Another Hard-Won Obstetrical Battle

I am nearing the end of my pregnancy. As delivery draws closer, I can feel my internal rebel pushing to be let out. At my last appointment, my obstetrician insisted I transfer all of my blood glucose readings from an app on my phone to a piece of paper so it could be scanned and added to my chart. This was shortly after an ultrasound that showed a healthy, proportionate baby. He doesn’t have extra belly fat, as babies tend to with moms who suffer from uncontrolled gestational diabetes. I had shown her my numbers, letting her know I was managing quite well (after I reduced my carbohydrate intake a bit lower than the recommendation given to me by the nutritionist), but this wasn’t enough, apparently. She still wanted the data detailing my blood sugar four times a day, every day, for the past month.

She also declared that they will continue to monitor my son’s growth closely with an ultrasound each month until birth. I didn’t argue this point because I know this is standard procedure for a woman in my position. I also know I haven’t technically gained any weight (I weigh what I did a week before pregnancy at this point, despite losing weight in the first trimester and then gaining it all back in the second trimester) which makes me nervous that maybe my son isn’t growing well. He is in the 60th percentile for overall growth, with each measurement proportionate to the next (except his head which is somewhere in the 70th percentile, which is a family trait). I am afraid that I might have an up-hill battle on my hands to be given the chance to labor normally and for as long as necessary. I’m not so blind to my own wants to not see that in certain scenarios an induced labor or C-section may be needed, but I’m just worried the subjective data won’t lean in the favor of an unmedicated birth. My internal rebel is ready and itching to buck the system, man! The man is always trampling our rights, man! Okay, my internal rebel sounds more like a hippie protester than a mom prepared to fight for the best birth for her baby. But, the point is this–preparing to argue with my attending physician during the birth of my child isn’t something I should feel the need to prepare for or avoid by coddling my obstetrician. Something has to change.

As I now will be seeing my obstetrician every two weeks, my focus for each appointment is to ready her for my son’s birth. I know this sounds so type-A controlling, but I feel like if I continue to remind her of my desires for a natural birth, preparing her for the fact that nothing has changed my desires for a natural birth, she will be more accepting of my choices in the moments that count (i.e. during labor). She assured me in the beginning of my pregnancy that she would be supportive of a VBAC and that she wouldn’t be placing arbitrary time limits on my labor. I hope she doesn’t forget that conversation when it matters most. I know that hippie rebel will attend my birth if necessary, but I prefer that she instead stays home.

I read this article from the Washington Post about labor from the perspective of a mother that is a well-educated physician, and I thought I would share it with all of you. You can follow the shortlink below for the article.

Pregnant doctor finds intense pressure to have a Caesarean delivery
http://wapo.st/1tLjhre

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10 Replies to “Another Hard-Won Obstetrical Battle”

  1. Here’s the thing at least for where we live….there’s no gaurantee our dr(whom I love) will even be the one delivering the baby because the rotate rounds. Also remember you always have a right to say no. Dr’s ad nurses alike will use scare tactics if they feel your labor is moving to slowly(My shortest labor was 11 hours longest 36) If you haven’t watched The Business of Being Born yet I highly suggest you try to. Take from you want from it but it is VERY imformative in a lot of areas. Plus you may also get some awesome nurses in L&D who will work their butt off to meet your desires.

  2. It’s true here, too, but my obstetrician specifically has a pretty good delivery rate. She delivers 90% of all of her ob patients herself. I have no difficulty saying no, but I found with Eva they didn’t bother to ask. There wasn’t a lot of informed consent happening. I have watched it and I have read Ina May’s Guide To Natural Childbirth and I have done a lot of research about pretty much everything (from labor and delivery to the immediate after-care for me and especially for my baby). Here’s hoping for some great nurses that have the time to listen! Upon admission, I plan to ask to be assigned to a nurse that is natural birth friendly. So now I just pray one is on duty and not overloaded with other patients. I also plan to labor at home as long as possible.

  3. Thank you for sharing all of this. As a plus sized woman, I am just now starting to learn about some of these things and intend to ask my OBGYN about these issues. I think it can be very difficult to find a body positive doctor. At any rate, I hope that your doctor really listens to you and what you want. Hugs to you!

    1. Thanks, Julieann! I am all about autonomy. I am no stranger to diabetes and my body because as even non-pregnant I am insulin resistant. This isn’t something scary, new and overwhelming to me. I will be telling her next visit that I won’t be transferring everything on to paper. If she would like an electronic copy I will give it to her, but I won’t be going out of my way to give her something I have a handle on. I don’t need a babysitter or someone looking over my shoulder. And enough of that rant. Ha!

      If things don’t smooth out, I will go somewhere else. I don’t need a specific doctor to deliver safely as much as I need to listen to my body and follow its cues. Hugs to you, too!
      (P.S. My pre-pregnancy weight was 217, so I understand the plus-size battle!)

  4. I felt like at the beginning of my pregnancy the drs I saw were all pro-vbac. Now, I feel almost like they don’t want me to get my heart set on it. They keep saying things like “If you change your mind and decide to just go for a planned c section….” kind of like they think a c section would just be so easy for me and the ability to schedule it will sway me in that direction. I really really hope you get your vbac!! And if my little guy is happy with coming naturally, I would be thrilled to avoid the c section myself. Especially because I won’t be able to lift Tru for weeks if I have to be cut open.

    1. I realize you have some clotting issues that make it all tricky, but man, I would think that they have solutions for this. Does vitamin K affect heparin? I know it counteracts coumadin, but I wasn’t sure about the heparin. Isn’t there some sort of drug to help your clotting times if indeed you end up needing it??? With all this medical technology surely there is…

      Obviously, I’m not educated on the subject. I’m really hoping that you get your natural birth. I know I sure want it desperately. I don’t think doctors get the difference in recovery for women with c-sections versus women with natural births. Even someone I know who ended up having a pretty severe tear recovered so much faster than she did when she had her c-section. Maybe I am being unfair, but I feel like most doctors I have dealt with really just would prefer that everything is nice and neat and orderly and scheduled and follows a favorable timeline. If only life really worked that way!

      1. Yes you are right about the clotting agent. (I don’t know what it is called) It has to be administered at least 6 hours after my last dose from what I have been told. Which really shouldn’t be a problem since most labors are at the very least 6 hours long. Plus, I don’t even want an epidural for a natural birth but my drs do want me to have one placed “just in case”. But still my drs keep pushing that as a negative to trying vbac. Ironically, I would have to get the clotting agent to have a c section too if I go into labor naturally before a scheduled date unless I am just fine with general anesthesia which I am NOT. Apparently a good many women would rather not be awake for that but I for one, definitely want to be!!!

        And yes, I too feel that some drs are just thinking “But scheduled c sections are so neat and tidy and everything is so predictable!” I don’t feel that way AT ALL!!

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