Wednesday, October 1, 2008

Trust in Pregnancy and Birth? Definitely NOT the American Way...

First I have to say, HAPPY BIRTHDAY TO MY AWESOME MOM, I LOVE YOU & LOOK FORWARD TO CELEBRATING WITH YOU SOON!!! Sorry you had to work all day :(

Sorry this is such a long post, but I have a LOT to say on this one... Let me preface this by saying that I am not a doctor writing this and it is not meant as advice in any fashion or form, these are simply the rantings of a pregnant woman, hormonal, surprised and freakin out that any day now I will be welcoming the arrival of a precious human who will be dependent on me 24/7... And- this precious human has to make the journey out of ME, and I do not even have my entire birth kit ready or the plastic for my bed or... AHHH! So amidst all of this, this week, my precious husband and I have our first appointment with an OB/GYN. Some of you who may not know me or my paradigm are surely freakin out at this point, "What?! Only a few days left of your pregnancy and you have never seen a doctor?" I know, what a freak I am! But, before you get too carried away about what a crazy mother I am, I will say that I have seen a chiropractic doctor (who actually takes more hours of schooling than the regular MD) twice a week at least, and I have been seen by a licensed birth provider throughout my entire pregnancy. Yes, we chose to use a midwife to care for us throughout our pregnancy. And, I know I got a lot more care from her than I would have the average doctor. Considering that I saw her following a regular pregnancy schedule (just like an OB would have scheduled visits, but starting earlier in my pregnancy) and my shortest visit with her was an hour. Compare that with my friends and patients who see OBs- they usually report seeing a different provider each visit (often a nurse or different doctor than the one who will attend their birth) and that each of their visits only lasts a few minutes. I could go on and on, but this post is about my report of my doctor's visits. Everything I am ranting about is backed up by research, and not just my opinion, so feel free to request a copy of it if you so desire.
So why did we choose to visit an OB at all? Well, if you know my A-type personality, except for when it comes to cleaning/organizing my house :), you understand that should the need to transfer/transport during my pregnancy/birth arise, I do not want to meet the doctor then for the 1st time. Therefore, we chose to go in for a consult this week. Now I know first hand how my patients and friends feel when they have to stand up for their beliefs and justify themselves. It is especially not fun when you are pregnant and hormonal. As we walked to the office, I commented to JB about how much I dreaded explaining why I did not want an ultrasound or a vaginal check. We also laughed at how the doctor's face would look when he asked me why I was seeing him... See we know that normally he meets patients at this point who have problems like low iron counts, babies with positional issues, high blood pressure and so forth. Me on the other hand as his new patient: I have only gained 20 pounds, my iron levels have been rather high, my blood pressure has been 120/70 at its highest, and I have done prenatal yoga and weight class 1x/week at least. I am in better shape pregnant than when I am not; but, can you blame me- it is what I preach and do for a living! I have lots of people watching me, I better behave!!
The office was really nice, and the staff and doctor were great! However, let me tell you my problem: I am so saddened by the fact that what I saw yesterday is a better than normal version of maternity care in our nation. I have a lot of respect and appreciation for the doctor we saw yesterday. He has blessed my business and my patients with his care and support. But, he is still a medical doctor in a severely erroneous paradigm! And, had you been there you would have probably seen nothing wrong with the picture I am about to paint, unless you have had maternity care by someone other than a typical OB or have done your research thoroughly.
After the usual paperwork, the visit began with a question from the nurse before taking my blood pressure, "Have you ever had an abnormal "x" test?" To which I replied, "No." She answered, "Great!", and ran off to her desk. JB looked at me and laughed, see my "x" tests have never come back abnormal because I have never had one. Again, this is a whole other discussion for another day... Next came by blood pressure reading- done while I was talking with a digital cuff. Both of these can make the test inaccurate. My reading that day? 130/90! My complete medical records sit in my chart showing how abnormally high this is for me, but nothing is made of this. The one thing that should have been an issue was not! Oh well, taken later with a normal cuff and me relaxing, it was back to normal. Next comes our wait for the doctor. If we complained about this part, our patients would laugh at us because this is a common occurrence in my own office, one I can NOT fault this doctor for. So, we waited patiently without complaint.
