Thursday, July 8, 2010

Sheep or unruly mama - are those the only options?

I've been trying to articulate a post for a while now and have been finding it so difficult. I feel so passionately about several topics that all seem so intertwined to me, and find myself discussing them at length with people who quite likely could care less and would love for me to just stop talking! I generally stop talking right about the time I realize I've managed to offend a friend, someone I unwittingly judged in my ranting. I just reread my last post and I sound like such a judgemental jerk, preaching from my soapbox, and I'm sure I come across that way so often. But that's not what I'm trying to do.

What am I doing? Grappling with this frustrating idea that so many of us don't think things through for ourselves, just accepting the way things are as good reasoning and following along blindly like a good little herd of sheep. And it's not because we're unintelligent. I constantly watch intelligent people not questioning questionable methods instead of deciding thoughtfully. And I can't blame them, we're not just not encouraged, but discouraged, pushed and bullied into behaving the way those in power find convenient.

Are you saying what in the heck are you talking about Victoria?

Take my prenatal doctor appointments for example. Even though I feel fine, I do as I'm expected as a pregnant lady and go for monthly appointments. Just in case, because if something went wrong with baby I'd be to blame if I didn't go to the appointments expected of me. This hospital in particular has five prenatal doctors and you're not 'allowed' to make your appointments with just one of the doctors throughout the pregnancy, you have to accept whoever is on call that day. The reasoning is that you can't guarantee which doctor will be on call when the time comes to deliver the baby. Do you see how that really isn't relevant reasoning? I understand if you have to accept whoever is on duty to deliver the baby (sort of, what happened to the personal level of care of midwives who would have worked their schedule to be available when they had a patient near her due date?). But okay, let's accept that doctors are on duty on their shift and you may or may not get yours for the delivery. But why does that mean that you can't have one doctor follow you throughout the pregnancy anyway? What about attempting some level of consistant care? Instead, I have to meet a new doctor most visits and be asked the same questions over and over again. For instance, I have dry skin/eczema, have had it since I was little. Each visit, another doctor measures my belly, points out my dry skin, attributes it to the pregnancy, and makes redundant recommendations. One time is was "Your skin is dry, isn't pregnancy a pain? You can try some baby oil." How about no, to begin with pregnancy is not a pain actually, and if you knew me at all you'd know I just have dry skin and quit pointing it out. I know that sounds so trivial, but I am so tired of being poked and prodded at and treated like a specimen by strangers.

And the tests! I'm pretty sure there is a panel that makes up a test per visit, because they think we may be bored at our appointment and need tests to fill up our day. Take the glucose screening test for diabetes. I'm on baby number four. I have never had gestational diabetes. The test consists of guzzling a sugar drink (something I'm sure would be on the ridiculous pregnant diet no-no list if not in the name of science) and an hour wait between a couple blood samples taken. It's not that the test is unbearable, just a waste of time and resources if it's unnecessary, no? And another way to make me feel like a specimen? How about if I show symptoms of diabetes then we do the test? Would diabetic symptoms be unnoticable? And if so is it actually a problem anyway? How about you tell me what the symptoms are and I'll keep my eye on it. How about the doctor actually tell me what happens to the baby if I do have gestational diabetes and it goes unnoticed. The worst I could get out of the nurse or the doctor is that the baby could come out bigger than usual. Is that really even a problem? This is the part that makes me so frustrated... when I'm asking these questions the nurse and doctor behave as though I am being the most difficult patient in the world. Why else would I ask these questions other than to just ruin their day? Why don't I just behave like the other sheep and believe the doctors are all knowing and infalliable. They get grumpy and bully me into feeling bad for even questioning them.

Part of my dilemma on this topic is that I do start to feel guilty for being so argumentative. I think about women in generations before me who died in childbirth from things that are now easily preventable, or women in poor or undeveloped areas who would cherish the level of care I am offered. But does it really have to be an argument? Why can't it just be a conversation?

My latest 'arguement' involved the test for group b strep. I didn't remember this test from my previous pregnancies so I asked the nurse, what is group b strep? Oh, it's a virus the mother can unknowingly carry and the baby can catch during delivery. What happens to the baby if they contract it? Well, they get very sick, she says. How? They just get very sick, kind of like pneumonia. Getting details from the nurse on this was like pulling teeth. She couldn't tell me how or if the baby could be treated if they did contract the virus. When I asked what would be done if I did test positive though, she proudly said, "Oh, we'll just give you a shot of antibiotics when you go into labor, just in case." Then she sent the doctor in with her guard up, as though she had been forewarned that there was a difficult patient waiting for her. After going through the same string of questions with the doctor, to no avail or pertinent information offered, I decided just to say no to the test for now and go home and read up on it myself, at which the doctor looked at me like I had three heads and pushed my next appointment up to one week instead of the planned two. Because apparently I have to ciphon through every decision on my own research, attempting to weed out the good sources from the bad on my own, because my doctors are hard-wired to feed me an ad campaign from whichever drug supplier they're pushing instead of offering me the information I'm asking for to make an informed choice. The information I did find? (From a very conservative source too I might add.) The baby has a 1 in 200 chance of contracting the virus from a positive mother and the antibiotics have to be given 4 hours before the birth to be effective. While to begin with my longest labor has been three hours, making the whole arguement irrelevant, why would I want a preventative shot of antibiotics in my newborn baby on a .5 percent chance that they may catch something? There must be a greater chance of an adverse reaction to the antibiotics! Let alone the link between antibiotics overuse and later allergies, and the idea that their immune system may need half a chance to establish itself naturally.

At this point in the story I got called Dr. Victoria by a friend, insinuating that I think I know everything and the doctors don't know anything. Which I don't. Which is exactly what frustrates me. I am not a doctor! Why can't I trust my doctor to give me the information I need to make an informed choice, instead of pushing a biased strong opinion on what they want me to do, regardless of whether the why makes sense.

Does this make sense at all?

3 comments:

  1. You are making complete sense. I was a sheep with my first pregnancy. I didn't "get" that I was allowed to question things. I had a good heart-to-heart with my OB during my second pregnancy (not that I saw her more than three times in total) and she told me to ask questions about everything. And I did. I was still a bit of a sheep, but I felt like I had more control over the situation the second time around.

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  2. Gestational diabetes often does not cause typical diabetes symptoms, and the main concern - besides a large baby - is that the baby's organ maturation is slowed, thus increasing the risk that the baby will be born with immature lungs requiring treatment which may not be available in all hospitals. As well, babies born to mothers with GD can have a problem regulating blood sugar after birth, requiring a quick stay in the NICU to stablize. HEnce, this is why all women are screened - better safe than sorry. Babies still do die before, during and after childbirth for various reasons, and why wouldn't you want to take every available precaution? My child was in the NICU for several weeks and I saw many GD babies pass through. Is 1 hour of your time more valuable than your babies life??

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  3. I appreciate what you're saying, for sure, it's the possibility of scenarios like that that keep me going to the appointments as scheduled.

    It's the culture of fear and intimidating women into taking the tests that is frustrating. Our medical system has women scared into believing that their body can't do birth without intervention, and questionable medical intervention has become the norm instead of the backup plan to be relied on when needed. How many women do you know who "couldn't make enough milk" when they attempted to nurse? Do you know that's a north american phenomenon? Most other cultures have never heard of such a thing. But the seed of doubt in our own capabilities is deeply planted here. The doctor can discuss facts with me and suggest their opinion, it would actually be really nice to trust that I am informed of the facts by them instead of feeling suspicious about what line they're selling me and what their motives are.

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