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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.

13 Comments Post a comment
  1. Remember my postpartum introgation? (Ok actually I never blogged it, so no, you don’t). Postpartum questionnaire for birth certificate, idiot nurse asks me, “During this pregnancy, did you use alcohol, tobacco, OR CRACK?”. Three guesses whether I lied about my occasional glass of wine.

    August 6, 2015
  2. Martha #

    I finally went into labour last month (11 days overdue) with my third after 2 glasses of wine at a BBQ earlier in the night.
    6 hours later when the L&D nurse asked if I had any alcohol during pregnancy I just lied and said no. I’m with you on this but unlike you I fear judgement! I believe a little once in awhile doesn’t hurt and may even benefit if it helps you relax a bit (as I strongly feel it did me– I was so wound up with a heatwave and anxiety about leaving the older kids etc– think the wine was a real factor in tipping me into labour at last).

    August 6, 2015
  3. I’m all for patient education and informed consent, yadda yadda yadda, but I agree that, once your OB has told you of the risk of continuing your pregnancy past 37 weeks, she should let you make the decision of whether you want to take that (small) risk to benefit your baby. I think oftentimes these doctors are either so afraid of liability, or so unused to dealing with educated patients, that they are afraid to allow that.

    August 6, 2015
  4. This sounds frighteningly familiar. I spent 5 weeks in the hospital with g fighting with my OB about when to deliver based on the small risks to my life vs risks of prematurity. And when I told my OB about my anxiety issues after g was born, she dismissed it as that new parent worrying thing. It was me who later pointed out to her that something was REALLY not right and practically ordered my own tests for postpartum thyroiditis – indeed.

    The take home message is that you really do have to advocate for yourself.

    August 7, 2015
  5. The frugal ecologist #

    I also lie about the occasional second-half of pregnancy glass of wine. Bully for you for being honest.

    I am currently pregnant w twins and it’s hard knowing how much is really risk for me/babies vs. cya bs from my OB. And I really like my OB.

    Hope you end up with a c section plan that is a good fit for you & Bunter.

    August 7, 2015
  6. Socal dendrite #

    “after all, why should you have any control over your body–it doesn’t really belong to you anyway”
    This. I understand plenty of women like being pregnant, but I really don’t, except for maybe a couple of weeks in the second trimester. I think a large part is the loss of control and (now I’m 38 weeks) not being able to physically do some of the things I like to do, and the fact that strangers are all annoyingly cheerful at me about it, when, actually, I’m really not looking forward to the looming prospect of being FUCKING DEPRESSED and having no intellectual stimulation for weeks on end.
    I’m sorry your OB is being an irritating asshole. Mine is not so bad, though he did try and railroad me into a (to my mind unnecessary) induction on my due date last time round (#1 must have realized he was about to be evicted and got his act together a couple of days beforehand).

    August 7, 2015
  7. Maggie #

    I agree! It shocks me how bad the OB field is. Like in many ways they are really terrible doctors. I felt pretty confident that my doctors could deliver a baby in distress or do a decent c-section if needed, but in all the other aspects of OB patient care, they were terrible– not emphatic, bad listeners and quite arrogant. And in for so many decisions, I really don’t trust their judgment. I ask around from time to time to see if friends have any better experiences, but they really don’t. (And also about pediatricians– I don’t really care for ours either.) For both doctors, there is some kind of fundamental disconnect about the kind of patient/parent I am (reads too much, trusts my own judgment) and the kind of patient/parent they expect.

    August 8, 2015
  8. Steph #

    This reminds me of walking into a salon, something that gives me anxiety and I don’t do very often because of it, being 25ish weeks pregnant, and being denied hair color because it would harm my fetus.

    Fuck that doctor. Keep that baby in until the end. Speaking from someone who’s had a 35 and 37 weeker.

    August 9, 2015
  9. Ah yes — when pregnant, you are just an incubator and everyone knows better what the baby needs than you, for you cannot be trusted.
    Steph’s comment reminded me of a Flonase (steroid nasal spray I take all the time) incident during my last pregnancy. My OB (who is wonderful, I must say, unlike my grouchy and patronizing general physician) gave me a renewal prescription for Flonase (the nose was getting extra stuffy in late pregnancy). The fucking pharmacy wouldn’t fill it — apparently, they know better than my OB! — because it was not safely tested in pregnant women, but instead insisted I get Rhinocort which didn’t do anything for my nose; OB said that was ridiculous, and that barely anything from the nasal spray gets into the blood stream, let alone crosses the placenta. Thank god the brave pharmacists of Walgreens are there to save my baby not only from myself (we’ve already established that I am a stupid incubator), but apparently from my evil OB as well.

    August 9, 2015
  10. SRB #

    AGGRAVATE is a great word for this sort of thing. So many decisions/suggestions/declarations in prenatal care seem to be arbitrary. And by arbitrary I mean both based in hospital policy and from an insurance perspective. Those things seem to be given equal (if not more) weight than, you know, the ACTUAL PATIENT.

    Anyhoodle, I drank a glass of red wine here and there in the 3rd tri, and drank beer (gasp!) and coffee (GASP!) while breastfeeding. OMG! Mostly because I am an educated, reasonable person capable of making such decisions. I mean, can you IMAGINE?

    When *will* Bunter come out??? I need to outfit this wee bairn.

    August 10, 2015
  11. Well done, Bunny! I’m really glad you put your foot down and told her that 37 week was not going to be a good time for Bunter’s arrival. It infuriates me that you get treated that way at the OB’s office. I’m not surprised about the depression screens. I was asked to comment about some other medical department in the hospital using a depression and suicide screen with their paediatric patients. They wanted advice on which measure, and I wanted to know what they were going to do with the information. They didn’t know. They just felt they needed to screen. ARGH!!!!!.
    Enjoy that glass of wine, darling. Small pleasures are vastly more important than a nonexistent risk.

    August 10, 2015
  12. Good for you! I’m sort of waiting on baited breath here for this little baby. But keep it in as long as you can! Makes you long for midwifery, if only they could wield scalpels. Actually, fuck that – they’d probably advocate for anesthesia-less c-sections. Please enjoy your wine!

    August 12, 2015
  13. Jos #

    Ugh, I read this when you first posted, but I was on my phone and couldn’t comment. I saved it just so I could come back and say ARRRRGHHHHH about the entire field of obstetrics. It drives me nuts when they discount patients and treat them like total idiots and at the same time fail horribly at other parts of their job. Harumph.

    August 20, 2015

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