Great Expectations: Julie @ 25 Weeks

Last week, I had my first appointment with the midwives. My intent has always been to have a midwife birth. When I was in college, a very long time ago, I read a paper on the medicalization of birth and ever since that reading, had planned to not give birth on my back, with an epidural. Of course, I've never gotten this far in a pregnancy, but this is for real now. This girl is kicking like crazy, sometimes so hard that it freaks me out, and I have to remember she's in there and there is not some sort of emergency problem I'm having (like a scene from the movie, 'Alien').

I like to pretend I'm a regular lady and that my birth could be like anyone else's. The only problem is that I have a serious wildcard factor to my health. In 2013, I suffered a rare, reversible brain condition called Reversible Cerebral Vasocontrictor Syndrome (RCVS). This condition is characterized by 'thunderclap' headaches (the worst headache of your life, comes on in under two seconds, the pain so bad you just start vomiting); after nine of those headaches, and nine visits to the ER, I would intermittently lose coordination on one side of my body. The three+ week episode ended with five strokes, each one resolving within about 10-30 minutes. At that point, my brain was bleeding and they finally figured out that I had side effects associated with one of these rare conditions that you may hear of at the end of new medication commercials. The trigger for my condition was a commonly prescribed SSRI. They told me it would never happen again, as long as I did not use an SSRI; however, the only other time that it could happen was during pregnancy, during delivery, or post partum. There are no documented incidences of having two different triggers, but nobody can say absolutely that this will not happen to me again.

This condition can and does happen to pregnant women, albeit rarely, and it can be associated with eclampsia/pre-eclampsia. It is so rare that it is underdiagnosed. At least with me, they would know what was happening this time. I've come to the conclusion that I need some sort of formal, written birth plan that includes that outlier chance that this will happen. The pain associated with the headache is excruciating and I would need to have morphine administered directly (morphine is actually safe for babies). From there, I would assume the baby would need to be taken by C-section. This would all take time if I was not directly in the hospital, crucial time if I was in the middle of birth.

I can't tell if I feel relief or defeat at this decision. I could fight tooth and nail to be at the birth center and if the baby had meconium, I would be precluded from birthing there anyway. It's birth'anything can happen and it rarely goes the way it is planned. Beyond being cautious, I think the decision now will save me 15 weeks of hedging. My parents have been very concerned and are of the ilk that if something happened, and I could have prevented it by making a better decision, it would be my fault. Harsh, but perhaps true. And if I learned anything from my trip to Aruba, you can't force yourself to relax or feel comfortable about something that deep down you aren't really confident in. The stakes are too high while having a baby.

I can still have the midwives help deliver at the hospital, but I am having to say goodbye to the idea of the Jacuzzi, the birthing tub, the laughing gas, the homey atmosphere, the pretty windows to look out of (it sounds like I was looking for a spa - really, I just wanted natural pain management!). My focus will be to work with the midwives on how to have the best planned hospital birth I can. I'm also following up with a vascular neurologist (the regular neurologist knows less than I do about the condition at this point) at the excellent hospital where I stayed in 2013. My husband says to wait to see what this doctor says about birthing outside of the hospital but to be perfectly honest, I guess I do feel some sort of relief about this decision, punctuated with disappointment.

I have not exactly decided about any birth classes and maybe no decision is a decision. I am leaning towards seeing my old therapist who does hypnotherapy and buying the Hypnobabies CDs. I just can't see my husband sitting for three hours every week for six weeks at a class. He said he will do whatever I want for the classes but the reality is that I think he is going through something right now, and I am too. I have been having what I think is more than the old pregnancy hormones. Apparently, as the blood volume increases during pregnancy, medications can become less effective [thus my slightly down and serious post]. I am going to try to do acupuncture to improve/regulate my mood, but may have to take more of the medication I'm on to get back to my old chipper self (this med is also safe for baby).

I met with a very organized friend last week who, at my request, sat me down and helped sort through what products are good and not so good to have for a baby. That helped with being overwhelmed to make the 'perfect' choice for a stroller, a car seat, and anything else needed. She also gave me some adorable baby clothes from her daughter and, thank God, they were in greens, oranges and blues. She sold me her white spindle Jenny Lind crib that you can see in the picture here (I made her put a price on it), and used getting my nursery further together as a tool to get over some of the 'blues.'

Today I built up the guts to do my 93 degree 'warm' yoga. On top of my many night-time sleep disturbances, my hips have started to hurt again and now my tailbone. I had these hip problems prior to pregnancy and nothing helped but the combination of the heat and stretching of those yoga classes. I drank about 64 ounces of water all together, before, during, and after the class. I took it easy. I lay down when I was too hot and near the door which had a little breeze. I did mouth breathing and drank cold water, which both cool you down. Most of the instructors at this studio are moms who practiced in the heat their whole pregnancy. So I'm trying to be confident about its restorative nature for my body and that baby also enjoyed it, rather than being stressed by it. See you next week!