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My (Terrifying) First Visit with My Homebirth Midwives

Melanie at

I’ve mentioned before that I’ve sought the care of homebirth midwives for this third baby of mine. My first birth was in a hospital with an OB (a doctor I happened to adore when he was simply providing gynecological care) and my second was with the team of midwives I’m with again now, after my first birth was a less than positive experience (more on that in a later post).

Anyhoo, yesterday evening was the first visit I’ve had with my midwives during this pregnancy. While many OBs see patients as early as six or eight weeks, many midwives might not see patients until the end of the first trimester as they use a Doppler to hear the heartbeat instead of looking for the embryo or fetus on an ultrasound. That’s the case with my midwives, at least—and they need to wait to be more likely to successfully hear the heartbeat. That being said, I’ve already had two ultrasounds (including the nuchal translucency) at an imaging center they referred me to, so I wasn’t too impatient for this first visit.

My midwives don’t have an office, so in addition to their clients giving birth at home, they also have all prenatal appointments at home—which is kind of equal parts awesome and awful when you have two little kids around who are interested in sticking around for it all. My blood draw and physical were mostly uneventful, and the kids got to hear the baby’s heartbeat using the Doppler—but then came the time for my midwife to check my blood pressure. This is always a stressful moment for me for some reason.

The first time she took my BP, it was so high that she gasped and refused to tell me the actual number. She hung out for a while longer, chatting with me on my couch, just talking about the changes in my life and their practice since my son Henry’s birth three years ago, which she attended. While I closed my eyes, tried to relax and think of a happy place (a quiet, warm sandy beach), she took the reading again—and was equally dismayed. 142/100. (The desired range for adults according to the American Heart Assn. is anywhere in the 90-119/60-79 range.)

High blood pressure is never healthy—but during pregnancy, it can be particularly dangerous for both mom and baby. Among the potential problems it may cause: decreased blood flow to the placenta (leading to restricted growth for the baby and low birthweight), placental abruption (when the placenta separates from the uterus prematurely), premature delivery, preeclampsia… In short, it can be really serious.  

While moments before we had been chatting about their new birth assistants, my midwife changed course and started to tell me about the hospital where they have admitting privileges. They used to be able to take patients to St. Vincent’s Hospital in lower Manhattan, which was a particularly midwife-friendly hospital. But after it shut down in 2010, they were left to find another hospital where they could continue patient care (they can do everything except perform C-sections, so if I were induced or we had to transfer during labor but didn’t need a C-section, they could still care for me). So now they use a county hospital that’s farther away and wholly inconvenient. She spoke about the potential need for blood pressure medication, that homebirth would no longer be an option should my blood pressure remain high, that I would need to go in for additional ultrasounds and possibly seek the care of a perinatologist (an OB who manages high-risk pregnancies)… As a midwife, I want her to think of all of these scenarios and plan for them, but for me as a scared expectant mama, I just wanted to shut my ears and tell her that we could discuss all of this later, if and when we really needed to; for now it was just freaking me out.

So, it was overwhelming, to say the least—to go from thinking about a calm, peaceful birth in my home to delivering at a county hospital a fair distance from home. And while I’m committed to doing everything in my power to fix this now (including listening to guided meditation, taking my blood pressure regularly at home, going for acupuncture, reducing my sodium intake, eating more fresh fruits/veggies, cutting out caffeine, trying to relax, etc.), I’m kind of terrified. I don’t know that I can cut out all of the stress that I need to while working full-time and then coming home to two rambunctious kids (I’m not sure which is more stressful for me at the moment, actually). But I’m going to try. I’m committed to homebirth as a safe and healthy option for this baby and me—IF it is a safe and healthy option for the two of us. And if not, well, I guess I’ll deal with that when the time comes.    

Did you ever have a health scare during pregnancy? How did you handle it?