Tuesday, July 27, 2010

Some more pregnancy ramblings

In the past few days, I have been absent from blogging due to being busy with several check-ups. These days left me, more than ever, wishing I could switch to midwifery care and have all my prenatal exams done efficiently, quickly and peacefully, by someone who knows me, cares for me and listens to what I have to say instead of treating me like an idiot.

Unfortunately, independent midwifery is out of reach, financially, for most Israelis. It will continue to be so while the government only funds hospitals where a patient is like a tiny cog in a huge machine.

When I was pregnant with my first child, I already saw how time-consuming it is to always be sent here and there to do this and that examination, not before being sent here and there to get the necessary documents, the vast amount of which often left us fumbling with the net of medical bureaucracy. However, now that I also have a child to take care of, I clearly see how our health system is, with no exaggeration, disruptive to the home life of anyone who doesn't live in close proximity to a hospital or a large health center where all necessary check-ups are available.

My doctor recommended twenty minutes of fetal monitoring three times a week. When I pointed out that in order to accomplish that, I must waste half a day on traveling by bus and back to the nearest city and wait in the blazing heat at the side road (usually with my child in my arms) for an hour or more, all of which is not exactly conductive to the well-being of a heavily pregnant woman, the answer I got was more or less "well, that's your problem."

Yesterday, a doctor told me that if I want to stop being bumped into the "high-risk" and "IUGR" categories, my gestational age must be counted differently. Oh really? What an amazing discovery.  Isn't that what I have been saying all along?

I was told in a very patronizing tone that what I must do is lie about the date about my last menstrual period next time I'm asked. Technically this can be a solution, of course, but I somehow find it mind-boggling that I must lie about an actual fact in order to get the hysteria and threats of immediate hospitalization off my back. Why can't doctors simply face the fact that the date of last period does not always correspond with gestational age? After all, I had several ultrasounds done which confirm just that. Oh but wait, no one has an extra minute to waste on listening to your stupid ramblings. So just tweak the facts.

I wish I could give birth and have my post-natal recovery, if not at home, then in a place where my family could all stay together. I didn't mind being in the hospital last time so much, but now, I have a 19-month-old who is not really old enough yet to understand what is happening, and I find it a daunting prospect to have to disappear from her sight almost completely for at least several days.

Admittedly, my hospital of choice is in many ways the best option I could have, and I'm grateful for that. I just can't help but wish that overall, in all the current system, there was a bit less poking and prodding and treating pregnancy like an emergency, and a bit more humility and facing the fact that doctors don't and can't possibly know everything; that unexpected twists and turns do happen, and it is no solution to have a healthy woman become practically a resident of clinics and hospitals for months.

We are all in God's hands, including unborn babes and their mothers, and this knowledge gives me peace. 

41 comments:

Coffee Catholic said...

Did I miss something, Anna? I've been on-and-off bloggoland because of our three wee kids... why are you high risk? Why 20 mins of fetal monitoring, 3 times a week?? If you could drop me a quick comment on my blog (I'm not always able to get over here to yours) and just let me know you're ok??

And please don't strangle me with your bare hands for asking THE most asked question but... what is your due time?

Anonymous said...

Hi Anna,

Have you ever considered an unassisted homebirth? I have one with my second child 4 months ago and it was the most amazing, liberating experience. My first birth which was a midwife assisted homebirth does not even compare with my unassisted homebirth. Most people will tell you that it's not possible and dangerous but don't believe them. God built us perfectly to give birth. My advice is to put your faith in God and not the doctors. If you would like more infomation on it just Google "unassisted birth" or "freebirth" and you'll find quite alot of information out there. Hope this is some help to you.

-R

Mrs. Anna T said...

R,

To be frank, I wouldn't recommend a completely unassisted birth to a woman who can't be helped at least by her husband during advanced stages of labor. You might not know that, but Jewish husbands do not touch their wives after a certain point in labor. They are allowed to do so if it's an emergency and there's no one else to help, of course, but we aren't supposed to initially put ourselves in such a situation.

Miss Kelsye said...

Unassisted home birth does sound like a great idea in this case, but it can be quite dangerous if there is not a person that doesn't know the medical side of things. The best way to get prepared for a unassisted home birth is to research it. I recommend reading the Bradley book, Spiritual Midwifery ( I do not agree with the spiritual side of this book but there is still a whole lot of good info.)and any thing by Ina May Gaskin. There are also many questions that need to be answered to see if it is even possible to have a home birth like: have you ever had liver damage ( can affect ability to clot), have you had high blood pressure, do you see dots ( a sign of preclampsia), does any type of hereditary disease run on your husbands side of the family. Getting a birth kit together is also a very important thing. Baby, Birth, and Beyond is a very good place to find them for very reasonable prices. If you don't want to but one here is a link what you need yo have: http://pregnancy.lovetoknow.com/wiki/Checklist_for_Home_Birth~1

If you have any question feel free to contact me at my blog.

