I passed the second OGTT, with all the numbers clearly below the cut-off. Baby is growing well, according to weight and measurements, which are as they should be at this point. Baby is now the size of "a large jicama" (I had to look it up)—about 3.75 pounds, on average.
Also, I had both my annual eye exam and one of my twice yearly dental check-ups, and in both cases I was deemed healthy.
Other happy news: Paul and Emily's baby boy arrived on Wednesday! (That's my youngest brother and his wife, if you didn't know.) Rhen was born in the morning and weighted in just under 9 pounds. Everyone is doing well, from what I hear—I've yet to see pictures.
On to the bad news, and it's a biggie...
The short of it: the midwives' office is closing at the end of September instead of at the end of October as they had planned, and so I have to find a different care provider.
The longer version: I've known since I when I opted to be with this office that they were being shut down. They're operated through the hospital and the hospital Powers-That-Be decided not to continue supporting them. When I started with the office, I asked when they would be open through, and was told the end of October—long enough to take care of this pregnancy. I was not happy that the hospital was discontinuing support, but what could I do?
In conversation with the various midwives I've seen at my appointments, I learned that of the six midwives at the office, two were office-only care providers (i.e., they don't attend births) and the other four were all looking for work. Fair enough, really.
By July, one midwife had left (ironically, she's now working at the other local hospital—which I can't go to because it's not in my current insurance plan—with the midwife who delivered my first three babies. Another was leaving some time in August, I think, so there would be only two midwives attending births for the last two plus months of the office being open. This was not enough for their patient load, so they were looking for an OB who would be willing to be part of the rotation.
Well, they couldn't find one. In the area, there was not one OB with privileges at this hospital who was willing to be, for a rather short time, part of their rotation of coverage. And so the hospital told them they would have to shut down a month sooner.
Where does this leave me? Excellent question.
Emotionally, I'm okay now. I was sort of numb at the appointment, and rather concerned for the midwife who was having to tell me this—she was visibly distraught and obviously felt terrible about the whole thing. By later Tuesday, I was angry. Really angry. I had a terrible night's sleep then, and so Wednesday I was weepy and confused. Last night I slept better, and I've had some time to think things through, so today I'm okay.
Practically speaking... There is a practice that has agreed to take in all of the office's patients due from late September on. A practice I know nothing about, who wanted the next appointment scheduled with them, immediately. I said no thank you, I want to consider my options. And after thinking about it for a day and a half or so, it seem my options are:
- Find an OB I can live with and have the baby at the original hospital
- Switch to the midwife at the hospital in Niles
- Switch to the midwifes in Goshen—just under an hour away from our house
- Have a home birth (if there's a local home birth midwife with an opening in mid-October)
That being said, I don't really want to give birth at home. I like to be away from home for labor. I like to be in an environment where I can totally separate from my home responsibilities and just focus on giving birth. I like the time alone with the new baby, without the responsibilities and chaos of home. So while I recognize it as a (potential) option, a home birth is really my last choice.
Then there's the Goshen option. Almost everyone I've talked to has spoken highly of this office. But ... it's an hour away. Each way. I have probably six to eight more office visits—a minimum of 12 to 16 hours driving—and the gas money for that driving. Plus there's the drive down to Goshen when I'm actually in labor. The drive to the hospital has always been one of my least favorite parts of labor, so the idea of doubling or tripling the drive time is unappealing, to say the least. So, this option isn't my first choice either. I may call and talk to someone there just to see if they're willing to even take me on, and to verify that the midwives within the practice do hospital deliveries (there's also a birth center associated with the practice, where one doesn't stay long after the birth, but that's not what I'd want).
As to the first two choices, they largely come down to the same issue: there is an OB who I believe would be a good match, and I think the midwife in Niles would be a good match ... but they both work in rotation with other OBs who's approach to birth is not at all what I want. And while the care provider would most likely only be with me at the very end, for the delivery, their attitudes and expectations are going to majorly affect the behavior of the nurses, who I will be with for most of the labor.
I'll probably call and make appointments to talk with both the midwife (who I've already communicated with directly via email already) and the OB (assuming he's willing to take me on this late in the game—this afternoon I called a family practitioner who attends births and sounded like a good possibility only to be told I was too far along to transfer to him). Maybe after discussing my concerns with each of them it will be more clear what I should do.
The whole thing is incredibly frustrating. I don't think what I want is all that radical. I want a safe, clean environment to labor in. I want trained professionals who can keep an eye on my stats and baby's, just in case something develops. And other than that, and unless there are true signs of a problem with one of us, I want to be left alone to do what I need to do!
I don't want to be managed. I don't want to have my labor speeded up so that it follows some average pattern or fits someone elses time table. My births aren't quick, and that's okay. FWIW, Mairi was almost four days from the onset of real contractions to her birth, Nora was probably about a day, and Dorothy was a bit shy of two days. (Time in the hospital with each of them was less, of course, and none was over 24 hours of laboring at the hospital.) I don't want to be encouraged to take drugs to take away the pain—yeah, contractions hurt, but so do lots of other kinds of hard work (which we don't take drugs for). I've done this before and I can cope fine, thanks. I have my own support system (husband, doula, sister) and I really just need to be let be.
Why is this such a hard thing to arrange to have?
Anyway, that's where things stand for the moment. The only thing I know is that the baby will come, one way or another. I'll let you know how things develop...