Disclaimer: This is going to be a long post.
I’ve been thinking about this for awhile now, but was hesitant to post it on here because I didn’t want what I wrote to be misconstrued or for anyone in the blog hemisphere to be insulted. But then I realized, this is supposed to be the place where I don’t hold things back, so I’m writing about it. And, c’mon, only like 10 people ever read my blog anyway.
I loved my gynecologist — as much as any girl can love her gyno, because that once a year appointment where you have someone you barely know intensely check out your private bits is more than enough. But, you know, she made it as low-grade awkward as possible, which I appreciated. So when I got pregnant, I stayed with the same practice, naively assuming she’d just put on her OB hat with me from then on. I said naively, I know better now.
The practice typically has midwives run the show for prenatal care and delivery. (As long as there aren’t complications, the literature said. Then they bring in the doctors if need be.) I was a little uncomfortable with that, not because I thought the midwives were incapable, I just didn’t know a lot about them. But I had liked the practice so far, so I just went with it.
At my first prenatal appointment (6 weeks), I anticipated they’d take blood or a urine sample to confirm the pregnancy beyond the stick I peed on from the grocery store. Everything I’d read about initial prenatal appointments led me to believe this. They didn’t. One of the midwives asked me a bunch of questions that I felt I could have just filled out on a questionnaire and turned into them when I came for the appointment, and indicated we were done. She was very nice. But I had to ask about confirming the pregnancy. She very cheerily told me they trusted the stick I peed on and sent me out to schedule the first ultrasound at 8 weeks.
I was kind of bewildered. I definitely got a little weepy on the drive home. I had just wanted a medical professional to confirm through medical practices that I was pregnant. I couldn’t understand why they just trusted the pee stick. I wasn’t even sure I trusted the pee stick (despite have a bunch of stereotypical preggers symptoms)! Shockingly for me, I know — I just wanted a concrete confirmation. And I didn’t feel I had gotten it. Other pregnant women I talked to had said one of the very first things their OB office had done was a blood test. I didn’t know it then, so I didn’t make a big deal out of it, but there’s a tremendously important reason for taking a blood sample — to see if the pregnancy hormone levels were where they should be.
Shortly after this appointment, I got a vicious cold, but knew I couldn’t necessarily take the meds I would normally take because I was growing a human. So I called into the office to speak to a nurse about it. She was really quite short with me, telling me this information was in a “mother’s journal” I should have been given at the first appointment. When I told her that I’d been told at the appointment that they didn’t have them printed so I hadn’t gotten one, she openly scoffed, clearly not believing me. She asked me at least three different times about how I hadn’t gotten it and obviously was unwilling to think it could be true. When she finally, finally, just told me the meds I could and couldn’t take (which would have taken 30 seconds if she’d just done it to begin with), she was extremely short and clipped.
I have to say, that I get being pissed off at people for not reading information that was already given to them — I feel this way quite frequently with parents who don’t read things I have sent home repeatedly and then get mad at me for “not telling” them. Because I get it, I was trying to be very calm and not get upset with her for how she was treating me (even though I had legit never been given the information). After all, how dare I call and take up time because I’m trying to avoid harming my baby in utero. But by the time we got to the end of the phone call that had eaten up half of my lunch break, I couldn’t help say a little something. So when it was time to hang up, I thanked her, and then I apologized for wasting her goddamn time (okay, I didn’t put the curse word in there, but I thought it). And all of a sudden she was shiny and friendly and chirped, “Oh, not at all!” Ugh. Hubs was super pissed when I told him about it and wanted to call the office, but I just told him to let it go.
When we finally went in for the 8 week ultrasound, I was so relieved to see my baby, to hear the heartbeat and be told that it was strong, to hear that the baby was measuring right where it should be for how long I had been pregnant. But they still never took a blood sample. And around that same time we learned that for some reason, they didn’t have privileges at the hospital that is quite literally 5 minutes from their office and 5 minutes from my house. When the baby came, we would have to drive 20 minutes away to deliver. Which I was a little uncomfortable with, but again, I shook it off and told myself when the time came to deliver it would be fine.
We were told the 12-week appointment would be long, so we expected to be there about an hour. We were with a different midwife this time than at the 6-week visit, and I really liked her. She was genuinely friendly and answered all of our questions, and she did an internal exam and assuaged my fears by assuring me the spotting I’d been having was completely normal, and she could even tell it was from my cervix being a little more “pliable” (I think that’s the word she used). But throughout the whole thing, no blood samples were taken. Hormone levels weren’t talked about. At the time, I wasn’t even thinking about it. She couldn’t get a heartbeat using the handheld fetal doppler, but assured me this was completely normal because at 12 weeks the uterus is just starting to rise up from behind the pelvic bone. She set up the ultrasound tech so we could for sure hear the heartbeat and I wouldn’t go home worried.
