Frustrating Appointment

Yesterday, Eric and I had another doctor's appointment and while technically everything was OK, it was a rather frustrating appointment. Up until this point, I have been extremely happy with our doctor - he's been very open to us wanting an intervention free birth and seems to be OK with a lot of things hospitals and doctors generally discourage, such as no IV or heplock, eating and drinking during labor, and delivering in any position we want. He even encouraged us to write a birth plan. Yesterday, we went over our birth plan, and while he was on board with a lot of it, there were two critical elements that he was not OK with and one of them is an absolute non-negotiable for me. First, he insisted on pitocin after delievery to speed the delivery of the placenta - I know that this is routine in most hospitals and I know that the research on this is split. Since the baby will already be out, this is also one battle I'm willing to let go - if there are any adverse side effects because of it, it will be to me and not my child, so I'm OKwith that.

The second issue was my non-negotiable. I don't want to be induced and I don't want my labor augmented, but if for some reason it must be, absolutely under no circumstances do I want Cytotec to be used. Cytotec is technically a prescription ulcer medicine, but it is used off labels by OBs to induce and augment labor. The problem with Cytotec is that it has been shown to create extremely strong contractions - stronger than Pitocin - and to the point that it can cause fetal distress, increased risk of uterine rupture, and in some cases brain damage or death of the baby. I know that every intervention and drug has its risks and I know Pitocin doesn't come without risks - many of which are similar to Cytotec. However, the rate of incidence of these side effects is lower with Pitocin and things like brain damage and fetal death are a much lower risk. When I raised these points to my doctor he basically told me that I can't dictate how my labor is managed, which is total BS. If it comes down to it, I would rather give up my natural birth and have a c-section than risk my child's life with Cytotec - that is how strongly I feel about not using it.  Eric promised me that he would not let them use Cytotec no matter what and that he would make sure that they tried Pitocin first, so I feel better about that. I know it's pretty likely that I'll go into labor on my own and that none of this will be a problem, but it still stresses me out a bit.

I guess my biggest issue with the whole process of how childbirth is managed in this country is how doctors look at it as a medical issue - something that needs to be managed and treated. I feel like it is not a medical issue - I'm not sick and birth is not some scary thing that needs to be treated. It is something that my body was made to do, so why can't I just let my body do what it was meant to do? If the average length of gestation is 41 weeks, why on earth would you expect everyone to have a baby by 41 weeks? Especially when you can monitor both my baby and the placenta through non-stress tests and ultrasounds to find out if anything is abnormal. Average by definition means that some will be less and some will be more. Same goes for the rate of dilation - the average is 1 cm an hour, but if I don't dilate for 4 hours and all of sudden dilate 4 cm, doesn't that average out to 1 cm an hour? I think that there are a lot of great things relate to childbirth that have come out of medical involvement, but I also believe they apply to a very limited number of women, most of whom demonstrate signs of risk way before labor and delivery. I get that obstetrics is a field that carries a lot of risk for the doctors who practice it, after all no one is more sue-happy than a mother whose child has suffered birth defects, trauma, or death because of a preventable situation. However, I would gladly sign all the waivers placed in front of me, promising that I wouldn't sue if I could just do what I thought was best for my child. I've spent my whole pregnancy doing everything I could to keep my son healthy. I haven't so much as taken a single Tylenol, gave up tea and coffee, and forced myself to eat healthfully even when what I wanted to eat is junk. My biggest fear is that my vigilance will be for naught as soon as I walk through the hospital doors, and I'm afraid of how much Eric and I will have to fight to protect our son from the drugs and interventions that may be thrown our way.

I used to think that anyone that wanted a home birth was out of their mind and it never even occurred to me to look at a midwife as a care provider during my pregnancy. I wish I knew then what I know now about childbirth and pregnancy because I would have made a different choice. I wish I had trusted in my body and my ability to do this from the very beginning and it saddens me that we live in a culture that conditions women to believe that childbirth is a traumatic experience that needs to be managed. I know I haven't given birth before and I don't know first hand how painful it is, but I truly believe it is pain with a purpose. I don't think that it is something to be managed and it frustrates me to no end that I have to fight a system to let my body do what it was meant to do. I'm hopefully that everything will go smoothly for this labor and delivery, even though I know everything will not go exactly as plan.

On another note, I need to let my mom know that I completely understand now why she was always so pushy and embarassing each time we went to the doctor as kids. She would call and complain about not being able to get an appointment and would bug the nurses if we had to wait too long and stop by member services at Kaiser to fight to get approvals for things she thought we needed. It drove me nuts and I swore I would never do it. Mom - all I have to say is that I get it. I get it because my kid isn't even born yet and I would already do all of that for him to get here safely. I might try to go about it in a slightly different way but, when push comes to shove, I'll embarass the hell out my kid if it means that he'll get the care he needs and that's going to start the second I walk into the hospital to deliver him.