We’ve decided to go with a hospital birth after all. Turbo OB said with infinite confidence that St. Francis is the best place in Oklahoma to give birth, and after the tour I believe it. Simple fact is, as fit and healthy as I may be, and as young as I may feel, it turns out there are increased risks when using an egg donor and when delivering at age 38. The main risks are high blood pressure (18%) and pre-eclamsia (11%, but that can be reduced to about 8% with 150mg/day of aspirin). But anyone can have stalled or stuck labor, or have their baby suddenly go into distress, or just start hemorrhaging randomly.
There’s still probably a 90% chance all will be fine (my blood pressure has always been exemplary), but I’ve come to realize that if I do try the midwife, I’m going to be stressing out the whole time thinking, “Please go smoothly, please just work, please don’t transfer me to a hospital…” Especially since the midwife’s place isn’t all that handy to a hospital. 15 minutes or so, which isn’t bad, but it can definitely make a difference if something crazy goes down.
Whereas if I’m at a hospital already, I can relax knowing this is definitely where I’ll give birth, and everything I or the baby could possibly need is right around the corner. And from what I understand, Turbo OB is one of the best in the state. It still seems crazy to me that I was able to just call up his office and get in within a few weeks!
Kinda sucks how expensive it’s going to be, though. My usual out of pocket max has been around $7,000, not including the premium (which will probably go up next year), and childbirth will probably hit that max, and this is assuming ObamaCare is even functioning well next year as Republicans try their best to sabotage it.
And to top it off, I’m thinking very seriously about hiring a doula, which costs another $800. Doulas are pretty much the only factor that’s been proven to reduce labor time and reduce surgeries and other interventions. The doc just shows up at the end, and the nurses come and go, and it seems like it would be really nice to have someone in my corner the whole time. My husband will be there, of course, but he’ll probably need breaks sometimes, and he hasn’t been trained as a childbirth attendant. (We’ll take classes, of course, but a few hours of classes can’t compare with years of experience.) Putting all that on him seems like a lot of pressure, when he should just be enjoying the moment as much as he can.
I just know so many people who’ve had traumatic, dangerous, or just miserable childbirth experiences, it seems eminently reasonable to me to tack a few hundred bucks more onto this astronomically expensive endeavor to have a much better chance of a healthy and happy birth experience. And I found a doula who seems crazy compatible. Just very cool. If all goes well, we’ll meet her next week.
But yeah… bracing ourselves for another massive drawdown on our savings, which were just starting to recover a little.
What else? I got my blood work back from my first OB appointment with Dr. Hillcrest. That’s not his real name, but he delivers at Hillcrest South and St. Francis South, and I call him Dr. Hillcrest to distinguish him from Turbo OB. Yeah, I made appointments with two different OBs who deliver at two different hospitals in case one doc or hospital ended up being insufferable somehow.
Dr. Hillcrest was recommended by a friend, and he was great (and so empathetic), but he doesn’t deliver at St. Francis, and ever since the tour I’ve kind of had my heart set on St. Francis. (It’s also where I was born.) Plus I understand Turbo OB’s caesarian rate is only 4% or so, which is phenomenal. I’m not sure what Dr. Hillcrest’s rate is, but it’s hard to beat 4%.
(EDIT: I tried to find that 4% figure again and couldn’t find it. Maybe my progesto-brain made it up? I’ll ask him at the next appointment. 4% would actually be worryingly low, from what I understand. But he is one of the rare docs around here who will do VBACs, which is not relevant to me at this time, but just shows he doesn’t mind pushing the envelope a bit to help women have the birth experience they want. He’s also happy to work with doulas.)
I keep putting off “breaking up” with Dr. Hillcrest because I like him so much (and I didn’t want to cancel the Thursday ultrasound because I still don’t know when I’m going to get set up with the perinatologist that Turbo OB referred me to), but I should really go ahead and cancel on Monday. Insurance is going to start looking at me funny if I keep bouncing between OBs, and I still have no idea what these appointments are going to cost. I have a feeling it ain’t small change. And they always take forever to send the bills, so it’s that much harder to make informed decisions.
Anyway, I had already done most of the recommended prenatal blood work just to qualify for the donor embryos, so I asked if I could just do iron, vitamin D, and TSH for now. He agreed, and my H&H was fine, vitamin D was 36 (low end of normal — I’m stepping up my supplements, and I’m going to try to spend 15 minutes in the sun around noon every day; the research I’ve done shows vitamin D is very important in pregnancy), and my TSH, all of a sudden, was 0.03! That puts me at hyperthyroid. Which isn’t that bad in early pregnancy — certainly better than hypo — but I’m cutting back my dose again, to 100 for a while to let it settle and then back to 112.
