Monday, March 31, 2008

Big Baby and the tentative birth plan...

So my supposedly-going-to-be small baby is it turns out, still measuring two weeks ahead! 98th percentile for a 30 weeker.

Then again, all my boys get straight 90s! (says proud mama....chuckle)

My placenta has great blood flow, the PI (pulsatility index) is nice and low, my right umbilical artery is not as great as the left, but still both are okay. Seriously, for a woman who makes sucky placentas and rarely gets a live baby---this heparin therapy has been a miracle. A really amazing miracle. I don't care how many shots I have to take, I have to believe it's making a difference. As for other concerns, my blood pressure is fine, (I didn't see any relatives this weekend-coincidence? Who can say?) only trace protein in the urine, the head is down, lots of movement, and damn this baby is cute! He was smiling at me today, and has already grown nice big cheeks, just like his brothers had.

Oh, I can't WAIT for this kid to come out!!!! 10 more weeks will kill me, and 8 weeks will be hard enough to manage. Human gestation is just way too long if you ask me. We should make God change it or something. I've never been good with waiting. 2 week waits always killed me, well, this is like----arghhhhh.

Anyone have a time machine handy?

That said, I am now a babbling fool because I am worried about two new things. I actually don't want to repeat Mac's experience when I went into preterm labour at 32 weeks. Between the dilating, and the funneling, not so fun. Even more ridiculous? The resident who examined me had the LARGEST hands ever recorded in the history of humanity. He kept saying that I was only dilated a fingertip, and I couldn't help but point out that a. Fingertip dilation is still not good at 32 weeks, and b. So large were his appendages, that his fingertips were the width of the average person's hand. Not.even.kidding. So really? I was probably dilated a hell of a lot more. Still taking prometrium in hopes this is keeping my cervix closed.

Next babble? Which doctor I'll get at my labour & delivery. I am stressing about this because I am control freak, I don't want Dr. A at the high risk practice, who is a total asshole, but I like my OB and the other high risk guy as well as a few of the regular OBs. I want a Doctor who knows high risk but doesn't think that means we have to throw every single piece of technology at a problem. My OB is wonderful, and gets this, but do his colleagues?

It's not a zero sum game, as I've argued before.

It is possible to have a live baby and a regular vaginal birth, even *gasp* a nice gentle one. Silly me, I'd like to avoid PPD this time. I'd like to avoid PTSD this time. I'm hoping that even if I do end up needing every single medical intervention on earth---I'll get treated with kindness and decency and people who show me some consideration, and not just run me over like a Mack truck.

First request: if even one person treats me like a weirdo or a trainwreck or a medical horror story, I swear I'll lose it. I might BE a medical horror story, but they can suck it up and pretend I'm normal, but slightly in need of extra consideration, right? Staring, whispering, and pointing are uncool. If they have a question, and I'm not in the middle of a contraction, they can ask me to my face.

And as for what they say to my face? I will resent deeply if anyone tries to imply that they are more concerned with the safety of my baby than I am. You know? The old threat, "Well, we're only suggesting this because our priority is saving the baby. You don't want to risk the babies health, do you?"

Seriously, can you imagine anything more insulting to say to any woman, never mind a woman who has delivered dead children already? As if my only priority is to schedule my post-birth plastic surgery and fuck the fate of the baby. *eyeroll* And yet, nurses and doctors regularly say this to patients to bully them into doing whatever the medical staff wants. I mean, come on, like they are actually affected more than we are after a baby dies? Sure, maybe they get upset for a day or so...but in the end, they go back to their families and living kids---and we go home with empty arms and coffins.

I don't have any medical need for a c-section for example. And unnecessary c-sections have a higher rate of fetal death than vaginal births. If I actually do need it, say if the baby goes into distress, or is stuck, I'll happily do my own c-section with a rusty butter knife in a swamp....but if I don't have a medical need and I can do a vaginal birth, which I've done before, then why the hell not?

Can we not "right-size" the medical interventions? Just give women what they need without the whole damn menu thrown in?

Like---I've been positive for Group B Strep so I want my IV antibiotics in the parking lot, because there is a risk, but I'm okay to wait for the epidural until I'm having regular contractions a few minutes apart. I've done this before, I'm not as terrified as I was the first time around. I know that all those TV shows showing screaming women falling to floor clutching their stomachs are BULLSHIT. I'll be okay until round about 5-6 cm...then I'll break Mr.Cotta's hand.

Another point: I am very susceptible to infections, so if I actually need a urinary catheter, (and most women don't, it's just standard practice to stick them in us) then I'm bringing my own pediatric sized silicone catheters, a whole box, and donating the rest to any other poor woman who needs 'em! Silicone because it's 90% less likely to result in a UTI or urethritis, or a damaged bladder due to retained urine than the standard plastic/rubber combo. Why pediatric sized? Because I may have a vagina capable of pushing out a 9 pound baby, but I own a very very tiny urethra. Very sensitive. So sensitive that if I was in charge of licensing doctors in this country, I would make it a mandatory law that all Doctors be forced to get an oversized foley catheter inserted and then removed with no anesthesia. Let me tell you---those fuckers would think twice about ordering them on patients if they had to feel that kind of exquisitely searing pain. Guantanamo has banned catheters as a form of torture, yet Docs order them everyday for no reason other than tradition. Anyone see an issue with that?

Episiotomy? Nope, I do not consent. There is literally no medical evidence they are ever useful. They are Western medicine's version of female genital mutilation. They cause incontinence, sexual dysfunction, infection, and traumatic healing. And they don't save babies.

