Thursday, September 25, 2014

The 36 Week Check (in which I rant)

Warning: If you dislike kind-of-rants or words like "dilation" or "pap" just breeze on by this one.  It's a pregnancy update/ appointment post so these things will be mentioned from time to time.

There's one every pregnancy.  A venting post.  A why-oh-why do I have to meet every doctor in the practice post, because one of them will inevitably be unable to keep their mouths shut about our family size or about their thoughts on the fact that I'm not signing up for a little packet of pills the moment that this baby is born.

I understand the reason for the policy of meeting every doctor... because one of them might be on call if the baby decides not to make it to his due date... but that doesn't mean I don't dread going in to meet the newest hire because in my mind chances are that since the two doctor's that I've been seeing are great and respectful and understand that violating my religious beliefs just isn't going to happen, the newest one will probably have thoughts on the matter that they just aren't quite able to keep to themselves.  At least that's what I've taken statistically from my own experience moving from OB to OB as we moved across the country.

Before she came into the room I saw a flier on the wall that said that her specialty included contraception, but I didn't think much of it.  She's an OB/GYN, for quite a few of them that's a pretty big part of their jobs.  Besides, this practice and hospital have both been pretty awesome in the past about not pushing contraceptives.  When I was having Patrick they actually asked if there was anything they could do that I would find offensive and I was thrilled to be able to say "Yes.  I would love it if people wouldn't try to push the pill on me while I'm here because our family doesn't believe in contraception and I'm not going to be changing my mind." and for the first time in my experiences having babies in hospitals no one acted like I was an idiot or made comments about how I'd be back in a few months having another one.  

I like my doctor.  I like the other doctor in the practice.  I was hoping I would like Doctor #3.

She walked into the room and introduced herself and immediately asked me what form of contraception I was on before this pregnancy and what form of contraception I would be started after it ended.  If she'd looked at the chart the answer would have been staring back at her, but she didn't, or if she did, she ignored what was there because she obviously wanted to lecture me on the subject.  When I answered that I wouldn't be going on the pill she launched into a description of the dangers of having more than four c-sections.

I naively thought that maybe she just hadn't looked at my chart.

"Thankfully so far we've been really lucky."  I found myself saying.  "It seems that I don't really scar very much and during the last c-section they found again that there was very little scarring and that I would likely be good for at least two more c-sections, although we'd reevaluate as we went along."

"Well it's true that scarring can be important" she said "we don't really know what's going to happen.  We don't really know whether or not your uterus is going to rupture."

I didn't roll my eyes and say what I was thinking when she said "we don't really know what's going to happen" which was something along the lines of "You're right.  We don't ever really know what's going to happen... I could walk out the door and get hit by a car in the parking lot... but at this point every single doctor who's worked with me has been incredibly impressed with the state of my c-section scars and uterus after three c-sections, both inside and out, so... so far, so good."

She then began to explain how she had been in a practice that was very, very supportive of NFP in the past, and was "very familiar with it" before beginning to explain why it just wouldn't be right for me and ending with "how old is your youngest anyways?"

I'm not entirely sure but she may have been slightly disappointed when I said "22 months right now... He'll turn two just after the baby arrives." because it wasn't the scathingly condemnation of not being on the pill post c-section, that I suspect that she was looking for, that it might be if I was having Irish twins less than a year after having the surgery.

Then she glanced at my chart and said "Oh did your doctor tell you that your pap came back as abnormal?"

Now since she said those words I've talked to quite a few friends who have doctors who won't even do paps when they're pregnant because the chance of a false positive during pregnancy is so incredibly high and the results rarely accurate.

I shook my head.  "Well it did." She continued cheerfully.  "It might be false.  Who knows.  There's a little chance you'll just have to get another one done at the six week appointment and that will be it.  We can't really tell at this point or do anything about it until you've had the baby.  We'll retest at your six week check up."

