lest you think that i was so greatly effected by seemingly unimportant issues at the end of my pregnancy, think again. unfortunately we received some questionable, if not spectacularly bad, medical care, too.
ever since we lost jesper, we have had the same plan for pregnancies. increase monitoring. plan for a home birth, but induce labor at 40 weeks.
when i was pregnant with nate, i called around to nearly all the OBs in santa fe trying to find someone who would "follow along" so that if we got to 40 weeks we wouldn't have any problem getting someone to agree to induction. see even with a recommendation from a perinatologist, if we were to walk in to L&D off the street at 40 weeks but not in active labor there was always a chance that we could be turned away. even though, in theory, by turning us away the hospital and doctors would be opening themselves up to a certain amount of liability.
with nate i could not find anyone who would agree to follow along. so when we got to 40 weeks, my midwives had to call in a personal favor with a family practice doctor they know in order to get us into the hospital. "stressful" is an understatement.
with willow, i actually found someone (family practice) who agreed to follow along. she had been recommended by several people. so around 3 or 4 months pregnant, we went to see her and have a good talk. everything seemed great. she said it would be no problem, that she does it all the time. she said "come back at about 34 weeks.
we went back to see her at 33 weeks. it made me a little nervous that she didn't exactly know why we were even in her office at 33 weeks. she had been faxed some, but not all, of the various test results. but seriously, did the file not say anything about what she had agreed to? it also made me a bit nervous that she didn't want to see us more frequently. i thought she'd at least want to get to know us. instead she said to come back at 39 weeks if i was still pregnant.
despite my reservations, i kept reminding myself that we had not ever even met either of the doctors who had delivered both jesper and nate. so at least this time, we had met the doctor, right?
so we went back to see her at 39 weeks. this time our midwife came with us. my file had been faxed over.
at 37 weeks we had done the standard group B strep test. it came back positive. this is not uncommon. the usual medical treatment is prophylactic antibiotics during labor. the goal is to decrease the amount of GBS present in the birth canal during the small window of time that the baby is passing through. but it is not an unproblematic treatment, and it is not a guarantee of anything. having done the research and having a major issue with prophylactic antibiotics for anything, i choose to not take the antibiotics during labor for GBS. i don't have a problem with antibiotics for an actual medical reason, but simply having GBS isn't necessarily a medical mandate.
it wasn't until the 39 week appointment that we had the chance to discussion my GBS status and my choice to not take the antibiotics during labor. this is the point at which the doctor said she might have a problem with our decision.
since you probably don't want to hear all the minute details, i'll just say that at 39 weeks pregnant i was basically fired by my back-up doctor. at 39 weeks. it has something to do with the "standard of care" and how she has to give the care she feels is appropriate. i'm not exactly sure why that overrides the care i'm willing to accept, but that's the reason i've been given by quite a few people.
i offered an alternative to systemic antibiotics. she said no. i offered to sign a waiver, she said no. i offered to stay an extra 48 hours (something she originally said they would want to do in lieu of antibiotics, and i said wasn't my first choice--ever slept in a birthing bed?), she said no. but she did say, "if you think we can see eye-to-eye by tuesday, give me a call." really? i was the one coming to the table with alternatives and compromises, she had nothing but "standard of care" and "i'm the doctor, you're an idiot." and so . . . seeing eye-to-eye . . . would have been? yeah, it would have been me agreeing to take prophylactic antibiotics during labor. yeah, that wasn't going to happen.
and exactly how ethical is it for a doctor to fire a patient at 39 weeks pregnant for this reason? to leave them in the lurch when there is a direct recommendation from a perinatologist to induce by 40 weeks? knowing full well that it will take a small miracle to find a new doctor. when the only reason for it is a disagreement in treatment plan? since when are patients not allowed to refuse debatable or questionable treatment?
so then i had to find a new doctor at 39 weeks.
let no one ever tell you that getting through life is about what you know; it is all about who you know. luckily, we know someone who is a nurse for the local OB, dr. combs. in absolute desperation and with no expectation that we would get anywhere, i called mrs. fox and asked for a huge favor. i told her the whole story. she already knows our history of loss. she told me to have my midwife fax over my file and that she would personally put it on the OB's desk so that she could decide whether or not to take us. ultimately, she did agree to take us. and for that we are more grateful than they will probably ever really know. "thank you" doesn't seem enough.
we went to one appointment on tuesday afternoon, and went to the hospital wednesday evening for our scheduled induction. willow was born a mere 48 hours later.
yes, the end result was perfect. but, really, was the stress necessary?
No comments:
Post a Comment