Being sick when you're not sick...

I'm still hanging in - 34 weeks, 1 day. Whew! Every day and week that passes is another day and week better for the baby, but yesterday was a big milestone - 34 weeks mean the baby's lungs will mature on their own (so much for the steroids shots that left my arm all bruised!) if it was born today, and it will have the suck/swallow ability (how much you wanna bet Ron Hart makes a comment on this?) thus eliminating the need for any sort of feeding tube if it should be born today. So I'm feeling slightly less anxious. Though I did have a quick return trip to the hospital earlier this week for more bleeding, I got to go home quicker which was a relief. (Highlight was overlapping by a day with Penina, so I got a quick look at Baby Pod-xander before I left - he's yummy!) Third time is no charm though - if it happens again, I'm booking myself a one-way ticket to stay there until I deliver. I am taking this bed rest thing much more seriously now, though still plotting to figure out a safe way to make an escape for High Holy Days. While most people are dying to get out of a 2 hour musaf, what I wouldn't give to be out of the house! We'll see...taking it slow.

Fortunately we've gotten so much love and support from friends and family. My mom did some grocery shopping for us last week, and generally helped around the house - I tasked her with reorganizing our linen closet, one of the menial tasks on my List. We've had lots of weekday visitors from friends and play dates, which has been great all around. It gives Ivy something to do other than sit on the bed with me and smack the baby or bother Mike while he makes dinner. (Except for the pee pee incident with Polly that proved to be more activity for me than I had anticipated.) And we've been the lucky recipients of some delicious food, everything from pizza to sandwiches, Shabbat challah, and the best - donuts!!! Who knew? And how could I forget this lovely hesed basket from IKAR and the other Gorgeous Fatties:

Step away from the Pirate's Booty, and no one gets hurt...

Thanks to all who have been so generous and supportive - we love you!

While I've been home, and with this pregnancy and birth on my mind every waking moment (and even in my dreams) when I'm not working, I've been thinking a lot about doctors. And hospitals. And insurance. And the generally abysmal state of health care in our country. It's a slippery slope, I tell you. Every time my mind wanders onto one of these topics I fall down a rabbit hole.

I met a lot of doctors during my stays in the hospital. Some of them I think were only 5 minutes out of med school because they were impossibly young-looking. There were even a couple med students who I swear looked more like they were in high school. I got all the rounds - resident on call, Maternal and Fetal Medicine on call, group practitioner (from my OB's office) on call, NICU pediatrician (to have the "what to expect in case I deliver early" conversation) - and of course oodles of nurses. And don't forget, shift change is 7am and 7pm, so you're always seeing someone different.

I heard everything from "If I had my way, I'd keep you here in the hospital on strict bed rest and do a c-section at 36 weeks" to "Everyone around here freaks out about a little bleeding, and I'd rather have to give you a blood transfusion than deliver you before 37 weeks". You can imagine the big ol' WTF I was thinking every time I got a different opinion (even though I liked some better than others), which was usually followed by tears and a meltdown. I just wanted to talk to MY doctor! I appreciated being able to think through all the possible scenarios and options (though believe me, it's not hard to imagine the worst case scenario), but after 4 days it was time find a course of action that made sense and that I trusted. But my OB was out of town over the weekend so I wouldn't be able to connect with him until later in the week.

I love my doctor, Dr. Tsui. The man seriously rocks. It was sort of a fluke that I found him - my primary care doctor referred him a few years ago when we started to talk about getting pregnant. So without any questions or research, I showed up in his office and it's been great ever since (even though, for some reason, he felt the need to explain to Mike and I how one gets pregnant, but that's another story). He's totally laid back, calm, and practical - totally my style. I liked he was pretty conservative with mother and baby in mind (with Ivy, he wouldn't even talk about induction until I hit 42 weeks), as opposed to practicing defensive medicine. And the first time around everything was just easy and complication-free, so we never had to make any challenging decisions or deal with any issues. Plus, he's the only one in the group who delivers all of his patients - the rest rely on whoever's on call that day. This was really important to me, because he knew me the best and I trusted his practice and philosophies. Sure he's super busy and sometimes hard to get an appointment, but worth it to me.

