A Healer’s Geste

ob first

My appointment on Tuesday, “ob first” according to the sheet, went tolerably well.

If I have any male readers, feel free to tune out now. :) No gory details, but nothing of interest for you, either. :)

My appointment was at 1:50. I arrived at 1:45. I was called back at 2:00. Next time I’m bringing a book, because Parents magazine is dumb.

Now, at my “ob education” class last week, just one week prior, the scale had read 11 pounds more than my scale at home. I had weighed myself just before coming, to be prepared, and on my scale I was up 2 pounds (which I attributed to it being later in the day after lunch). This nurse took me to a different station, where, according to their charts, I had lost 5 pounds in one week. She didn’t note that discrepancy until we’d gotten to the exam room, and then she took me back to try again. Down another half pound in 5 minutes! I told her it’d been a different scale last week and I really should have asked to go weigh in on that one to prove that this was all their problem. But I merely lodged my complaint verbally and the nurse was ready to acknowledge their scales being in the wrong. Ok. She took my blood pressure, commenting, “Oh, you’re very relaxed!” I tried not to snicker. My midwife’s comments generally ran along the lines of shaking her head and saying, “You and your mom….” Back in the exam room we went through the typical, “Nausea? Headaches?” questioning, where I gave the typical answers, she did her best to be sympathetic but unhelpful (no one can help any of those symptoms, that’s not her fault). She gave me the results of my blood work, too. My midwife didn’t do initial blood work, so I wasn’t sure what it was all for. The nurse the previous week had said they wanted to know my blood type “and stuff.” They took plenty of blood to determine my blood type! Well, turns out I don’t have hepatitis, I’m just barely immune to Rubella, I’m immune to chicken pox, and my white and red blood cell counts are healthy. Ok, fine, I guess we can all sleep easier now. :)

The nurse left and soon the PA came. Despite her not getting my overall seal of approval, I was still glad it was a woman and not a man (right now all their M.D.s are male; they had two women M.D.s, but they’ve recently left the state) — the room was cold and the exam gown embarrassing. Barb has said they’d given her a bathrobe to wear over it, but none was offered to me.

She ended up asking again several questions about my history because she said the nurse last week hadn’t entered into the computer properly. At least I can see that they quickly (and accurately) move me to the low-risk category…the train of questions was unmistakable: “Do you work outside the home? What number is this? How old are your other ones? How were the others delivered? Any pregnancy complications? When you got pregnant, were you using birth control? What’s your husband think?” She tried to make it sound like conversation, but it was a pretty thin veil. :) I thought about cutting to the point of the questions and saying, “No, I don’t do heavy lifting and I’m not on my feet for 8 hours at a stretch, I’ve had two totally normal and uncomplicated pregnancies and births, I do want this baby, and my husband does not beat me.” :) Instead I maintained the polite conversation routine. :)

The PA saw that I had “lost” 5 pounds in a week. I reiterated to her what I had told the nurse, but pretty much got a cold disbelief. She didn’t seem to appreciate my volunteering the whole story and placing the blame solely on their scales. She responded with “Well, it’s not abnormal to lose weight in the first trimester.” I almost laughed, but instead just smiled and nodded.

With both nurses I’d seen so far, I’d tried to get them to move my due date. My cycles are longer than average, and my midwife had pushed the due date back for Jaeger and he was born the day after that adjusted due date. We both agreed then that Hans was probably only one week overdue and not two weeks, which makes more sense. So I want my due date to be May 4th and not April 27th, as the little spinner thing indicates. It’s all just a peace of mind issue, really. If I’m hoping for and planning for an end-of-April baby, it’s going to be hard to wait until we’re in May’s double digits. I know, that’s what happened with Hans. If I’m planning on a “first week of May” baby, waiting until the 8th or 10th won’t be emotionally and mentally such a challenge. Anyway, the nurses both said they couldn’t change the due date, that would be the doctor’s call. I was anticipating their computers taking in the data and doing the calculation, not them still relying on the little spinny things, but ok, I’ll wait for the doctor. The PA, who I’d already guessed didn’t like any input unless it was asked for, also didn’t appreciate my pushing the issue of the due date. She said they’d wait for the ultrasound to see what it said, but they don’t usually adjust due dates unless it appears to be 10 or more days off. Great, well my babies measure big…they’re not going to adjust the due date.

We heard the baby’s heartbeat a little bit. It took her a long time to find it. Attempting to show that this didn’t worry me, I said, “It was hard to find it in the first trimester on my other two, as well.” To which I received a cold shoulder. She found it, got the rate (160), and stopped within maybe 10 seconds…she wasn’t lingering over anything sentimental. She might have been a little put out at it being so difficult to find. On finding Jaeger’s heartbeat for the first time, though, I was on the table for more than 5 minutes – my midwife had to find it, but she wanted to keep it, too, and he kept moving…she took his rate a few times, even though he was squirrelly. Anyway, the PA sounded a little relieved when she told me after the exam that my uterus was pointing back, not forward, and that’s why it was so hard to find.

