a dose of epidural is not an ounce of prevention

My new motto is, "There's nothing wrong, until there's something wrong."
My OB would like me to believe that an epidural is the way to prepare for an emergency situation like an emergency c-section (ignoring that that very epidural could throw things off course and lead to an emergency c-section).
Funny how all of this so-called "prevention" is planned for the day of delivery, but in the 8 months that I've been pregnant, I've never been asked:

• how are you feeling?
• are you taking your vitamins?
• are you stressed out?
• how's your diet?
• are you resting?
  

So, now, is when we're going to try to prepare and avoid complications? Interesting. Glad I have a midwife who is concerned about me getting to term in good health so I can avoid preventable complications. Dealing with "the medical establishment" stresses me out to no end.

hospital drama, part 1

I hope to never have to write a part 2 or 3 or 4 or 5 to this blog post, but somehow I don't think that's possible.

Yesterday, I went to my routine OB appointment and he asked me to start the Non-stress Tests TWICE a week (in addition to seeing him weekly). I went ahead and did the first one right after I left his office.

I had to go do it in the triage area of labor and delivery and get strapped down with 2 fetal monitors, a contraction monitor, etc. I got a great nurse, thank God, that didn't freak out that I was having contractions (which I couldn't feel). Then the ultrasound lady, which didn't seem so confident about what she was doing, said the fluid around the babies was borderline low. I coulda kicked myself for not making an extra effort to hydrate....but then again, I didn't know I would be doing this procedure.



So after the doctor saw all my info, he wanted me to wait around 'cause he wanted to see me. I was like "No!!!! I'm going home. Tell him to call me. I am not in labor." The nurse went back and forth with my doctor. He finally told her if she would examine me and confirm that my cervix was not dilating, that I could go home. She did. I wasn't. I went home.

The nurse I had, Jennifer, was great. She talked to me about the chances of my delivering without an epidural (next to none). She asked me about my first experience at that hospital giving birth to Maxton and I told her that I had some really horrible nurses that I had to ask to leave my room. She went to do some investigating and find out who the nurses were and hopefully not have them again. I'm hoping she'll be around for my delivery.

Anyway, she told me some other things that I didn't know. She explained that with twins, I will end up delivering in an operating room just for everyone to be prepared for an emergency c-section. She told me the devastating news that even if I come it dilated 10 centimeters, they'll still insist on an epidural (as a precaution).

Last night, I went to bed asking God, "So, how are you gonna work this out?"

flashbacks: letter to OB

We took Maxton in for his physical today and ran into the doctor who was all set to be my OB when I was pregnant with Maxton. (BTW, I had to find an OB that would accept my high-risk case at about 28 wks. My son's heart condition prevented me from being able to deliver at the birth center.)

After our initial appointment, I left his office in tears and we switched doctors. Later, I felt compelled to write him a letter, which I never sent, but I'm sharing with you below.

I'm not disclosing his name, for two reasons: 1) If I never sent the letter directly to him, it's not fair that he could accidentally find it online (simply by googling his name) ; 2) I'm convinced that, because of the state of obstetrics in this country, it really could have been written to just about any OB out there. This is the standard of care.


****
Summer, 2007

Dr. G, MD
Glendale, CA 91204

Dear Dr. G,

As you are now aware, I have transferred my obstetric care to another
physician. It is important for me to share with you the reasons for my
decision.

From our first meeting, it was clear that you practice defensive
obstetrics and have a standard protocol that
doesn't deviate with each of your patient's individual situation.

In addition, you stated to me that I wouldn't be able to handle the
pain of labor and would need an epidural (especially because you
planned on using Pitocin as a routine procedure—never once taking into
consideration my needs or wants as a patient). In telling women that
they cannot handle labor on their own (at your first meeting with
them, no less), you are doing a great disservice. You have no right to
instill fear and doubt in your patients, when your job is to provide
information, concern, respect and support. I find it hard to accept
that a doctor whose patients are exclusively women has little faith
and belief that their bodies are able to handle birth. It is not right
for you to make this assumption for every pregnant woman who walks in
your office. Frankly, it's disrespectful and you're misusing your
authority in their lives for your own convenience.

At our last meeting, you stated that whether or not I tested positive
for Group B Strep, you were going to put me on an antibiotic. This,
again, was an example of how you choose intervention, whether
warranted or not, to deal with your cases.

I am an informed and well-read patient and was able to see the red
flags during our visits very clearly. After our first visit, I left
your office in tears, terrified that I would be under your care on my
delivery date. The stress of the situation was overwhelming. My
husband and I realized then that no amount of cost savings (because
you're in our HMO) was worth the anxiety and stress of dealing with an
OB whose philosophy of care was so opposite from ours.

Because you run such a busy practice (and for medical-legal reasons,
I'm sure), it's probably more convenient for you to choose
intervention rather than deal with each case individually, but I hope
in the future you will be able to balance this point of view with the
needs of your patients.

Dr. G, I wish you only the best and sincerely pray that you'll
take my concerns into consideration as you deal with the women who are
trusting you during the most important phase of their lives.

By the way, I genuinely thank you and your staff handling my HMO
referrals so expeditiously.

Sincerely,
Delina Pryce McPhaull