Finally, in comes the doctor. The first thing he asks us is about how we got into running our birth center and how that is going. After some chit chat he comments on why I am in to see him and that hopefully I will not need him after this one visit, but that our track record has not been that great as of late as far as the birth center is concerned. Again, JB and I had a good laugh about this later... What he was referring to is that he has received a lot of referrals from us. I would not laugh about this as a bad track record. After all, midwives are supposed to care for NORMAL pregnant women. If they deviate from normal, it is our responsibility to catch this and send them out for doctor evaluation. I think the fact that we have done this routinely is a great track record! I would not want to go to another midwife who does not practice within their limits and not do this. Plus, can you even consider it a track record if we are referring out for things we have no control over? Anyhow... Then comes the doctor addressing the fact that we desire to have a homebirth. Again, take your time to freak out about how I am endangering myself and my child if you do not know me or have not done your research... He then says that if asked his opinion (which he was not because I already knew it- remember this is what he does for a living) he would tell me that hospitals are where everyone should give birth. Hospitals, after all, are the safest place to be because there are always emergencies. Well thank God He invented hospital and created medical doctors before giving us the right to procreate because after all, IT IS SOOOO FREAKIN DANGEROUS TO DO WHAT MILLIONS OF WOMEN HAVE DONE SAFELY OVER THE YEARS UP UNTIL RECENTLY!!! Again, if you want the research, just ask me, but only recently did women start seeking out hospitals/doctors for pregnancy care and birth. So we shook our heads yes that we understood. He asked if I had any questions, and when I did not, he told me he felt like he should be saying more but since there was really nothing else to cover after going over hospital procedures with us, he would listen to my baby and measure me and let me go. As he laid me down and approached my tummy, he asked me when my last ultrasound had been. I told him at 6 weeks of pregnancy. He asked me why, and I told him I had had a lot of bleeding then and the only reason we chose to do that one was to make sure the baby was okay and I had not miscarried. Then, when everything was normal, we agreed not to have anymore unless an issue came up in which we felt we needed it. The baby's heartbeat and movement, my measurements and weight have all been normal up to this point so we have not needed another one. He gave me a weird look and asked if I was still opposed to having one. I told him I was because everything was normal. Again, the research on ultrasounds is something that we rarely look at- they are not, contrary to popular belief, proven without a shadow of a doubt to be totally safe. And, like I tell my patients, it is just like our x-ray machines- I am so glad we have the technology when it's needed, but it's not something that I want to use to take fun pictures with everyday just to see. I'll be brief and just say that many inaccurate reports come back and stress moms out from ultrasounds, some research says that they cause hearing issues for the baby, cause cells to divide very rapidly (potentially increasing cancer risk) and the radiation they produce is equivalent to having 250 chest x-rays. So we were not being dumb when we chose to only have one, we had good reason! When he checked the heartbeat, it was normal. Next came the uterine measurement. This was totally different than with my midwife. She will first feel my bare belly and then take quite a bit of time measuring. This is a crucial part of maternity care! Feeling a mom's belly tells you a lot about her fluid amount, baby's position, and her growth. Doctors do not feel bellies a lot because it's not something they are routinely taught, believe it or not, and they do not put a lot of weight on this because they have ultrasound technology. Now you tell me, which is more accurate when it comes to weight and volume evaluation- feeling and holding someone or looking at a picture of them? So I moved my shirt out of the way, and I was going to let him move my pregnancy band on my pants so he could measure accurately. He quickly measured over my pants, and the tape measure was loose. Then he asked, "How big is this kid?" I replied, "Last week they estimated with palpation (feeling my belly) that the baby is at least 5.5 lbs." He looked at me with doubt and shock and said, "Really?!" I did not tell him 3 midwives had been at that particular prenatal visit and all 3 felt my belly and guessed in their heads before all saying their measurements out loud and getting the same guess. I'd say that's pretty accurate! But, with the look on his face, I said, "Why, are you measuring me smaller or thinking the baby is smaller?" He said, "What did they measure you at?" I laughed at this reply, it reminded me of someone saying, "No, I'm not telling you what I got, you go first!" So I said, they got 35.5 centimeters for 36 weeks (2 centimeters either above or below your week of pregnancy is considered normal). He then said, "Well, I got 34!" So I politely replied, "Well I am seeing my midwife this week, and if I have lost weight or measure smaller I will have an ultrasound done to make sure all is well. We then thanked him for everything and left.
All of this ranting to say, I thoroughly appreciate wonderful doctors who will even consider seeing patients who are choosing a different route of care, especially seeing them this late into the pregnancy. But, it is just SO sad that this is considered normal! Oh, we were also reminded to do kick counts all throughout the day to make sure the baby is ok. Question: Why can't moms be congratulated on having a wonderful pregnancy and taking care of themselves?! Why do we have to make them dwell in fear, waiting for something to go wrong. After all, pregnancy is NOT an illness like it is routinely treated. Thank God it is a blessing and a wonderfully normal event because were it not one of us may not be here!! Why can't we use medical doctors like firemen? If there is an emergency, I want them there, but if I used them on a routine basis for regular situations, I have a feeling there would be many more problems created out of what would have been normal. Do your research!!

10 comments:

Hannah said...

wow! so if this doesn't get my blood flowing! I am not ready for these battles! its why I am working to be a midwife! I am impressed for you going to see them anyway..you are a better person then me! and i agree thank God for Doctors..I just don't get some things! And congratulations on a amazing pregnancy!! you are an inspiration to many!!!

