My Pregnancy Diary Week 11 & 12

So in this week's edition of my pregnancy diary you can look forward to hearing about how we got from week 10 to week 12 in one week, about my thoughts on gynaes and GPs, my doctor's response to my plans to give birth at home, what I'm doing with my toddler to get her used to the idea of a sibling, and one or two other thoughts related to planning a home birth.

I know the heading says week 11 and 12 of my pregnancy diary, but this time it is not due to procrastination and busyness, but rather due to my deliberate vagueness on due dates and the like, in combination with a good dose of pregnancy porridge brain. So all that means that I am actually now at about 12 weeks, not about 11 weeks as I thought, which is actually quite cool as it is one less week to worry about in making it to that golden 12 week milestone.

So what that means is that baby is now 5.4cm long and weighs just under 14g.

So this week started with my 1st trimester checkup, which was rather eventful! First of all, we (the good doctor and I) established that I was a week further along than I thought. If you're wondering why this whole 12 week thing is a big deal, after 12 weeks your risk of miscarriage is only about 1%, and many people only start making the news of their pregnancy public at 12 weeks for precisely that reason. So consider the news public!

Most miscarriages occur before you even realize that you are pregnant, but at 6 weeks pregnant your risk is about 15%, at 8 weeks it is 3%, and at 12 weeks it is about 1%.

So, even though I'm hoping to have a homebirth, I still need to go to a doctor for various checkups. As I mentioned in a previous post I feel that automatically going to a gynae is not only financially debilitating (Over R700 for the first consultation at one of the local gynaes), but, in my humble opinion, a bit like calling a paramedic when you have a cough. I remember feeling a bit cheated with my first pregnancy. Each (monthly) 15 minute appointment (in 2008) cost R330 (divide by 7 for the dollar price). During those 15 minutes the doctor checked my blood pressure, weighed me, palpated my belly (prodded around), and asked one or two questions or mentioned one or two bits of advice. One piece of advice was to buy a good book on pregnancy and the other was to go to antenatal classes.

...pregnancy is not an emergency, or a disease, or a complication

When I went to my GP, because I thought that R330 was a bit exhorbitant, he did all that and a urine test, which is actually really important for early diagnosis of some pregnancy complications. And my GP appointment cost half of what my gynae appointment did. So anyway, I am not 'anti-gynae' but I really believe that they are trained to deal with emergencies and complications, and I also believe that in the vast majority of cases pregnancy is not an emergency, or a disease, or a complication. The unfortunate thing is that on the whole, GPs can no longer deliver babies because the insurance costs are just too high.

So fortunately in the town where I live we have something that resembles a solution. We have a GP practice that delivers babies. They have become known for delivering babies and so many ladies come to them for that purpose, which means that they can make it worth their while on the insurance side of things. So, I went to one of the doctors in that practice for my 12 week checkup. (If you know me and you do figure out which doctor I'm talking about, please keep it to yourself!)

I dropped the H-bomb, I told him I wanted to give birth at home. His response: (I quote) '100 years ago 50% of women died in childbirth.'

So I told him the date of my LMP (last menstrual period) and we worked out my due date. I told him about my previous pregnancy and the birth of my daughter. And then, I dropped the H-bomb, I told him I wanted to give birth at home. Now his partner is apparently used to working with the midwife I'll be going to, but this chap is new in town and may have not been updated because, despite the fact that I am about as low-risk as they get, he told me he advised against it. His main reason was, I quote: '100 years ago 50% of women died in childbirth.'

Poor chap, I thought, I should come with a warning.

Poor chap, I thought, I should come with a warning. Things had been going really well until then. The fact of the matter is, from about 1850 to 1930 the maternal mortality ratio in England and Wales hovered between 3 and 5.4 per 1000 live births. (1) Maternal mortality means that mothers died while giving birth, just after birth, or in the days after the birth. This is a very high statistic by today's standards, but certainly nowhere near the 500 per 1000 live births (50%) my doctor seemed to be referring to. The only statistics available earlier than this in England are concerning midwives in private and dispensary practice, and they had ratios of between 1 and 6 per 1000 live births, with some recording ratios of less than one per 1000. (1)

Those who gave birth in hospitals were far more likely to catch puerperal fever due to unhygienic practices, compared to those whose births were attended by midwives.

The funny thing is that around the 1900s the maternal mortality ratios were much higher in the wealthier areas. The reason for this was that the wealthy were the only ones who could afford medical practitioners and 'lying-in' hospitals. Those who gave birth in hospitals were far more likely to catch puerperal fever due to unhygienic practices, compared to those whose births were attended by midwives. And before the mid-1930s puerperal fever was the cause of over 40% of maternal deaths. (2)

Granted, he may have been referring to the lifetime risk of maternal mortality, i.e. of all female deaths, 50% occurred during childbirth or as a result of complications of childbirth, but today, even in the poorest countries the lifetime risk of maternal mortality is 1 in 6. (3)

I was thinking to myself that I should change doctors. Then I thought, maybe I should try changing this doctor.

So while he was telling me what a bad idea home birth is, I was thinking to myself that I should change doctors. Then I thought, maybe I should try changing this doctor. I don't know how to say that in a way that doesn't sound arrogant, but I do believe in informed choice, and I believe that planning to have a home birth is an informed choice. I'd like to help him understand how I came to that conclusion; because it seems that he hasn't had access to the information I have had access to.

So I'm busy collecting evidence of how home birth is as safe as (if not safer than) hospital birth for low risk pregnancies, which I hope to be able to relay in as humble and un-cocky way as possible. I think that will be that hard part, as I do sometimes tend to get a bit 'insistent', to put it politely.

Anyway, I promised I say something about what I'm doing to get the toddler ready for a sibling. I know it may seem a little early, both in terms of the pregnancy and the fact that the toddler isn't yet 2, but I can't help it!

We wash the baby, tickle the baby, kiss the baby and sing for the baby. And the baby gives the toddler a high 5 in return...

Our main baby-bonding time is in the bath. I mentioned last week that she knows the baby is in my belly and she knows it's little. So what we do is we 'wash' the baby (we wash my belly), and we tickle the baby (we tickle my belly), and we kiss the baby (you get the idea) and sing for the baby. To make things a bit more interactive, the baby gives the toddler a 'high 5' when she puts her hand gently on my belly, or at least the toddler believes the baby gave her a high 5.

Oh yes, I knew there was something I forgot - the belly pic. Hopefully we'll have it ready for next week...

So that's my pregnancy diary update for this week! Apologies for the marathon reading session. For someone who appreciates brevity, I'm not very good at it. Let's hope I do a better job with Week 13 of my pregnancy diary.

References:

1. Loudin, I. 1984. Maternal Mortality: an historical audit. Journal of the Royal College of General Practitioners. 34:585-588. Click here to go back to where you were.

2. Loudin, I. 2000. Maternal mortality in the past and its relevance to developing countries today. American Journal of Clinical Nutrition. 72(1): 241S-246S. Click here to go back to where you were.

3. Ronsmans, C. and Graham, W. 2006. Maternal mortality: who, when, where, and why. The Lancet. 368(9542): 1189-1200. Click here to go back to where you were.

New! Comments

Have your say about what you just read! Leave me a comment in the box below.