Anyway, like I said, I don't want a c-section, but if it's medically necessary, I consent, well, same with god forbid, a hysterectomy. With my history of retained placenta, it is a possibility and so, if AFTER every single measure has been taken to avoid one, yeah, you can do it, but only if the Doctors realize that I would consider it mutilation to lose my uterus. I would mourn the loss of a body part. Especially because by the time they are removing my perfectly healthy but lazy boggy uterus---my husband will be holding my perfectly healthy live son in another room. So tell me peeps, what could be the point? I see none.

And I would actually want to die, but only after suing their asses, if a Doctor ever took my perfectly healthy ovaries. Except for cancer, there is almost never a medical need to take out ovaries. I've lived through sudden premature ovarian failure. I would rather kill myself than ever go through that again. For me, it really is that bad, no I'm not being facetious or funny for the sake of anyone's amusement. I plan on taking HRT until I'm on my deathbed at 101. It keeps me sane, but only because I still have some form of working ovaries to supplement me. Without that....shudder....some women do okay without them, hell, some thrive without estrogen. I am not one of them. I know my husband would divorce me and my kids would hate me for life. I would never ever get or keep a job again. Hell, after some of my low estrogen blow-ups, I've wanted to run away screaming from me. (In case you are wondering, I looked a lot like I was in a manic phase with severe anger issues, but the kind where no meds work, ever. Terrifying...)

And finally, I want respect in the delivery room. All women deserve respect, and some Docs---just don't get it. I don't want to be talked down to, like I'm some uninformed fool and I want the nurses and Doctors to take to my face. I am not a piece of meat.

Do not speak to my vagina. Speak to my face.

If you are doing a c-section, do not speak to my incision. Speak to my face.

This last bit, I think will be the hardest one to get. Why is that so depressing?


  1. I can't wait for your post in June about your perfect birth experience :-) Because, you know, from what you've written it can only get MUCH better :-)

  2. If the anaesthetist doesn't try to kill me this time, it will get much better! Thank God for Narcan!

  3. Wow -- talk about putting things in perspective/getting my mind off my own trivial concerns...
    Sending lotsa positive energy your way; everything medically-speaking sounds SO GOOD that I trust all will be well (your body knows what she's doing, after all)!
    I would not relive the last month of MY pregnancy for anything on this earth: unsurpassed for both physical AND emotional misery...

  4. Did you ever look into getting a doula? They're wonderful at totally humanizing the experience... sort of a buffer against clueless medical staff.

  5. I totally get the whole human gestation thing being too long. I am probably one of the most impatient people ever, as well.

    Hoping the next 8 - 10 weeks goes by quickly and the doctor you get has fingers in the normal range.

  6. Oyyyy.

    My and Dr. S's theory is that most doctors are trained in such a hierarchical way that they just try to slot everyone in to not-a-doctor. Intelligent, well-informed people don't have a slot.

    By the way, when do you think you'd be comfortable receiving baby gifts? (If the answer is 'When the kid's three weeks old, it can sit around!)

  7. Oy. Did you get a chance to discuss this with your doctor? It might help if more people at the practice knew of your wishes and how firm you are with them.
    This also makes me realize, again, how lucky we are with our hospital. very gentle and not-bossy deliveries there, both times. Live baby and dead, with respect and kindness.
    Good luck!

  8. I think Julia's suggestion is a good one. Maybe you can talk to your OB about your concerns and who knows, he might even have some influence on how the other docs treat you.

    I hope these next few weeks and the birth go smoother than some of your previous experiences.

  9. "Do not speak to my vagina" Can I put that on a teeshirt?

    I hope that things continue to go well. As to the ideal birth, I never had one, and I was a "normal" gestation. I will continue to pray.

  10. Just getting caught up on your posts!

    I know what you mean about the plan. I like more monitoring than the average patient, but it doesn't mean I need people to *do things* at every turn. If it's fine, well, don't fix it. But let me know it's fine.

    Hope you can get staff on site that understand this perspective.


  11. I'm with rachel, here's hoping it goes well.
    It can. I had a great birth at Women's with zero interventions. Hell even BAMH was good (only because I had a midwife though!). It can happen. Things can actually go well.

    I know, hard for you to believe, but true.

    Lay it all out for them. That's one hell of a birth plan and if all else fails you can slap someone in the head with it.

    9 weeks!!!

  12. I'm 0 for 3 and make bad placentas. They haven't found anything to justify the anticoagulants though. Nothing abnormal in my bloodwork. But you know, after reading your post, your joy and your heparin, I will insist on taking heparin with our next pregnancy. You, Meg, and a few other women here have said the same thing. So (I know kind of strange), thank you. Reading posts like yours is probably what's going to save the life of my next child.

  13. i'm late for this, by a long shot, but what a fabulous post, Aurelia. if i get to the delivery room point of things, i may just print it and bring it in with me.

    last time, i was focused mostly on getting through birth to a live baby. and had an even more traumatic, frightening birth than the first time around when all was crisis and i was alone and Dave barely even made it in time. but the first time was mostly circumstances, whereas the second time was just bad management and the on-call doc rushing and being arrogant and my own post-traumatic stress reaction to labour and the fact that i deliver fast and make bad placentas like Antigone, all of which kinda added up to an experience that shocked me.

    this time, getting to birth is still my primary focus, but oh man, i'm going to hope and fight and try for a decent experience. and i thank you for this, too.