And you all know what happened then. I wish I had ended up just worried instead of devastated. And that night we moved from midwives to an OB, because we needed one for the D&C.
Looking back, I get hung up on the fact that they repeatedly did not take the opportunity to take blood samples. Through my research in the aftermath, I learned that the pregnancy hormone found in the blood should be at a certain level at certain times, and increasing. That low hormone levels could have indicated that something wasn’t going the way it should be. I know you can’t prevent a miscarriage, but I still wonder if they had checked the levels, if we at least would have had a heads up that the baby would die. I don’t know if that would have mattered, but it might have.
At the two week post-procedure check up from the D&C, being back at that office was a major trigger. Add to that, the doctor was not receptive to my questions (I think I’ve written about that before). He seemed very defensive when all I wanted was to understand and gain information, and very dismissive when I inquired about ways things could be done a bit differently during a subsequent pregnancy. Progesterone? Possibly not projecting my baby onto the ultrasound screen until a heartbeat had been confirmed? Somehow medically confirming my pregnancy right away? Being more prepared for a devastating outcome? I was crying, yes, because I was grieving but also because how he was treating me was pissing me off. He wasn’t actually hearing me, he wasn’t actually trying to, he wasn’t answering any questions I had. He said he could mark on my chart that I was having trouble getting over it. If this had been many decades ago, I swear he probably would have tried to commit me to a home for the mentally infirm.
When I left the office that day, I told myself I wouldn’t be going back. Things had bothered me and I had pushed them aside, trusting that the medical professionals knew best. I knew I couldn’t go back to a practice that wasn’t willing to hear me — as a devastated maybe mama, but also as a person. I knew that if I got pregnant again, I needed a practice that would work with me, be open to my thoughts and fears and willing to support them and me. I knew I would be terrified because of what happened to my first baby, and I needed a place that would both see that and respect that. And I knew it wasn’t this place.
Please hear this: I don’t blame the practice for losing the baby. But I do kind of blame for how they handled the aftermath. And I know that the OB that I dealt with is not the only one there. As a whole, the practice is, I’m sure, extremely competent in the medical side of what they do. And I’d bet that for pregnancies that go smoothly, they’re great. But they clearly didn’t have any sort of plan in place for when pregnancies go wrong, and how to support women and families after that kind of loss. And I just plain old didn’t trust them anymore. I know there are those that would argue that they only need to be held accountable for the stark medical nature of things, not the emotional side. And to an extent, that’s true. But the thing is, they are treating human beings, so they need to be able to treat human nature as well.
There’s a part of me (which we could psycho-analyze all day long), that was almost afraid to switch to another practice. Some part of me that learned over the years that I should just go along, just deal with it, just trust the professionals even if you don’t, don’t rock the boat, yada yada yada. But I decided to tell that part of myself to shut the hell up.
It is okay to walk away from your OBGYN, or anything else, when you feel like something is wrong.
So I started the search for a new OBGYN office. I had a few awkward conversations, because I would cold-call these places and ask to talk to someone about how the practice was run, what were the routines, the feelings, the procedures and protocol, how did they handle unfavorable outcomes, etc. I was honest, and told them I had recently had a miscarriage and felt I needed to switch doctors. I told them that before I did so, I wanted to get a feel for the practice to see if it would be a good fit. Sometimes blunt honesty can be cring-worthy. I think I threw some places off, possibly ruffled some feathers.
I found a place where the receptionist kindly but quickly connected me to a nurse’s voicemail, saying that’s who could answer my questions. I left a message, where I kind of babbled a bit, and fully expected not to receive a call back. But surprisingly, I did. After I got through the initial stumbling explanation of what I was looking for, and the nurse was able to process it, she became the first person who was willing to listen and talk with me about it. Through her, I learned what was done first when a women made the first appointment for pregnancy. She told me tests would be run to determine several things, one of which was hormone level. When I asked her if that meant a blood test, she kind of paused and then said, “Well…yes.” Like it was baffling to her that that would be something new.
She told me about the procedures they have in place for when a miscarriage occurs, and said that medical professionals have to realize that they are treating people, not just a condition. SWEAR TO GOD, she said that without any nudging or leading on my part. She said that given the fact I had already had one miscarriage, they would probably be checking more often on different things to make sure any subsequent pregnancy was okay (or not). She was unbelievably kind, gave me all the information that I asked for, and when I hung up I knew that this was the place I was going to take a leap of faith on for whatever happened next. I am so grateful I got to talk with her.
I wanted to tell this part of my story, but I also want to tell you this: If your story is similar in any way to mine; if you are unsure, or uneasy, or just feel like something isn’t quite right with the health professionals you are putting your faith in, it is more than okay to walk away and go in search of something or someplace else. It is.