Tuesday, May 18, 2010

How it all went down (Part 7)

March 4th 2010

This was the first time I met my OB. I was 16 weeks and 4 days pregnant. I thought this was late in my pregnancy to first be meeting with my OB...but that's the way it worked out. Because of my heart condition I had to have one specific OB...him and no other. I was also to be followed by a cardiologist who deals with pregnant women with cardiac defects. You can see how specialized we are getting here. This OB was on the 'other team' from the fetal medicine specialist that we saw at our 13 week appointment. Our shiny new OB was pegged as the one to 'deal' with my maternal medicine 'issue'. Super.

Let me just say right off, that a male, high risk OB was not what I would have wanted. In another dimension where my heart was perfect and healthy and whole, I would have wanted a female midwife or OB, a hospital birth but no epidural, and for the baby to be placed on my chest as soon as he or she was born.

Of course in this other dimension my son was also alive and full term...but I digress.

I went to my first high risk OB appointment with lots of questions. In October 2008, Brian and I had 'pre-pregnancy counselling' with the aforementioned cardiologist to discuss the risks of pregnancy. We were told I had a *small* chance of heart failure, arrhythmias or death. The cardiologist felt, however, that I was 'healthy' enough to attempt a pregnancy. So here we were a year and a half later, and that 'attempt' had become a reality. I wanted to grill my new OB on what to expect both later in my pregnancy, and during labour and delivery. I wanted reassurance that he thought I would do well, and that generally they were expecting a completely normal delivery.

Instead, I felt he made me more upset. He told me that I might only make it to about 35-37 weeks of pregnancy due to the stress on my heart. I was not to labour at home for any length of time. I needed to be monitored in the hospital. I would need an epidural. I would likely have a vacuum or forceps delivery to avoid the 'pushing' part of labour. I would need antibiotics after delivery. All of this I knew before meeting with him, but it still hurt to hear him say it so plainly. Although I wanted the absolute safest thing done for both me and my baby, I also felt that he negated any strength that my heart and my body possess. This OB knew nothing about my heart before walking in to see me, other than my diagnosis. Did he know that generally I function like a normal person? Did he know that I can walk up stairs? That I can run (albeit for short distances)? My heart doesn't slow me down on a day to day basis...was delivering a baby really that much of a strain? He made me more fearful.

I also asked the OB about my current bed rest situation and about my on-going bleeding. The bleeding was dimissed all together as 'likely the clot bleeding out'. Um...ok. But, he said that I definitely SHOULD NOT be on bed rest due to my increased risk for blood clots, which bed rest can cause. However, then he shocked both me and my husband by following this information up with, "but, your job is pretty stressful, so why don't you just stay home for the rest of your pregnancy and take it easy". Looking back, I'm not sure if he said he would keep me off work because he thought that's what I wanted, or if he really thought that would be best for my heart. In any case, the on-going bleeding did not get investigated with an ultrasound...which at the time Brian and I had been hoping for in case they could determine the sex. Oh...how naive we were.

I left that appointment feeling confused...this was the 'best' care...so why was I so upset? I think I just wanted some choice in the matter. If the OB had approached it as "these are our recommendations..." then I think I would have felt more like I was 'choosing'. Yes, I want an epidural, a highly monitored delivery, a vacuum extraction, lots of antibiotics and the next 6 (!) months off of work in order to have a healthy baby. And I would have chosen that...no question. I was just angry that, once again, I felt like a failure before I'd even tried. That despite my body being able to 'so far' do well with a very stressful pregnancy, my doctor didn't have confidence in my ability to 'handle it'.

In the end, however, that's not what we got. A week later, my whole world would change.

1 comment:

  1. emily, you can't beat yourself up over this. hindsight is 20/20, but as you said, at the time you simply trusted your doctors. and you should be able to. i love my OB and trusted her completely until my 4-wk post-partum appointment, when the precautions she said we would take in my next pregnancy were not nearly as thorough as what i had expected. she's not even referring me to a perinatologist. i had thought anyone who'd had a stillbirth would automatically be sent to a peri. so ever since i have been wondering if this means i will need to find a new doctor. otherwise if something goes wrong again next time, i will blame myself for not being more proactive.