Strangely, neither doc talked at all about nutrition, exercise, what to avoid, and all that kind of stuff. I guess they assumed I already knew it? Maybe I fit the profile of obsessive researcher? I also had to bring up to both of them that I was using a donor embryo (they didn’t ask, which I guess makes sense), and both seemed relieved. A 31-year-old egg is much easier to deal with than a 37-year-old egg.
They didn’t recommend genetic testing and warned insurance wouldn’t pay for it for a 31-year-old egg. (Plus with a vanishing twin possibly contributing some of the cfDNA, results may be that much less conclusive and needlessly worrying.) So I guess we’ll have to have some faith that the small odds of genetic problems won’t clobber us and wait until 20 weeks like everyone else to know the gender.
(UPDATE: Just got the insurance notification for my first OB visit with Dr. Hillcrest. Ultrasound will cost me $150, minor blood work will cost $50. Still haven’t gotten a notification of the cost for the visit itself. Ouch. At least with Turbo OB, I’ll only be billed for a visit this time. Next time we’ll see what his ultrasound and blood work cost.)
Speaking of gender, I haven’t liked referring to this embryo — now graduated to fetus — as “it” or “he or she.” It makes me feel more removed from… it. I’ve always pictured myself with a daughter, and Ahmed feels the same way, so for now I’m just calling her “baby girl.” If I end up having to adjust, I will do so happily. Little boys are amazing, too.
Either way, we plan on raising our kid in a gender-neutral kind of way. We won’t force trucks on a boy or dolls on a girl, though of course we won’t forbid them, either — we’ll let them take the lead on what they like. But I worry that as soon as we do announce the gender, certain people will immediately begin purchasing a mountain of gender stereotypes. Ah well — there are worse problems. But it’ll be an interesting challenge.
One thing we both agree on: Our child will play soccer. Or at least we’ll do our damnedest to instill the love.
I’m also settling into the reality of not having twins. It’s fine, really. It just gives our next kid the chance to be that much more unique, and this pregnancy won’t be nearly so hard on my body or on the remaining child. (Most clinics recommend against transferring 2 or more embryos these days for that reason.) I still get a little pang every time I see twins in real life or on Facebook, but it’s OK. That’s just not our story. Our story will still be good.
One of the things that has helped me move on is a comment by a friend who’s a new father after a tough three years of trying. He said he is totally loving the infant phase, and it’s going by so quickly. He’s already looking forward to doing it a second time. And I realized — if we’d had twins, that probably would have been it. We’d have done a whirlwind double-duty infant phase, and then it would have been over for us for good.
Now we have time to really learn and focus on this one and then apply everything we learned to the second one and savor it all over again. It’s such a fleeting time, like an eclipse. Two eclipses at once — and then never seeing one again — would have been intense and wonderful, of course, but I’m OK with waiting a couple years for the next one. Hopefully not seven years, like for the next actual eclipse…
(Of course, having a toddler and an infant at the same time is surely going to be its own special kind of… intense. 😛 )
Finally, my husband and I rarely have serious disagreements. We’re pretty good at working things out and compromising and taking turns giving ground. But he put his foot down when I wanted to get a doppler fetal monitor. They’re only $40, and it seems like it can help put my mind at ease during the endless waits between ultrasounds. (Hearing a strong heartbeat at the midwife’s place let me breathe again a few days after my symptoms started tapering off.)
But he’s afraid I’ll just over-analyze every time it’s easier or harder to find the pulse, or what the heart rate is, and it’ll just make me that much crazier. Plus it’s not perfectly non-invasive. It uses ultrasound waves similar to those in a visual ultrasound, which can heat up tissue. It’s never been proven not to be safe, but the possibility remains that it’s better to limit exposure as much as possible.
So I’m trying to learn to breathe even without fancy hardware, and even when I’m feeling pretty good and not as tired or queasy as usual. (Symptoms coming and going is VERY NORMAL.) My next ultrasound is three and a half weeks away at most, and if the fetus dies between now and then, I’ll either know it right away or know it soon enough. A matter of weeks won’t make that much difference at this point. And so far all indications are that it’s perfectly fine.
And if it is perfectly fine in three and a half weeks (I’ll be almost 14 weeks by then), maybe I can start to relax for real, just a little bit.
I’ve already told a handful of close friends and family about all this, but it’s still hard to fathom a general announcement. I think I’ll need visual and tactile evidence before I can even contemplate that (i.e., a bump and feeling the baby move). And then I’ll have to figure out whether to do it at all, and if so, how to do it as sensitively as possible.
I really hope that’s a “problem” I’ll have before too long.
I really look forward to the moment when I stop holding my breath and stop instinctively clamping it off when I find myself feeling too much joy. But the joy is there, waiting to be unleashed.