Both of my children were born at 37 weeks gestation. I had gestational diabetes with both, preeclampsia with my second, and was induced early both times. I was lucky that my gestational diabetes was diet controlled (I plan to make a post about eating for gestational diabetes!), and the preeclampsia occurred late in pregnancy. My first was a surprise induction, but my second was planned, which was a much nicer experience. I want to share my birth stories, and why I chose a different provider experience for my second birth.
The Surprise Induction
With my first, my son, I was induced immediately following an ultrasound at 37 weeks. I was completely caught off guard and did not have a hospital bag packed or a car seat installed. I was very upset about being told I needed to be induced right then, and the reason was not explained clearly to me. I was admitted to the labor and delivery room near midnight. Luckily, my body was very responsive to the cervix-ripening agent (I didn’t even get to the pitocin), and I started having contractions overnight, which got stronger and closer together very quickly. I tried to go without pain medicine but requested an epidural when things got too painful (apparently the midwife told my husband from the start that she expected I would need an epidural for this delivery). I pushed my son out in the morning in about 30 minutes when I was sufficiently dilated. The epidural was great. It allowed me to rest before pushing. I was still able to feel the contractions when pushing. Recovery was somewhat difficult. I felt pain in my stitched perineal area for well over the usual 6 week recovery time. At my 6 week postpartum visit, which was conducted virtually, I mentioned the ongoing pain, and the midwife said that was fine and that I could start having sex. That’s all the postpartum “care” I got.
The Planned Induction
With my daughter, I was diagnosed with preeclampsia at 36 weeks, which meant my induction was planned for 37 weeks. I loved having a planned induction! We casually strolled into the hospital at 9am (read my hospital bag checklist), got checked in immediately, ate some breakfast, and started pitocin. I was a bit apprehensive about using pitocin since I never got to that point with my first baby, but it worked out just fine. I was already 5 centimeters dilated when I arrived at the hospital! My nurse told me that since my son came out pretty quickly, and since I was already so dilated, I’d probably have my daughter by lunchtime, and she was right. I got an epidural about an hour into labor. This time the epidural did not help as much with the pain, and labor felt like a bowling ball was falling out of my pelvis. I will say that feeling the pain helped me pace the pushing, and while I had a second degree tear with both births, my recovery the second time around was much easier. I stopped taking pain medication within 12 hours of giving birth to my daughter.
Choosing a Provider: From Hospital Midwives to a Small OB/GYN Practice
I’m not making any statements about midwife or OB/GYN practices, just sharing my experiences with both. I chose a hospital-based midwife practice for my first birth because I read that obstetricians pushed C-sections, and I wanted to have a vaginal birth for an easier recovery. At the same time, I wanted the option to have an epidural and access to physician care if I needed it. The midwife practice I chose had glowing reviews, and I thought it was the best of both worlds to have midwife care and hospital support. However, it turned out not to be the best choice for me. I did not feel like I had the level of expert care or trust in my providers that I needed when my case got complicated, and I didn’t get the warmth that midwife care is known for. My prenatal visits were in a hospital setting, and it was a revolving door of midwives; I never saw the same person twice. For my second birth, I chose a small, office-based OB/GYN practice. The continuity of provider care in the small practice was so important to me, and no one pushed a C-section. I will say that I could not have known my preferences going into the first birth, and I have no regrets about going with the midwife practice for that one. Even if it wasn’t perfect, I still generally got good care and had a healthy vaginal birth like I wanted in the end.
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