Saturday, March 6, 2010

Health Care, Pregnancy, TMI

For those of you who are not already aware, I am pregnant for the second time. This pregnancy was a surprise, as my husband and I forgot birth control for the first two weeks of the new year.

With that TMI out of the way, I wanted to discuss the health care system and how it is affecting me.

I have known I was pregnant since January 15th. I called my doctor's office on January 19th. My first appointment was not scheduled until March 3rd. I will not see my actual doctor until March 16th. I will be 1 week shy of completing the 1st trimester when I finally see the doctor.

I am frustrated.

I have had some abnormalities with this pregnancy as compared to my last one. If this means that there is a problem, then waiting until the end of the first trimester to find out puts me in a dangerous predicament. Also, when I told the nurse that I was having constant nasuea, she did not recommend any remedy except a prescription for a drug that causes such extreme drowsiness that I am not allowed to drive if I take it.

So, feel like your gonna barf all day long, or go into a coma while teaching class. Not exactly ideal.

Luckily, I had fantastic care while in Albuquerque with my previous pregnancy. I was under the care of midwives, and they had an affordable (often free) solution for nearly every pregnancy ailment. Now I am just rifling through my brain to remember them all. And since I did not have as many problems with my last pregnancy, I didn't have to use very many of the remedies they casually mentioned.

Take notes when you go to the doctor. You never know when you will need the information again.

Aside: Do not go to WebMd to diagnose ANYTHING. It will just horrify you. I nearly always end up with the diagnosis of schizophrenia, stroke, or something I've never heard of. (If you suffer from those diagnoses, I am not mocking. I am simply pointing out that Web MD could not possibly "know" that from my symptom of a headache.)

My most frustrating discovery this pregnancy is that I am required to have a C-Section, because I had one 2 years ago.

This is not because my fetus is abnormally large, or because I am having multiple births, or even that I am high risk. This is because the hospital needs to schedule an anesthesiologist if one is required, so they won't be able to call one in if I "need" a C-Section during normal labor.

I also believe that it is because the hospitals know that it is more profitable for them to schedule a C-Section when it comes to insurance. I am not being a conspiracy theorist. Hospitals make more money per patient on C-Sections (especially pre-scheduled ones) than on long labors.

This choice has been robbed from me. During labor with my first child, I chose C-Section as a last resort. I had been in labor for 25 hours, and I pushed for 5 straight hours. My daughter entered the birth canal and then returned behind the cervix and turned upside down. The nurses were dumbfounded that someone could push so hard and not produce a baby. The option was to stop pushing for 2 hours (those of you who have been in labor know how hard it is to stop pushing, let alone after the baby has already entered the birth canal) and then try again, or have a C-section. I opted for the C-section.

That was my choice.

Now, between hospital insurance companies, and health insurance companies, my choice has been taken. I will not get to experience the drama and beauty of waiting for my child to be ready to leave the womb, using all of the physical, mental, and emotional force in my body, and gathering my family for support during labor. I will turn one of the most human events I have ever experienced into a clinical appointment.

This is not to disparage those that choose C-sections for health or convenience for themselves. That should be your choice that is made between you and your health care provider.

But I haven't even seen my health care provider, and the decision has been made.

C-Sections are serious surgery, and the recovery is very difficult. I was terrified that my stitches would rip, or that my scar would get infected, or that my uterus would fall apart (that last one was irrational and fueled by mild post-partum depression). One day I simply pushed my dog off of the couch and I ripped a staple. The pain was excruciating, and the wound became slightly infected, oozing and smelling. Luckily I was able to see a midwife before the infection became dangerous. I can't imagine what it is going to take for me to see a doctor here since I can't get into my OB for 3 months.

Now I will be recovering in a multi-story house, with 2 children. This increases the possibility of interrupting the healing process, and therefore infection. Infection is very dangerous if it is near a major organ (my uterus!).

I don't feel as if my health is being considered. No one has reviewed my file to determine if I am a good candidate for VBAC. I feel that I am at least due that consideration. Then I will feel that the health care providers are considering my health.

But for now, I feel as if my health is secondary to profit and convenience. That is not care.

When I finally see my doctor, I will request that he determine whether or not I would be a good candidate for VBAC, even if the hospital will not allow the process. I at least want that on my file.

I should be in charge of my health. I will do my damnedest to take charge.

6 comments:

  1. Michele, I wish I could make things better for you. Albuquerque could still be an option you may want to look into.

    I just find it ridiculous that they claim it's because they need an anesthesiologist. Don't a lot of people need those at any given time? And in the case of emergency c-sections? Why should it be any different the second time around?

    If I was your doctor, I would let you have a VBAC (if it was safe for you.). There, does that help? No? Sorry.

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  2. Michele, I assume you are talking about San Juan Regional Medical Center as the vbac-ban hospital? There are two CNMs on the staff of the hospital. Even though the "ban" would apply to them, too, I would like to put you in touch with one of them, who's a friend of mine. Maybe something can be worked out for you to avoid having an unnecessary repeat vbac. Have you checked out the information online about the recent vbac conference at the National Institute of Health? Try googling NIH +VBAC and see how many hits you get. All the new research is in favor of vbac and the conference panel ended up recommending that the ACOG guidelines that call for having an anesthesiologist in house must be changed. Since you still have about 5 months or so until your baby is due, lots can be done in the meantime.
    You can contact me at susan@thebigpushformidwives.org
    Good luck and keep the faith.
    Susna

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  3. I wanted to do a VBAC this last pregnancy but ran into similar problems. I had a few choices. First I could not go to the hospital until the baby was basically crowning. Then they wouldn't have time to do a c-section. Second I could deliver with a midwife at home. Since I live an hour and a half from a midwife we were going to use a birthing center near a hospital. My situation was a little different considering I had already had two c-sections but there is no reason you couldn't do a VBAC. There is just little to no chance you could do it in a hospital. I wish you luck. Do your research on the VBAC and you will find a way.

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  4. Hospitals need to be reminded that we are customers paying for a service and frankly I agree with you. Every time I go to the hospital or doctor I feel like they are trying to sell me something. Find a doctor that will let you do a VBAC or have a home birth. TAKE CONTROL and good luck!

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  5. Try contacting a university hospital, if you have one near your area. My doctor will not allow me to try a VBAC, or any private hospital in my area, and I found a group of nurse midwives that work in a university hospital close enough to where I live that will allow me to do it. They will even come to my house once labor starts. So don't give up, I know sometimes it seems like we have to fight against the world to make ourselves be heard but it's worth it. Good luck!

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About Me

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Farmington, NM, United States
Old enough to know better, young enough to change.