I was so relieved to finally get to see him a few days after I got home from the hospital because he really helped bring me back down to Earth. He was cool as a cucumber - not overly concerned at the situation, but obviously wanting me to relax and take care of myself. Just his attitude and approach alone made me feel so much better. I'm on very modified bed rest, meaning I should be relaxing as much as possible, but leaving the house is also an option. He prefers that I work from home, which I can, thankfully. Probably not a good idea to walk around the mall for 2 hours, but going to a movie where I'd be sitting down the whole time is certainly reasonable. (FYI - I did that last weekend and even though I was sitting I was SO uncomfortable, thanks to my gigantic girth!) And he wouldn't even talk to me about scheduling a c-section yet. Even though the liklihood of my placenta migrating anywhere this late in the game at 32 weeks (because let's be honest I'm not sure how much more my uterus can expand...read how much bigger can my belly can get?) was slim to none, he still wants to wait and see.

Oh and you'll like this one - the baby has decided to be breech because, hey why the hell not?! Can you freakin' imagine - by some miracle my placenta gets the hell out of the way of my cervix only to have Dos chillin' FEET FUCKIN' FIRST?!?! I'm not even going to go there, because knowing me and my issue with odds that would happen.

Anyway, so we're still keeping 39 weeks as the magic number - he's not anxious to get in there and do any cutting before then, unless of course I bleed again and I am close to or just past 37 weeks, and even with my last hospital visit, where I saw him a couple times, he's still not rushing to set a date. This made me VERY happy. As uncomfortable as I am, and ready to be done with this pregnancy already, I'm happy to keep Dos cooking as long as possible.

But despite my great experience I've had for the last several years with my doctor, I find it interesting how many women I hear about, either personally or anecdotally, who don't trust their doctors (perhaps because of a prior traumatic birth experience) or, worse, just blindly trust their doctors because the doctor has a medical degree and they don't. And I don't make this comment to blame the women - I mean, do you really want to challenge your doctor when they tell you your life and/or the baby's is in danger? Not all women have equal access to great medical care, or even the knowhow and research to better educate themselves...or even that they should because, hey my doctor said so!

Maybe that's easy for me to say, because not only am I educated and informed, and I do genuinely trust my doctor, but I also really trust my own instinct. That might sound a little nutty, but I really do and I'm usually right. I know it's not scientific or anything, but I know my own body better than any doctor ever could. Don't get me wrong - I do believe in medical science and know there are people with much more knowledge and experience in this field than I, in addition to knowing how to save lives, but there's something to be said for trusting one's self and letting nature take it's course. I know it's not so simple for everyone, and by no means am I being dismissive to women whose "natural course" has resulted in tragedy, but perhaps there's a hybrid somewhere - scientific/medical experience and healing care and letting a woman take charge of her own body, with all of the tools and knowledge to do, sans barriers.

Ever since my pregnancy with Ivy, I have been very interested in the anthropology and history of birth. I spent quite a bit of time reading and sifting through different schools of thought about the birth experience on the various pregnancy/parenting message boards that I visited. I "met" some really smart women who had a lot of information to share as it relates to the modern birth experience in hospitals of the last half century compared with the entire history of birth prior. At first, I dismissed it much of it as too hippy-dippy for me...I mean really, giving birth in an inflatable pool in my living room? No thanks. And I was never too into the idea of having a doula to be a supportive presence and advocate during the birth process. Too personal of an experience to have someone else besides my partner there. But then I began to appreciate the thinking behind what has become alternative birthing experiences, where there was good peer-reviewed science and research behind it, and I'm now even considering a doula to help me through the anxiety and experience of a c-section.

