Monday, October 15, 2012

The 36 Week Appointment

Today was my fourth appointment at the new doctor's office and it got off to an interesting start.  The nurse announced that they were doing the Group B Strep test and I (stupidly) said that that was a huge relief, because when I went into my intake appointment at the new place they had insisted that my old records said that I'd tested positive.  I pointed out that I hadn't had that type of exam during this pregnancy yet, and there was no way she'd done it at the August appointment as they claimed, since the only test that was run was a good old fashioned ultrasound.  Besides, I said, I was on clindamyacin for a week this past month.  It's used to treat MRSA.  It's used to treat malaria.  It's a nasty antibiotic (after taking it for that week I would seriously prefer any other antibiotic that I'm not allergic to as an alternative).  I mentioned that I doubted that anything at all could be alive after I'd taken it.

Then we joked about how it's not exactly a test that one forgets, and I pointed out that I certainly remembered it being done during my other pregnancies.

The nurse left the room and returned and informed me that the test had already been run and so there was no need to repeat it since I was positive.  I repeated what I'd already said, that the test hadn't been done and besides I'd been on the antibiotics.  She cheerfully responded that it had been run at my other doctor's office, and that the antibiotics wouldn't do anything and she didn't understand why they'd given them to me anyway, but that they wouldn't run the test "again."

I sighed and waited to meet doctor #3.  I don't have a problem being given antibiotics that I actually need.  But I've been pumped full of high doses of antibiotics way too often this past year.  There were the 17 days of doxycycline (plus an IV drip of it) before, during and after the D&C (also used for malaria, anthrax and the bubonic plague), the week of antibiotics after the chest x-ray in April and then the week for the nail (it's been a rough year!).  I'd rather not be pumped full of any more if it isn't actually necessary... because I'd rather not feel like petri dish for antibiotic resistant bacteria after taking such a ridiculous amount these past months.

I was surprised when doctor #2 (of the 9 Quick Takes appointment) came through the door instead.  He asked if I was still set on the VBAC and I said yes.  And I have to say, today he was actually very pleasant and polite.  I asked if I could have a saline lock instead of an IV, even with the antibiotics.  He explained that I would have to be hooked up to an IV for 20 minutes every four hours while I was in labor, but that I could request they remove the IV and leave in the hep lock, although standard operating procedure was to leave it in.  And that led us right into the conversation about monitoring.  He said that standard operating procedure would have me hooked up to a monitor for the entire labor.  I asked if that meant being in bed flat on my back for the entire labor.  He said that the hallways would be much to crowded if they let people walk the halls at such a large hospital (I guess that's a "yes" to the "flat on my back" question) and I asked if I might just sit on my birthing ball in my room and move around in there.

He said that both the IV and the constant monitoring were purely for insurance reasons and no one could force me to do anything, so all I'd need to do is sign a paper stating that I was refusing to follow standard operating procedure.  I'm going to start working on my birth plan this week... and am wondering how that will be received since apparently I'm going to be violating "standard operating procedure" right and left.  The biggest issue is that they want me to "get to the hospital really early" and  that makes me especially opposed to being stuck in a bed.  So I guess I'll be signing quite a few waivers.

I am kind of amazed at how difficult it is to have a natural birth.  Apparently there's nothing "standard" about it these days.  However, after having experienced the alternative and having researched and read, I'm pretty confident that we're at least attempting to begin in the right direction... and if we have to move on to other options because of a medical reason that's fine... but I'm definitely going the opposite route than the one I went the first time around.

Now to sew and relax a little... and hope that the baby decides to stay put for a couple more weeks!


  1. You can request then test again. its pretty standard to do so since whether or not you are positive fluctuates during preganancy. you can also take the antibiotics thru heplock. I did. You can also thru shot I think. dont let then fool you. you can always say 'no.' its really rare that babies get strep.

  2. meant no to iv and traditional drugs. google strep b alternatives

  3. I'd be insisting that they run the step test again. I tested positive for Group B with my first two and was so happy that I didn't test positive for it with my last pregnancy. The last thing I wanted was to be told I needed to get to the hospital early in labor for antibiotics.

    Just because you are hooked up to the monitors doesn't mean you have to be stuck in bed. They monitored me while I sat on a birthing ball with my last labor. I was also able to stand next to the bed and labor with my first while I was hooked up to the monitors. Just make your wishes known and have Paul advocate for you, too.

  4. They can tell you to do whatever you want but you don't have to consent. And you can labor at home as long as you like as well. Also, maybe check with DONA and see if there are any student doulas who might be willing to attend your birth for free?

  5. I agree- ask them to run it again! I had the test twice in my 1st pregnancy because I wanted then to double-check since I am allergic to pennicillin (it was positive both times and I ended up getting an alternative antibiotic)

  6. Try not to be too upset with 'standard procedures' in hospitals. I've been in health care for years and we've had to implement sooooo many protocols and wavers you about get carpel tunnel form signingnto get a basic procedure like an x-ray. Part of it goes back to corporate compliance, governmental compliance, and covering our own butts from a lawsuit. I personally don't work in a high risk area, but we are always worried that someone will (and people have) accuse us of not doing our job. And THEN we do pull out our suitcase of paperwork because one person's word/paperwork means squat. But four pieces of paper can and has come to our defense. So, sorry bout the paperwork, but nowadays there's not much either of us can do but to sigh and sign to get what we want.

    And remember, No One can FORCE you to do anything you don't want to. Keep your husband and birth plan on hand and make sure evryone knows that the buck stops with you and your husband!

  7. I don't mind signing the papers, its more the incredible pressure to not sign them and go with the flow because "it's standard operating procedure" that worries me. I keep offering to sign anything, and I'm hoping they'll leave it at that without pushing the issue!


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