Tests, Protocols & Waivers

It's obvious by now that my husband and I aren't going the "usual" route when it comes to having a baby. Our decision to put my prenatal care and delivery in the hands of certified nurse midwives, instead of doctors, has been questioned by many. "Are you sure that's safe?" No, I'm going to purposely put my life and the life of my child in danger.

Every decision we've made thus far has been in the best interest of our baby. And aside from choosing a birth center, there have been many other decisions that we've needed to make. Since I'm a bit of an oversharer, allow me to indulge you!

1) Genetic testing. When you go to your first appointment (mine was around 9 weeks), there is a slew of testing that's offered. If you want, you can find out right from the start if your baby has any genetic disorders or other things like Down syndrome. I knew that I wanted to opt out of as many of these screenings as possible. A) Tim and I have no family history of these conditions; B) We are both well under the age of 35, and yeah, I'm bragging about it (haha); and C) If it was determined our baby had some type of disorder, we wouldn't consider terminating the pregnancy anyways. Waiver, please!

Of course, I had the routine blood test for STD's, Hepatitis B, blood type & Rh factor. All were fine and I am Rh positive (which is good), so no further action was needed.

2) Ultrasounds. The birth center's opinion is that ultrasounds do not lead to better birth outcomes, therefore, they don't recommend that you get any if everything is progressing normally. We decided to just get one at 20 weeks to find out the sex of the baby. That was our choice and we were glad we did it!


Hey, little dude!

However, a protocol snuck up on us. Yes, even hippy dippy birth centers have them. It was determined from this 20 week ultrasound that my placenta was low, which can be VERY bad if it stays that way. They recommended I come back at 28 weeks for a follow-up ultrasound. I was not pleased, especially after reading that this "low placenta" condition is extremely common and clears up on its own 99% of the time. If I would have never gotten an ultrasound, this would have never been an issue. I presented my reasoning to my midwife and asked if I could skip the second ultrasound. She said "Sorry, no can do."
The next time around I will probably skip ultrasounds altogether, now that I know that wanting just one can lead to more. Luckily, my placenta moved up (as it usually does) and no further testing was needed.

3) Hep B Vaccine. The birth center does not offer this vaccine at birth like hospitals do, and that's fine with us because we're waiving it. I don't have Hepatitis B and I doubt my newborn is going to be shooting up with dirty needles in the alley way, so for now, that's one less needle prick on his first day in the outside world. It's a disease usually contracted later in life, so if he wants to get it one day, he can do so. We just don't feel that it's necessary on Day 1.

4) Vitamin K. We have the option of the Vitamin K shot or giving it to our baby orally. I can't tell you how many times I went back and forth on this one! It's pretty vital as it promotes proper blood clotting and since babies can go through some pretty traumatic things on their way out, we didn't want to risk our newborn bleeding to death. But I am just naturally wary of all types of injections, so I discussed the oral dosage option with a few different midwives at multiple appointments. The consensus was that they thought the shot was best and easiest. The only thing in the jab is a synthetic form of Vitamin K (which annoys me, but whatever). No fillers or other weird stuff though. The birth center waits a few hours to give it, so mom & baby get to rest and establish a bond. They told me the oral dosage is difficult, babies hate it, and it has to be done multiple times the week after birth. While it sounds more gentle than an injection, it would be one more thing to worry about after I left the birth center. So we're gonna stick it to him. Sorry, little guy.


I'm also going to make sure I include a lot of K-rich foods in my diet
so it's passed through my breast milk.

5) Antibiotic Eye Ointment. It's standard protocol in hospitals these days, but does it have to be? The purpose of the ointment is to protect a newborn from contracting an eye infection due to the mom having gonorrhea and/or chlamydia. So, if you know you don't have either of these STD's, your baby doesn't need his or her eyes all gooped up with ointment right after birth. I read up on this, asked my midwife if I could waive it, and she said all I needed was an extra culture done towards the end of my pregnancy to verify that I was STD free. I did. It came up negative. I filled out a little form and boom, my baby doesn't need this intervention. It's amazing what just asking about something can do!

6) Group B Strep. Another protocol the birth center follows, and for good reason. If you test positive, you need 2 rounds of antibiotics during labor. Luckily, I tested negative for this bad boy which means two things. If my water breaks early, I have a full 24 hours to go into active labor before pitocin is required, and if I go into active labor before my water breaks, I don't have to go to the birth center early for antibiotics. I can labor in the comfort of home for a longer period of time. I'm really excited. It's the small victories at this point, I guess :-)

7) Circumcision. This has been a hot topic in the news lately, mainly in San Francisco. Yes, we will be getting our little boy circumcised. Yes, we've done the research and weighed the pros and cons. I left the decision up to my husband and that's that!

8) Hospital Freebies. By going to the birth center, Tim and I are also "waiving" all the fun hospital freebies we've been hearing about. Everyone says make sure you grab tons of this and that before you leave! Well, the birth center doesn't really work like that. When I go into labor, I'm required to bring a lot of things with me that a hospital would normally provide. Example) They don't give you a hospital gown. You wear whatever you want, like an oversized t-shirt or nightgown. Also, it's BYOP. Bring your own pads. And food. And beverages. And anything else you want. Of course, they have all the necessary medical supplies - it's not like I'm going to give birth in a cave. They just don't have agreements with big companies that give out thousands of samples like hospitals do. You definitely won't be going home with any formula samples, either. They are very pro-breastfeeding. In fact, I think Question #1 at my first appointment was, "Are you planning on breastfeeding?"

If you want to be fancy, Etsy sellers have homemade hospital gowns!

So there are our choices & testing outcomes all laid out for you. I LOVE the fact that we were able to opt out of things we didn't feel were necessary. For two leos, having control makes us moewy happy. Yes, I just said that.