Until I felt judged for still wanting to give birth in a hospital. Okay, maybe not personally judged, but judged overall by the home/alternative birth movement, which while small is very vocal and present...at least in circles that I run in. Just watch Ricki Lake's THE BUSINESS OF BEING BORN, and you get the idea. (I'm sort of laughing at myself for the irony of saying that, because a lot of women act as if by simply seeing that movie makes you an end-all-be-all expert on childbirth.) I actually got a lot of out that movie - namely that regardless of what birth experience you choose, you are in charge of your body and should be empowered to make informed decisions with which you are comfortable. That helped me a lot during my labor at the hospital with Ivy, knowing that I could speak up for myself and ask for what I wanted and didn't want, even if it meant being pushy with the nurses. And during my most recent hospital visit, I refused to sign the c-section consent form unless it was an emergency, because I didn't want a doctor who wasn't mine making that decision for me because it was more convenient for them even if it was at odds with my wishes or my OB's opinion.

The movie is also another look into how messed up our medical and insurance systems are, with doctors increasing acting in their own self interest to avoid malpractice suits and still get insurance reimbursements, though I already knew that. But like any documentary, it has an agenda. I would have been fine if the agenda was only "here's how wonderful and healthy a natural home birth experience can be" and I would simply decide it wasn't for me. But it had to go further and tell you how horrible and dangerous hospital births are, what with all the drugs and whatnot. Sure, it's not perfect but come on! I really hate the extremes on both sides of this argument. On the one end you have "Giving birth anywhere but a hospital is a stupid idea unless you want to DIE!" to "If you have a hospital birth, especially at ____ (insert name of whatever hospital you're planning to deliver at), you're just asking for an unplanned c-section!" Come on now, people. Obviously there are always exceptions, for both sides, and the extremes here are pretty extreme.

A number of my friends and I have talked a lot about hospital births versus home births and other hospital-alternative births. Some of us only feel safe in hospitals with doctors around, others want a more comfortable and less medical environment. I personally would never choose to give birth at home (even if I had a choice this time around, which I obviously don't) because I would not feel comfortable, even though in theory I completely agree with much of the rationale behind wanting to do so - namely that "natural" births avoid unnecessary interventions (i.e. inductions for non-medical reasons, like fear that the baby will be "too big") that lead to unncessary c-sections (i.e. after said inductions fail). Public health officials estimate that half of all c-sections in the US are not medically necessary - not surprising in our country where over 30% of births are c-sections!

Even if my situation now was different, I'd still plan to be in the hospital, and even get that blessed epidural again. Because also, while home births may be a better experience for the mommy, I can't ignore the statistics that show the infant mortality rate more than doubling in these scenarios because of lack of immediate access to care in the event of an emergency (which is why I hate the flimsiness of the argument "better safe than sorry"- show me the science and then I'll believe you, because by that logic alone none of us should ever even leave our houses in the morning).

Though frankly, after having spent more time in the hospital than I would have liked, I am not in love with the idea of having to spend more time there. There's nothing worse than being "sick" when you're not actually sick. One of the doctors I saw even laughed at the process of how patients like myself are treated, with nurses constantly running in to take my temperature or check the fetal monitor (when clearly nothing was wrong with the baby if it could keep kicking the monitor off!). Yes, I had some complications and I'm glad I sought medical attention. Wouldn't have had it any other way. But come on - pregnancy is not an illness, even with some complications, and all the alarmists who seem to think it is make me totally sympathetic to those who do not wish to give birth in a hospital. But of course I will be grateful to be there should something actually go wrong and I or the baby are in real danger.

So why haven't we figured out an answer that allows women to give birth in an environment that is healthy, safe and comfortable while also providing immediate access to urgent care and the incredible benefits of modern medicine that we have at our disposal? Oh yeah, because doctors are afraid of getting sued and even if they aren't they still aren't getting reimbursed worth their salt from the insurance companies. And our society has veered so far away from how birth has always been experienced for thousands of years and all over the world, with home births being largely considered kooky at best and unsafe at worst. (I know that's a very generalized statement, and it's a much more complex picture, but you get my drift.)

Okay well I really didn't intend for this post to turn into a rant about hospital vs. home birth with no point or end in sight, and since I don't have my research handy and I'm going to stop. I really hope this came out the way I intended...though having gone back and re-read it a bunch of times I'm not sure. But what can I say? I have a lot of time on my hands to think and write about it, clearly or not. And with that, I head into yet another weekend with little do but think...I'll try to come up with something new to talk about next week!