all the same pros & cons 🙂

    Reply

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