Wednesday, October 24, 2012

For the Love of OBs and Therapists

Lest anyone think my OB practice is a bunch of pushy surgeons, I should clarify a few things. Things I realized in therapy today. (Last sesh until after the baby. And then right back on the couch with a baby at my teat to deal with the likely postpartum anxiety. It's how I roll.)

It's clear to me now that my OBs weren't dwelling on the what-if scenarios because they don't expect them to happen. Scheduling the induction for 39 weeks was a placeholder move, in case we mutually decide it's the right thing to do (ACOG does recommend 39-week delivery via induction for gestational diabetes to minimize ongoing risks to mom and baby). Given my history of A) early labor during the 38th week and B) uncomplicated vaginal delivery of an 8-lb baby, my OBs are actually quite optimistic that a second labor, even if it's a big baby, will be both timely and fine. And as for C-section (which ACOG does suggest should be offered for babies expected to be in excess of 9-10 lbs), I have been absolutely reassured that I can labor through the ol' vag and that again, my history is encouraging since we know I can easily deliver a baby this way. If this was my first L&D they would be a bit more concerned, but this philly has produced results.

So my big realization was that *I* was the one blowing this out of proportion due to anxiety. Not that I don't deserve more info, which I am now getting having spoken up to request it, but my OBs really are just expecting a straightforward labor for me and were acting accordingly. If any of the what-if scenarios manifest, I'm sure (in the absence of recent conversations) they would give me the same non-pressured talk about options. It's just not my personality or in my comfort zone to wait and see and find out *then* what the options are. I need to know *now*. So now I do. Keep calm and carry on.

My OB practice is great, and I'm happy with them despite the recent hiccup (which was exacerbated by an idiotic scheduling nurse -- her, I could do without). After years of trying to conceive and a total of 4 IVF cycles followed by difficult (to differing degrees) pregnancies, I've not had the cajones to even consider a home birth, and wouldn't have been a candidate for either pregnancy anyway (hypertension during delivery with Jackson and gestational diabetes with this baby -- no midwife practice in this area would touch me with a 10-foot pole). And birthing centers are out for the same reason -- they only take low-risk pregnancy/L&D presentation. All of which is moot as I am perfectly content to have a hospital birth. I don't want my recent outbursts to stoke any anti-hospital/anti-OB fires or to suggest that a midwife or homebirth approach would be any better -- for me, it surely wouldn't. The same miscommunication could occur with any internist over even the most mundane medical issue, but because this is about having a baby, it's emotionally charged. I amped it up in my overly analytical way and let the stress of recent complications make it a much bigger problem in my mind than it was in the OBs'. Lesson learned, sometimes it's really not you, it's me.

But it does not escape me that this is my last one -- last pregnancy, last birth -- and I want to remember it well, not with remorse or panic over hastily made decisions or traumatic responses to complications. I have limited control over birth, as is true for any delivering mom (the tiny tyrant calls the shots, more or less), but I want to strive for the best possible experience. So these recent conversations with my OBs have at least led us to that request, laid out bare, so they understand that this is special. I fought as hard for this baby as I did for Jackson, and have suffered through a hard pregnancy at least as much (and here at the end, a bit more) and want the conclusion of it to be something I can remember fondly (just as I remember Jackson's birth).

Acupuncture and prenatal massage are next week. Same practitioners I saw the same week when pregnant with Jackson, and then went into labor less than a week later. Bang a gong, get it on.



bunny said...

Well, okay, I feel better. Still, I figure anxiety is par for the course with OB patients, and they could have done a hell of a lot better at reassuring you. Like maybe tell you all those things.

hope4joy said...

What you said about this being your last pregnancy and birth is very important for your OB to understand. I preached the fact that B was my one and only and I wanted to know everything and plan for as much as I could. I expected every appointment to go as I wanted and all of my questions to be answered. Good for you for sticking up for yourself. I am with you on the anxiety thing. It sucks to deal with but at least you are prepared for it. Enjoy these last few weeks.

Mina said...

I think it is minimum decency of doctors to answer patient's questions. Most patients are afraid to ask or simply have no questions. Don't appologize. It is your right to ask and their duty to answer.
Here's hoping your labour starts precisely when you want it to. :-)

Rhianna said...

Dude, I think you had legit concerns. And I think it's entirely understandable how anxieties can escalate in circumstances such as these. I'm relieved that you were able to assert your needs and hopes, and I'm doubly relieved that they were met with understanding and reassurance.

I love this focus on making Numero Dos' birth memory positive and warm. I am getting more and more excited for you guys every day. :)

Happy needlin' and massagin' this week! BANG A GONG.