I have a lot of conflicted emotions about medical care and for anyone that looks in through a window at my life, I’m sure they would be confused as well.
For starters, I work in the medical field as a registered nurse. I work with doctors, surgeons, case managers, social workers, physical, occupational, and speech therapists, dietitians, radiologists and so on and so forth. I seem to baffle a lot of my co-workers when I divulge the fact my first two children were planned to be born at home, in the care of midwives, given the fact that I should know what “could” happen and all that jazz.
If I’m being honest, I’m happy to be planning a hospital birth this time around. Two failed attempts is enough for me and while I support it wholeheartedly for other women, I’ve come to the conclusion that it’s just not for me. I wish it was.
This is the first pregnancy I’ve been followed by an OB, from the beginning. The OB that delivered Hooper was fantastic, fully knew and supported the midwives I was working with, and did a fantastic job navigating Hooper’s tumultuous birth (though I’m still against induction despite the fact I know it’s necessary at times — I blame much of the decline in Hooper’s birth experience on the pitocin I was given).
During my pregnancy with Van, I had to chose a different back-up OB (the previous OB suffered a sudden death heart attack, which hit many in the OB community like a ton of bricks). I met with the new OB one, maybe two times. Because Van’s birth involved an ambulance transfer to the closest hospital, the OB that actually delivered him had never met us before (and to-be-clear by delivered, what I actually mean is pushed on my belly until his 9.8 pound body literally popped out — it was, um, audible). Point being, I’ve had OBs that have had to intervene along the way, but this is my first pregnancy where I will have been seen by the same OB from beginning to end, and more-or-less, only by him (I can’t help but think as I type that how ironic it would be if he couldn’t make my birth for some unforeseen reason and baby #3 ended up being delivered by yet another, new-to-me, OB. Hashtag: funny not funny).
So in a sense, I’m merely jumping through the hoops this go-around. I’ve had more ultrasounds in the first half of this pregnancy than I had combined in my pregnancies with Hooper and Van. I’m taking my first ever glucose screening test (I opted not to with the midwives because I was checking my blood sugars regularly at work and knew that if anything, my sugars were running on the low side of normal — therefore ruling out gestational diabetes).
The one thing I did turn down was the genetic testing and that’s based on nothing other than the fact that finding out the results of the test would have no bearing my decision to go through with the pregnancy.
I had my first ever ‘comprehensive ultrasound / anatomical screening’, which I was surprised to learn is not performed by regular OBs but by perinatologists instead. The very definition of a perinatiologiat, by the way, is “a physician that works in conjunction with a patient’s obstetrician when pregnancy complications develop and is able to provide care for both the mom and unborn baby”. My eyes were already rolling before I even made the appointment because I understand the absurdity in involving a physician who deals with complications being involved in the care of an individual experiencing an uncomplicated pregnancy. But, alas, the hoops — I’ve agreed to jump through them (almost entirely for Willy’s sake; as he was rather traumatized from the first two births).
When I arrived at the perinatologists office, the receptionist pointed out where the bottles of water were; they sat on a fancy mirrored tray above the magazines that included none of the trashy stuff I only pick up in doctor’s office and in line at the grocery store, but instead “Travel & Leisure” and other sophisticated crap my burnt out brain cells didn’t feel like picking up. The sofa was oversized and included a large velvety blanket that I presume was there in the event anyone felt like cuddling. Point being, it felt very spa-like. Very pampered. And this experience continued as I was shown to my room, which was dimly lit with a desk at the window like you would find in a hotel room; a desk I’m sure no one has ever sat at with a small cup of pencils I’m sure no one has ever written with. At the sink were special soaps and lotions and a basket of hand towels. I sat back in the large chair, with my feet up, and watched the ultrasound on the big screen tv placed in front of me. I was a bit disappointed the chair didn’t have one of those massage mechanisms like they do at the manicurists. I’m being facetious.
It’s funny because sometimes I want to remind the very patients I care for in the hospital that they are in fact in the hospital, because of medical necessity no less, and not in a hotel. But I found myself on the flip side, wanting to remind the staff that they are indeed in a medical office and not some kind of massage pallor. It made me question further if any of this were necessary as I assume things that are necessary contain less fluff and more, I dunno, latex gloves.
In any event, all checked out fine. I closed my eyes while they checked out the baby’s goods and met with the doc at the end who summarized the findings; “My only concern”, he said, “is the baby’s size. You’re measuring a week ahead of where your dates put you”. He went on to suggest I have an additional test done to rule out gestational diabetes (because gestational diabetes accounts for larger babies). We then had a conversation about the birth weight of the boys (Hooper was 8.15 and Van was 9.8) and how neither of those involved any gestational diabetes. He also confirmed that birth weight has a genetic component (both Willy and I were 8+ at birth). And despite all the exchange of information, and this is the part that makes me hate the medical field, he wrote me script for the additional gestational diabetes testing and said he’d like to see me back, at 32 weeks, to “see how the baby is growing”.
Surely at 32 weeks the baby will be growing. It isn’t rocket science. It also doesn’t take rocket science to make the prediction that I will be carrying another large baby. The best indicator of the future is to look to the past, after all. I also know that ultrasounds later in pregnancy are less accurate due to the fact the baby is taking up more room. Sometimes they say weight can be plus or minus a pound, which is pretty substantial when you’re talking about a being that is only a handful of pounds anyway. And what’s it matter? It bothers me that women are not trusted to birth babies anymore; that so many are encouraged to go down the planned c-section path or the planned induction path (and while I have no judgements toward woman that chose this path, I do have judgments on practitioners that lead their patients to this path based on some kind of instilled fear). I have no doubt that this baby will be big. I also have no doubt in my ability to work with my doctor to get it out safely.
I could go on and on. I could even jump over to the other side of the coin and defend certain arguments from that side as well but all in all I think the take home message that I want to remind myself is this: Trust your gut. The care you receive is at times reflective of the larger population and fails to take the individual experience into account. Be your own advocate and ask questions that force your practitioner to see you as an individual.
And so, thus far I haven’t had many, if any, questions for my OB. I spend more time waiting for my food at the drive-thru window than I do in his office for an appointment. But when I did ask about the baby’s weight and his confidence level in delivering a big baby, he more or less shrugged off my concerns, boasted about the 9 pound baby he delivered that morning, and before-I-knew-it I was back in my car, on my way home.
I miss the care of midwives. I miss having my belly measured and touched. My OB appointments are exactly the same: pee in cup, stand on scale, check blood pressure, wait a minute for doc, doc comes in and asks “any bleeding, cramping, discharge, headaches?”, performs an ultrasound and listens to the heartbeat for maybe 7 seconds, asks if I have any questions, and I’m dismissed.
I remember listening to Kevin & Bean on the radio talk about that show ‘I didn’t know I was pregnant’, about women who actually go into labor and deliver a baby having never known they were even pregnant. They talked about how surprising it was that a lot of these women birthed healthy babies despite the fact they didn’t receive prenatal care. I’m not so surprised; prenatal care thus far has not impressed me. I feel like a cow being led through a corral.
Would love to hear from any mamas out there that also birthed big babies. I have a friend who birthed a thirteen pound baby at home and I always channel her in my pregnancies. Would also love to hear from any others about their prenatal care / OB experience.
When I was pregnant with Van I felt a certain amount of trepidation, like adding another child was going to somehow compromise the love I had already established for Hooper. I guess the love for a first born is like that, would you agree?
