November 28, 2011 by Leah
I haven’t been writing much lately. The overwhelming themes of the past three months have been my pregnancy, my job, and the whole home-buying process. Well, we’re in the house. It’s unprofessional to blog about one’s employment situation, no matter what the provocation. And Baby Bailey is now public (I’m 14 weeks along – second trimester, woohoo!). So, I guess I’ll be writing about baby stuff for a while.
After the initial shock of finding out I was pregnant wore off, I decided the most important thing to do would be to find a maternity care provider. (A note on that shock: This baby was completely planned, thanks to things like education and access to birth control for which I’m very thankful, but it was still shocking to find out I was pregnant. I was like, “Now what?” and then after about a week of being all freaked out, I realized that the answer is, “We wait.”)
I’ve been a homebirth wannabe for years, having been introduced to the idea that birth experiences are important to women and society by “The Business of Being Born,” and then having done a lot of further reading. I also have an innate mistrust of doctors, hospitals, and the conventional medical model. Let me clarify: I like having a father-in-law who is an internist. He gives excellent advice when I do things like leave my thyroid drugs at home over Thanksgiving. I liked doctors when they removed my ruptured appendix and my skull tumor. I didn’t like them when they prescribed psychiatric drugs to my still-developing adolescent brain. I haven’t had good times in hospitals. I’ve seen nurse practitioners for primary and specialty care for years, and have found that I tend to get a lot more time and genuine care from such providers.
All told, I had no desire to call an OB/GYN clinic full of surgeons for the completely normal condition that is pregnancy. First, I scheduled a consult with a naturopathic doctor who is also a homebirth midwife, who practices in a larger city about an hour away. The meeting was edifying, but I didn’t walk away feeling all happy-gooey about this particular care provider. She was a little intense for me. She was also an out-of-network provider, which means our insurance wouldn’t cover a cent of my care with her (let alone the expense of driving back and forth to the Tri-Cities every few weeks). Plus, she didn’t “do” known twins or breeches, which kind of irritated me.
There are two other certified midwives in the Tri-Cities, but after testing out the drive once, I wasn’t enthused about commuting for prenatal care. My next step was to schedule a consult with a CNM (Certified Nurse Midwife) who works in a practice that includes two CNMs, three OB/GYNS, and various assistants. Big bonuses include: the practice and affiliated hospital are within walking distance from my house and completely covered by our insurance. Biggest bonus of all: I really, really like this CNM.
I met her when she’d been up all night and she still exuded calm, which is very good for me. She also told me to stop reading so darn much and instead to direct my attention inward, to listen to my body and follow my instincts. (Apparently Aaron and I fit a profile which sometimes alarms birth professionals. Namely, we’re over 30, have a lot of education, and have or have had careers, which leads people to assume we are used to things being perfect and going as planned. Luckily, we don’t actually expect things to be perfect and go as planned.) I’ve followed this advice, except for a few random Googles, and have been much calmer for it. (I’ve also been mostly staying off those insipid pregnancy websites and message boards and have instead been directing my obsessive tendencies to researching cosleeping, breastfeeding, and chemicals in crib mattresses.) By the end of this initial conversation the CNM with my only question was, “Where do I sign up?”
So, I had my care provider. I assumed I’d deliver at the hospital with which this women’s health practice is affiliated, but according to all the initial paperwork I filled out, I had a choice. (Yes, Walla Walla has two hospitals!) I chose Walla Walla General over Providence St. Mary’s based on 2009 c-section data (24.9% vs. 29.5%). Plus, I’d heard anecdotally that St. Mary’s “likes to cut.” Try getting that out of your head.
I thought a lot about these decisions in the first weeks after making them, but my reasoning seemed sound every time I looked at it. $2500 out-of-pocket and hours on the road vs. $100 out of pocket (I know, I know, we are incredibly lucky) and a hospital and provider within walking distance. And, since we are so lucky as to be spending next-to-nothing on prenatal care and birth, I don’t feel bad about spending a little extra on prenatal exercise videos and equipment, a membership at the Y, high-quality food, and, I hope, a doula – if one can be found in Walla Walla.