It was around this time that I really started to not like her.  If I had to guess I would guess that my doctor probably didn't mention it because a) the percentage of false positives is high and b) he knows that I worry and decided that having me worry for six months when they were going to wait to retest at the post-natal appointment was pointless.  I just don't feel like it was her place as not-my-doctor to tell me without talking to him... because of course I spent the rest of the day worrying about what that meant and googling and then imagining worst case scenarios and how on earth I would handle a worst case scenario like cancer along with everything else that needs to be done.

The one bright point of the appointment (which I can find if I search hard enough) was that despite the fact that I was having serious contractions about two minutes apart (thanks to the walk from the parking lot) and was already at 1 cm when she checked (not bad for me at this point compared to past pregnancies when I was usually 3-4 with a month to go...and they did all make it past 39 weeks) she didn't make me go to labor and delivery to get checked because I was able to clearly describe how this has happened with each pregnancy and it hasn't meant I was actually in labor, even though it really, really looks like I am in labor with the contractions and their intensity and progress.

So I'm supposed to be careful and make sure I don't wait to long if they don't eventually stop when I lay down and hopefully we'll keep on chugging along until the scheduled c-section.

As I left the office I couldn't help but draw one conclusion that is totally anecdotal and obviously doesn't apply across the board, but that I can't help but think of all the same.  With the exception of the NaPro doctor that saved my life in Florida, most of the female doctor's I've had, OBs or just general practice, have not been able to contain their contempt with my not being on the pill (or accepting the tubal that they're determined to offer) and have instantly treated me like I'm obviously not all that bright and it's their job, in the most condescending of tones, to educate me on how stupid I am...

I've also gotten this reaction from male doctors who have mentioned that they too are Catholic and who can't wait to share that they know plenty of Catholics who love contraction.  Whereas the non-Catholic male doctors I've had have asked a few questions and said something along the lines of "well, it sounds like you've done your research... you're informed... and you've made your decision... so I can support that." and not brought it up again.

I know there are many, many doctor's out there that don't fall into that generalization, but that sort of condescending paternalism that seems to be born of what we have in common while condemning choices other than the one that they have made is one of the most irking things about these appointments.  It sometimes feels like these are the same doctors who would be all about reproductive rights, as long as the choices made with those "rights" are in line with what they would decide for their patients.

And in case you were wondering, now that we've gotten that lovely meet and greet out of the way, I will be refusing to see her a second time.  I just don't have time for that.  And I'll be pestering my own doctor with all the questions that I now have thanks to her little reveal at our next appointment, because I really didn't feel like asking her anything by the end of the appointment.


  1. I've seen two OB-GYNs, one nurse practitioner and one doctor, for really bad cramps. Both were female. I saw the first when I was a sophomore in high school, so I didn't know a lot and agreed to take the pill (which only made me nauseous and did nothing for the cramps). The second, the OB-GYN, was completely unwilling to discuss any options other than birth control - including invasive options such as an IUD, implant, or shot - despite the fact that I have medical contraindications for all of them.

  2. I'm feeling very put out on your behalf. :-\ So obnoxious.

  3. Too bad your husband can't come along with you to these appointments. That's what I do with doctors like that. I had one doctor who wanted to send me for a test (forget the name) that would induce an asthma attack. I had to go off my inhalers and was in such bad shape the tech refused to do the test. I had Colin come with me to the doctor next time and he told her 'no' and she said 'ok'. If I had tried that I wouldn't have gotten that response.

    Hope the baby waits until the good doctors are on!

  4. I wonder if it is because you have had csections, the part of the country you live in, or a subconscious evaluation of your choice of life vocation - my experience in general is that women are more sensitive and judgey when they think you might be evaluating THEIR life choices, as in they work full time instead of staying home with the kids. I have gone to an all women Oh/gyn practice for all six of my pregnancies in the past six years (though two miscarriages at three months along so my actual live child spacing is between eighteen months and twoyears due to breastfeeding). and no one has ever even mentioned contraception, and I am not Catholic, just Christian. but I have a Ph.D. and work full time, so I think they assess me as more like then than not, despite my conservative beliefs, and don't feel the need to justify their life choices by belittling mine. actually both doctors who did my d and c's -neither miscarriage completed on its own - encouraged me that they hoped to see me back again in a few months. I have had all vaginal deliveries, but gestational diabetes, so not atotally uncomplicated pregnancy.