Michelle said...

Girl, do you need to borrow my Rescue Remedy?!? LOL!! (or Peach Schnapps!! ;)lol!) I think you already know you're preachin' to the choir here. I've lived it and have the battle stories to tell - but uh, you already know that! How sad though that for YEARS women used only midwives and it wasn't until the doctors and their fear mongering became involved that birth then became a "medical" issue. It's also sad (and a little infuriating) to think the majority of women truly believe that they can't have a normal, healthy birth without a doctor present.
The only thing I fear about birth now (besides excruciating back pain that is!) is having to be transported. Ken would come unleashed on somebody, I just know it!
Hey, I'm jealous too - you still get a whole hour??? Wow, you must be some sorta special! ;)

neveraim said...

Most people wouldn't know that anything was wrong with this visit because most people see doctors that are soooo much worse than this. I have seen two of my clients schedule c/s after listening to the negativity from OB's time after time. They drop subtle hints here and there that something is wrong, etc. One lady was planning a homebirth VBAC. Her doc. found out and called her...talked her into 'attempting' her VBAC in the hosptial with him attending. I went with her to her 36 week visit. He did a vag. exam and told her that she was not dilated. Since her cervix was unchanged at 36 wks, it was not ripe...she would not go into labor on her own. She cried after that visit, feeling defeated. I did what I could but it didn't change her feelings about the situation. She believed him.

So, I guess they can add {cervix not ripe at 36 wks as a valid reason to do a c/s}

Cindy...you are going to do great. If you need to transfer...which you are not...then you'll be going to them because you need them...certian compromises come with that...but you know that. You can't go in ready to fight because you are on their turf. You hold to the things that are really important to you and let everything else go. They 'think' they are doing what's best for you. I have to believe that. It's the world they live in and they have learned to pass their own fears of liability on to the patient. You have such a great network of support and that's what is going to make a difference in the end. And even when you have to live in their world for a little while, you can always come back to ours...It's cool, because when you parent the way that we do...you get to connect with your baby even if birth doesn't go as planned.

I'm praying for you and sending happy, calm, relaxed birthing thoughts... It's time to clear your mind of all your fears and let your baby know that it's safe to appear. (hey, that almost rhymes! haha)

Love you guys!

lsprad said...

Oh Cindy---the things we know and wish everyone else did too! It is hard when we experience first hand what we know to be true of maternity care in our world today. We just gotta keep fighting the good fight--and trust that what WE are doing, is making a difference, one birth at a time!!

feltsdia said...

Wow...step down off of that soap box before your blood pressure really does go sky high! I love how God has educated you. He gave you this vision long ago and you had no idea how it would manifest! Look at you! You got your chosen career path and a husband all in one! You are blessed! I cannot wait to see this gorgeous bundle and look forward to watching you guys be awesome parents!

Superstar Kids Preschool said...
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Adam, Hilly and Wes said...

This is why I was excited to hear about you having a blog! I am not quite so eloquent as you, but my feelings for things like this are just as strong! Thank you for saying what I would love to shout to the world! You are an amazing woman!

Whittney said...

It's so nice to hear someone else that is unafraid of birth and the process! I felt like I had to explain myself my entire pregnancy...and it's tiring and lame. You need to send this OB your birth photos and show him what a safe birth really looks like. You're gonna be awesome! Had fun last night...thanks for the invite!

The Anderson's said...

Hey Cindy, This is a very encouraging post. I have been experiencing some fear about homebirth recently and thinking I need to hear from Cindy and others about why homebirth, with a midwife, is such a wonderful, lovely life-giving experience. This was a great reminder. Your words hit the spot. Praying for your delivery to be sweet!!

amsayers said...

Cindy, that was just terrific. I was "amen-ing" the whole way through. And as you know, we had our twins at your birth center, naturally (or should I say supernaturally!), not a doctor in sight, and I had the birth of my dreams! As you can imagine, everyone I met while I was pregnant looked at me like I had three heads when I told them I was having the babies naturally with a midwife (well, actually there were umpteen midwives there, but we were having two babies!). It never ceased to amaze me how people reacted. They'd comment on how they'd be terrified to have a baby naturally, much less two babies, and all I could think was that I would be terrified to have them un-naturally! If I would have seen an OB we would have had a c-section, guaranteed. Especially since Annelise was breech. And yet our birth was nothing less than perfect. I can only imagine the horror story I would have to tell if we had had them in a hospital.

And listen, I've done this a time or two, you are going to do great! Just trust your body, the process, and most of all God. It is going to be a beautiful birth ending with a beautiful baby. And remember, you have to get good at this if you're going to have twelve! :)