Barb had warned me that she didn’t like any of the PAs she saw, but that the doctors are great. So, on my next appointment I’ll see a doctor, though it’s not one of the hands-down favorites I keep hearing about. This is an unknown newer doctor. I’ll bring up the due date issue again with the actual doctor, hoping he will listen a little more carefully to my previous history, and if he doesn’t want to change it still, my next question is how long they typically let a healthy pregnancy go “overdue.” I’m not going to let them induce me unless I’m 2 weeks past May 4th or my blood pressure is up or the baby is in distress, but I also am not terribly confrontational and don’t like the idea of having to refuse an inducement, especially since there’s always something appealing in the last week of getting to plan it and go in for an appointment and not have to wait any longer. :) Right now I can say, “No way! No inductions!” But come 40 weeks, much less 41 weeks, boy it’s a mental struggle. :)

I also got a postcard in the mail the other day saying that my midwife is back and practicing again. After getting the cold attitude treatment from the PA I was ready to just switch then and there, no matter where I deliver. I didn’t want to have to introduce myself and forge a new history with someone, the impersonal treatment I can handle over having to interview midwives, choose one, and get to know her while letting her get to know me. But impersonal different-person-every-time over seeing one person (and one person only, the whole appointment) every time who already knows me — I choose the person who knows me. However, I am curious what the real doctor will say and an ultrasound there would be much easier, plus they’ll do 3-D with the push of a button. So on my way home from the appointment I decided to stick it out through the ultrasound and then switch back. A few days, later, and now I’m actually even reconsidering that.

–Consideration 1: My midwife. I remembered that during my 6-week postpartum check, she made a pretty clear “the world is overpopulated, people shouldn’t have more than 2 kids” type comment. Right after Hans was born she told me, “Next time it will not be this bad, I promise.” That proved to me that she knew me, because I felt reassured by that, there were absolutely no “I’ll never do this again” feelings…I was having, “How in the world can I do that again?!” feelings. :) So, at this postpartum check-up she reminded me that she had told me it would be lots better and it certainly was. Then she said something like, It’s too bad it works that way. It really would be better if the first one were easy and it got progressively more difficult; rather than it getting easier and easier and girls thinking it’s no big deal they can keep doing it. I tried to cut her some slack in that she mostly sees young unwed girls or just unwed, no insurance, low-income, 4-children-with-four-fathers types. I am definitely a minority category in her practice. Anyway, I don’t think she’d really make any comment, but every once and a while I just get small whiffs like that that show me she’s liberal with a new-age streak in her. Matt picks up on it more than I do and doesn’t care for her too much…I know her prenatal care and I’m happy with it; during labor I’m oblivious, but Matt sees her and thinks perhaps she’s just a bit too laid back and slow. :)

–Consideration 2: Curiosity. After thinking about it a little more, now I see that I have a situation where I might get some feedback from these doctors that is different than my midwife experience. They will be looking at my due date being a week early and I am very curious about the whole “we have to induce, this baby is too big” scenario. I am totally not concerned about baby size. I will be surprised if this baby is less than 9 pounds — 9 pound babies are the norm on both sides, and I’m surprised I haven’t had one yet. Big heads also run on my side, but my mom never had any problems. I have a different body than my mom’s, but I don’t think we’ll have problems. I am not an ultra-petite woman that’s married a giant, we’re both average people who have slightly-larger-than-average babies. Worrying about moms not being able to deliver their own baby is also one of the most common midwife/natural-everything complaints about doctors. My situation is ideally suited to discovering the truth, I think, so I think out of curiosity I might just follow the path…let them do a late-term ultrasound…let them advise me. I know what I’ll do and I’m comfortable in it, as is my husband, and I have a bold husband who won’t let nurses or doctors do anything we don’t want without giving satisfactory and convincing reasons first. I’ve not heard of anyone in the past 3 years (since that’s the time from which I listened to birth stories with rabid interest) having a routine episiotomy and only 1 having an emergency one. Quite a few turned into vacuum or forceps, which I hope to avoid — I’ll push for an extra half-hour to get that perfect baby head (I will say that now and I would say it after, but of course I wouldn’t say it during — that’ll be Matt’s job:). And, all in all, the baby gets delivered and you start a new life and how the baby was delivered doesn’t usually end up making a long-term difference unless you’re heavily emotionally involved and determined to have it go one particular way.

Anyway, there’s still lots of time to make the decision. In the meantime, my due date is May 4th and I’m 12 weeks today. Don’t let anyone else tell ya differently.