  5. I feel you after my last I almost died due to hemmorage my docs begged me to get a tubal I said no I've had vaginal deliveries but I still got bullied over family size then I get back to mexico and the docs actually put me down call me backwards for not getting a section since here all women whether first time or not usually get c sections then tubals after the third its government policy here and in mexico city its highly enforced I've been threatened over not using BC or getting fixed mean docs are everywhere I'll never have another baby due to a severely complicated ectopic but if I did I'd search high and low for a catholic doc to avoid the BC pushing and family size discrimination god bless you and safe delivery

  6. I've had appointments like that. Even appointments where I was in for a SINUS INFECTION and the doctor spent more time pushing birth control than evaluating my condition. I LOVE taking my hubby to appointments.

  7. Huh? Taking your husband to your doctor appointments to protect you from big bad doctors who challenge your possibly risky choices? Wow. Just... Wow. Ladies, you don't need a man to come advocate for you, and as a medical professional, when that happens it is a huge red flag for domestic abuse. At the very least, it is a red flag for a subjugated female being forced to birth some controlling man's army of babies at the expense of her health and sanity. Ladies, if your doctor is so bad that you feel you need protection from him or her... Switch doctors!

    1. I don't get your logic. How does having a low tolerance for idiocy somehow translate to not being secure in one's reproductive choices?

  8. Unfortunately with various insurances it can be really difficult to find doctors who don't have this sort of attitude, as is evident by the number of women who run into this problem. It's fairly common (I would say at least around the 50% mark) among the women that I know... and if a doctor is going to be repeatedly condescending and obnoxious I don't think they can be surprised if their patients don't want to be alone with them.

    It's actually such a problem in other areas that I know that Mae's case worker has to accompany parents to pediatrician appointments as an advocate because of just this sort of rudeness... it just so happens to be the case with some of Patch's doctors (we haven't changed because these particular doctors are known for their brilliance...) and my solution has been to send Paul to Patch's appointments where we found they were far more respectful and far more likely to listen to any concerns that were voiced.

    I don't know... I find it kind of concerning that as a medical professional you're first thought is to blame the patient for choosing to have someone she trusts advocate for her after being bullied by a doctor. There's a certain power imbalance in that relationship that seems to be being leveraged to attempt to get women to do something that they don't want to do.

    Maybe I'm a little extra bitter because the last doctor that tried to basically force me to do something (go on the pill after the miscarriage and ignored my pleas to do an ultrasound because I knew something was wrong) almost cost me my life. He laughed at my expense and condescended and was the best in the field and was dead wrong when I finally got another doctor to do an exam and after 30 seconds she found that I'd been retaining the placenta for three months... it kind of shattered my rose colored glasses that had me pretty blindly trusting my doctors up until that point.

    I'm sorry. I just don't think there's any excuse for that rudeness. My current doctor and I have disagreed once (about having an epidural) and he was able to convey his thoughts and have a discussion without resorting to rudeness. I find it deeply disturbing that it's so hard for so many women to find that same sort of respectful discussion, rather than coming to expect rudeness and insults as the status quo.

  9. Well said Cammie. And if 'anonymous' had bothered to read my post, my doctor issues aren't related to babies and 'risky choices'. It was the DOCTOR who was risky my health for no reason (so said the lab tech who refused to do the test on me).

    As an alleged 'medical professional' they shouldn't have a problem with us having someone along for back-up. What are they trying to hide??

    Oh yeah 'switch doctors' -good one. I don't know what it's like in the States, but up here in Canada, if you don't live in a big city, chances are there is only 1 or 2 options for a doctor (if any) and in the city most of the doctors are full and not taking new patients. So you are happy to have a doctor at all. Which is why you bring back-up if you get stuck with a rude bully who doesn't deserve the term professional.

