Oh field of obstetrics, you aggravate me.
This was the week when I had the fight with my OB about when to remove my fetus. I admit I was already grouchy because I’d been waiting in the boring room for 40 minutes, and I was anxious about the whole thing because I’m teaching for half the semester, so have some scheduling pressures. But when she told me that the recommendation is 37 weeks I said:
NO. I’M NOT DOING THAT.
She got a bit annoyed, and explained that she had to tell me about the recommendation, and I said and now you have and I’m not doing that. It wasn’t the finest example of a patient advocating for herself, and she seemed quite displeased with me, but FUCK HER. I understand the risks (in case you don’t: I am not allowed to labor because my uterus is held together with yarn thanks to the surgery that allowed me to get pregnant in the first place) and I am capable of making the decision that I believe is best for my fetus (to wit, keep it in as long as possible) knowing that it poses a real but reasonably small danger to me.
Friends, I am tired of obstetrics. It’s not just this most recent insult to my sense of having some right to make decisions, it’s some other things, too.
1. There’s been a flurry of recent stories about antenatal depression (e.g., this one). Let’s reflect on how my OB’s office monitors this aspect of patient health. At my very first OB appointment with this pregnancy, I told my OB point blank: I AM DEPRESSED. She had a nurse hand me some cards for some psychiatrists and hasn’t asked about it since. At some point I will be handed a screening instrument with a couple of questions asking me whether I feel sad or hopeless, and I’ll think: OF COURSE I feel sad and hopeless sometimes, doesn’t everyone? HOW SAD? HOW HOPELESS counts as yes? I feel like they want me to lie about it so they don’t have to take any action. It does not surprise me that antenatal depression is under-diagnosed.
2. Before both of my C-sections, some random medical professional has asked me whether I drank alcohol while pregnant. When I answered YES, they were visibly surprised. I know I am not alone in having very infrequent, very small quantities of alcohol late in my pregnancy. I feel like they want me to lie about this.
To be clear: Women are advised not to drink while pregnant because there is very little information about “safe” amounts of liquor to drink while pregnant, and the prospect of Fetal Alcohol Syndrome is so frightening. How could a woman possibly choose to drink knowing that her child might suffer forever, you ask? Well, FAS results from being a heavy drinker before pregnancy and not changing your habits when you get pregnant. This isn’t typical. But part of the reason there’s no information about “safe” quantities to consume is that women are told not to drink, so they drink and then lie about it. The studies that do exist show no increased risk of low birthweight, small head circumference, preterm delivery, etc. for low to moderate drinking in late pregnancy. I am totally behind women who choose not to touch a drop! I don’t either during T1 and T2 because it’s a particularly delicate period of brain development. I am totally NOT behind women who choose to drink heavily throughout. That’s insane. I just don’t want to be shamed for my educated decision and I don’t want to patronizingly told No drinking full stop: You’re not capable of understanding the difference between 5 drinks a day every day and one drink a week for the last three months because you’re a lady and math is hard for you and, after all, why should you have any control over your body–it doesn’t really belong to you anyway.
I’m glad that my association with this field of medicine is drawing to an end.
Too bad pediatrics isn’t any better.