Thursday, January 25, 2007

OB woes

I am starting to understand why someone would opt for an unassisted homebirth.

Two nights ago, I sat in my living room with a heating pad tied around my head. I turned it on high, draped it over my head, and then used a long tiki-print scarf to tie it in place. I sat like that for over two hours, while the pain in my head subsided a little, until I could finish my homework without having to stop and massage my skull every thirty seconds to dull the throbbing.

I'm sure I looked entirely stupid - in spite of (or perhaps because of) the small bow I'd tied in the scarf. I probably gave myself some sort of brain tumor, or my child will be born with two heads now. At this point, I don't really care, because when the baby is born I expect the headaches to cease immediately. At least the ones caused by pregnancy.

They started when I was less than a week pregnant, if you do the math. Blinding, pounding pain, usually in the front or top of my head. If the headache went on for long enough, eventually I'd get nauseous and sometimes sparkling flashes of light would dance at the edges of my vision. I tried chugging water, I tried peppermint tea, I tried laying in a dark, quiet room. I tried having a caffeinated beverage or two, I tried hot washcloths and hot showers. The only thing that helped even a little was VERY hot steam - I'd hold my head over a hot of boiling water with a towel over my head and inhale, my nasal passages searing and my face turning lobster-red. It usually provided enough relief for me to fall asleep and hope it would be gone in the morning.

When I started regular visits with my OB, I told him about the headaches. He said there was nothing to be done for it. Drink lots of water, take only regular-strength Tylenol for the pain. I just had to put up with it. I followed his advice, I drank lots of water. The two times I cracked and broke my oath to keep this pregnancy as chemical-free as possible, I immediately puked my guts out. Not so much with the Tylenol, then. Meanwhile, the headaches increased in frequency and duration, the average number climing to two or three per week. Sometimes they lasted for days. I told my doctor at every visit and asked over and over if there was something he could do, something I could take, anything. I got the same response every time: drink lots of water, take Tylenol.

I got the same response from him when I told him about my insomnia, another symptom that started after less than a week of pregnancy. I can't sleep. I can't fall asleep, I can't stay asleep. I have rarely slept more than four hours at a stretch since mid-August. I have asked about it at every visit, and again got "nope, nothing can be done." I specifically asked if there's anything I can take, because although I wanted to stay chemical-free, exhaustion is not healthy for me or the baby. A friend's midwife gave her Ambien during her pregnancy, and both she and the baby were fine. But he blew me off. One time he said "maybe try walking more during the day," but that's all I got. Not even "try yoga" or a handout with stretches and relaxation exercises or anything.

My husband has tried to step in and press the issue, and been similarly blown off. My best friend has advised me to get bitchy with the doctor, to just say "Look. I know I can have Ambien, it's perfectly safe, so just write me a damn scrip already." But I don't feel comfortable doing that. Truth is, I don't feel comfortable with my doctor at all. We barely speak at my visits, which are usually very short (less than seven minutes). The two times he's done ultrasounds, they were also pretty short - "okay, there it is, everything's fine, okay bye." If we hadn't pinned him down and asked him a bunch of questions at the first visit, we never would've known about the internal monitoring issue, or anything else about his regular practices.

I wanted to switch right away after that first visit, because neither I nor my husband was cool with the internal monitoring thing. I was bothered that the history they took was only about three questions long, with nothing about my own birth. But I thought I'd give it a few more visits with this guy, because when my primary care office referred me, the girl on the phone said he was well-liked, and he seemed personable enough. Switching meant picking another random name off the insurance company's list, so what if I wound up with somebody worse? I didn't want to be hasty. I figured I'd give it another visit or two and see how it went. If we liked everything else with this doc and I developed a rapport with him, we could deal with the internal monitoring thing one way or another.

But things have gotten worse, not better. I feel less confident in this doctor now than I did after that first visit. My mom told me that she also had headaches when she was pregnant with me, and was also blown off by her doctors. It's nothing, they told her. It happens. Then, whoops, sorry, ma'am, you have preeclampsia, we're going to to do an emergency c-section 10 weeks early. And that's how I was born. This means that my risk of developing preeclampsia is much higher than normal - four times higher, according to some studies. It's also my first pregnancy, which is when most cases appear. But my doctor has no idea my risk is higher, because he's never asked. And I never get a chance to volunteer the information - our visits are so short and I don't feel comfortable bringing it up. I don't feel comfortable bringing anything up, in fact. At the last visit I didn't even bother telling him the headaches were worse. My husband did tell him, and pointedly asked if there was anything that could be done about that or the insomnia. And again got blown off, the same "there's nothing to be done for it" as the doctor was on his way out the door.

I just feel so helpless and angry. I don't want this man delivering my baby. I want to switch to a midwife, but our insurance doesn't cover either the traveling midwives or the nice birth center nearby and there are no others in the area.

I called another OB to try and switch, except this time I was going to to do like the books advise, and interview them first. I called a clinic with three doctors listed, two of whom were female. I wanted a woman this time, to see if that would make me feel more comfortable. I was going to do things right and do my homework before I came in as a patient. I was going to be prepared.

Except those doctors don't do that, apparently. I called and asked if I could come in and talk to the doctors before making an appointment, but was told that I need to drop off the records from my current doctor for their doctor to review, and then he will decide if he wants to take me as a patient. The girl who answered the phone kept saying "he," and I gathered that it was the male doctor I'd be seeing if I'd even be accepted as a patient. One of the female doctors, although listed with this clinic's name and phone number, doesn't work there, she only works at their office in another city. The girl also seemed incredulous that a) I wanted to switch doctors at 22 weeks along, b) I wanted to switch just because I was unhappy with the care I'm currently getting, and c) I'd called up wanting to talk to the doctor at all.

So, basically, I'm screwed.

The message board I hang out on has members in other countries. The women on there who live in places with universal healthcare make it seem so effortless - they just ring up whoever they want and make an appointment. If they want a homebirth with a water tub and a crunchy-granola midwife, they get it. If they want the most sterile hospital environment possible, they can have it. Meanwhile I am stuck with no way to get what I want, no control over how this is going to go. My hopes for a nice, friendly midwife-attended birth are just silly fantasies. It's enough to make a person go buy obstetrics textbooks and take a crash-course in baby delivering.

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