    BTW, how is it domestic abuse if my loving husband comes along to make sure I get the care I want and deserve and respect. It's 'medical professional' abuse he's protecting me from. God bless good husbands :)

  10. My undying sympathy. I’ve made a point of finding pro-life OBs and now a midwife who are not going to hassle me over the subject when I am pregnant. And frankly, having someone to advocate for you while you are hormonal and vulnerable makes perfect sense to me. I wish my husband had been there with me in post-partum when a nurse did not ask me but TOLD me, 3 times in fact, that I was “done” having kids.

    So I haven’t had it from an OB but I have from other docs. Sinus Infection, thyroid check up… it doesn’t matter why you are there, if they are gung ho about contraception, they will bring it up and, usually, if they really are so pro-pill, will look at you or speak to you condescendingly for not falling seemlessly into their way of thinking.

    Hang in there…. almost there. :)

  11. Sometimes I can't help but wonder if the pushing of BCP is due largely to fear of being sued on the doctor's part?

    Like, I can understand a doctor saying "look,I have concerns about your health if you continue to have more children", or asking a patient to sign a form stating that they've been advised of the risks involved if they don't space out their pregnancies, they've been counseled regarding contraception, and they are still choosing not to use it.

    Not the best solution, perhaps, and I'm sure some docs would refuse to treat a patient who didn't agree to use contraception. But seriously there has got to be a better way of doing things!


  12. Dear Cammie, I think there is a difference between discussion of reproductive choices and bullying. And I would not put a ONE-time talk with a NEW doctor into the category of bullying. Instead, it is a good opportunity to show that we know what we do, that our choices are that: OUR choices -and that they are based on thorough thought, research and reasoning rather than blind adherence to something decided for us by others.

  13. Cammie, you say you are secure in your reproductive choices. But how secure can you be when such a little thing like a talk with your doctor whom by the way you owe no justification of your reproductive choices to irks you this much and makes you go so much on the defensive?
    When this happens to me I see it as a sign that I may not have examined and prayed over this matter as sufficiently as I thought. How about you?

  14. Hi Anonymous,

    I think a big part of what you're missing here is tone. Her tone was well... obnoxious. And condescending. She was talking to me in a way hat I wouldn't want to hear someone speak to my four year old.

    That's what I have a problem with. And she's not my doctor. I know that my doctor has our choices noted in my chart. Which is another reason that it irked me.

    And perhaps the thing that irked me the most was sharing test results, that can't be said to be accurate or not at this point, that my doctor was obviously waiting to share, knowing that it would likely cause about eight weeks of stress, when again, she ISN'T MY DOCTOR. She's someone in the practice that I had to meet one time because that's the policy.

    I'm actually really comfortable with our choice and confident in it.. however I've also experienced this tone/attitude many times (as have many other women who've commented here), and it's annoying. When I articulate that my doctor and I had already talked about it and were in agreement she should of backed off instead of continuing to push and insisting "it's not a good idea for you" when she really knows next to nothing about me from the amount of time she'd apparently put into glancing at my chart.

    Maybe you should pray a bit more of your tone and what your projecting on others online and look at what it says about yourself. Because you're missing the mark here and I think it says way more about you than anyone else in this conversation.

  15. The key here is this was not her doctor. That was mentioned in several places here... I'm not saying being rude or pushy would be anymore OK if it was (at that point I would look for a new provider... Exactly what I ended up doing), but there's still a big difference in what's going on in this instance. Her Dr is on with her choices, has them written down, etc. This was not the other drs place to step in and try to convince her otherwise esp with that tone.

  16. (Note: I posted this the other day, when you first wrote, but it was not published. I thought perhaps you thought it was too off topic, and chose not to let it through. Or it may have just been a glitch in the OpenID system. Hope it applies now considering the comment by Anonymous.)
    I'm glad you shared your experience. I think it reflects the general hostility of the feminist's movement toward pregnancy and life. I bet there are a lot of women going through this type of negative feedback in the OB’s office regarding having children. How many want more children, could support more children, but are convinced to stop having them by the obvious negative tone of the doctor?
    It's good to be prepared for this kind of pressure going in, and be ready for whatever they throw at you as they misuse their authority and professional status to browbeat you. The doctor's office is the front line of the contraception/abortion wars, and if you don't know that going in, you're going to come out shaken or maybe worse, doubting your decisions.
    The bottom line, though, is that the patient ultimately has the power over the decisions about their life and has the final say. That's what the permission forms at the hospital are all about.
    What’s really sad is it wasn't so long ago when doctors were the opposite of what you are finding today. If a woman didn't want any more children, and wanted the doctor to tie her tubes or give her a hysterectomy, he would chide her in the other direction, shaming her for not wanting more kids. I'm glad they did, and I think that's correct, but when the whole contraception/abortion issue came to the fore in the 1960's, the women’s "liberation” movement spoke of and treated conception and childbearing like a disease. This ideology seems to have won the culture wars, and has obviously infected the medical schools with that philosophy. That's what you’re up against.
    As you point out, its ironic that they are all about "choice," except when the choice you want to make is not contraception or abortion. When one or the other of them really aggravates you sometime, you ought to point that contradiction out to them.
    The same sort of pressure by doctors is being exerted on the other end of life: caring for an elderly parent. My mother's doctor is great; old school; "take care of the patient until the last breath" kind of guy. But oh, the other doctors that get involved in her care! The pressure to actively do things or withhold things to end her life is enormous. They come on full court press. They act like I'm an idiot who can't see she is old and frail. It's unconscionable. I fight their view of her as an old tree that needs to be cut down. It’s not easy being pro-life these days.
    God bless you always. Praying for your intentions. ~ Bonnie

  17. There are jack-wipes in every field. Male or female, they do not listen to their patients, do not take their concerns seriously, and do stupid ideology based actions that endanger client health. I have had so many different doctors prove themselves idiots in my life that I LIKE taking my husband. The same doctor who pushes the pill because I have TWO kids, from two textbook healthy pregnancies, two textbook natural births, spaced two years apart, and want more kids now that another two years passed-but STILL even in the face of easy pregnancies, easy births, spaced sensibly, and that I WANT TO GET PREGNANT still try to get me on the pill- is usually reluctant to argue that I should be on the pill after I say NO when hubby is there. I even tried cutting off the idiot push for going on the pill by reminding the doctor that I WANT to be pregnant, no good. Tried the I am Catholic statement, nope the stupid doctor STILL spent more of my brief appointment time pushing that pill that I do not want. And these are appointments for things like my bad allergies resulted in another nasty sinus infection, yet none of what I am there for is addressed, just a lecture in favor of birth control and a script for an antibiotic. So I feel no guilt when I take my husband to doctor appointments. I suspect my current doctors listen very carefully to me now mostly because they all know if I feel ignored I'll bring hubby next time so HE can tell them my symptoms. I have gotten MUCH better care since I started dragging my husband to my doctor appointments.

  18. I felt an attitude come from the nurse practitioner I saw for my well-woman check. Both the tech and she continued to ask what kind of birth control I was on and when I said "NFP" they asked if it was a pill and did I need a prescription. I just happily kept saying "Nope!" with a smile and thought in the back of my head that I won't be making another appointment with her. I love that my (male) OB-GYN said NFP is great and the decision was mine and to contact him if I ever needed anything. I can't wait for my next pregnancy to go see him again and have a happy discussion about how things are working out. I try to keep tabs on all the comments everyone else has said as I become a nurse-midwife because I never want to be that provider that someone doesn't want to see again because of the way I said something. I know I will make some mistakes because we all have lessons to learn about our delivery of information, but I am definitely taking notes! I love bringing my husband because we are partners and it's important to me that he is involved in the conversation too. It's not just about me, it's about us and our family :-D.


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