Blessings,
Kelsye

Thia said...

I too have lied about my last period just to avoid a fight over inducement. They insist on calculating due dates on a 28 day cycle and mine has never been so short! So I tweak the numbers and the sonos agree with that, so they never know.
The amount of monitoring they want to do seems extreme. I do hope things continue to go well with you and that you find some way to deal with it.

Rose said...

Dearest Anna, thinking of you even more than usual. I wish I could and be a help to you. Please keep us all posted. Hugs, Rose

Anonymous said...

Hi Anna,

Thanks for your reply. Just to clarify when I had my unassisted birth it was with my Husband there. Mostly just there for support although he did catch the baby when she was born and did have a look externally without touching me to see if the baby was crowning and he cut the cord. I was not aware of these Jewish laws you mention as I'm not Jewish myself (sorry if any offence was taken, none implied). But based on my unassisted homebirth from that point I don't see that there would be a conflict of interests if I'm not misunderstanding you. But of course the choice is yours as it's YOUR birth experience. But I just wanted to give you another alternative that you may not have considered.

-R

Becky said...

I feel so bad for you! It makes me grateful that, at least for now, I have the freedom in the United States to choose a midwife (though it will cost me a little more money, it's not prohibitive). Of course, that may change with all of the new regulations happening here....

Anonymous said...

I wouldn't recommend an unassisted homebirth to anyone, period; it's a statement, not a sensible practice, and if women choose to do it, of course that's their choice--but it is, frankly, a foolish one. We spent centuries dying in childbirth because there was no knowledge and help beyond the basics; thank God that has changed.

Anna, your frustration is palpable and understandable; I would only say, in defence of hospitals and staff, that the general public often bears some responsibility for much of the (sometimes illogical) practice they follow. Fear of litigation if _anything_ goes wrong drives a tremendous amount of medical practice these days. You say, rightly, that we are in God's hands (although you also know that we have an obligation to take care of ourselves and not deliberately follow high-risk paths); many people, however, simply are not willing to countenance that fact that life entails risk, and illness, as well as things like pregnancy and childbirth (which may be perfectly "natural", but are also often risky and dangerous to women), and that that means that, sadly, bad things sometimes happen. This attitude has led many physicians and hospitals in the developed world to waste a lot of energy protecting themselves from lawsuits. It's not really their fault in that sense. That doesn't really excuse silliness, but one can have some sympathy for talented, often overworked medical professionals obliged to operate within these parameters.

Best of luck to you!

Analytical Adam said...

Mrs T Wrote >Unfortunately, independent midwifery is out of reach, financially, for most Israelis. It will continue to be so while the government only funds hospitals where a patient is like a tiny cog in a huge machine.

Isn't the problem that the government is involved in this at all.

If the government wasn't involved and people had real choice the price of having a midwife would go down since more people would want to do it. If the government paid for midwifes that service would likely be lousy too as they would only be allowed to go what the government tells them and they would get paid only as much as the government gave them which would be a lot less and good women wouldn't be in this.

I am saying this because here in the United States it is becoming more gov't controlled and the gov't with the FDA has always been pushing doctors to push drugs and they make a better living if they put people on drugs.

The government controlling male doctors does not create good care but if they controlled midwives it would also lead to bad care as well. That is what anything the government controls usually leads to.

Anonymous said...

To anonymous, regarding risk, yes, the public bears some responsibility for our attitude, but research in the UK has shown that the public does accept risk, and even that midwives, doctors and nurses are human can maks mistakes. Even following a mistake and a dreadful outcome, many people are prepared to accept that sometimes these things happen - on condition that the hospital/midwife explains what happened, and if there was a preventable mistake, that it is apologised for and they know that the next time it won't happen. In these circumstances, people don't sue. They do sue when they aren't told the truth, or in countries that don't have universal healthcare, because they need to pay the bills caused by the medical incompetence. In both cases, suing can be the only way to get an answer.

I think it's a great pity, Anna, that you aren't able to have a midwife assisted homebirth. They're not common here in the UK, but they are available - my mother had two. They can work very well for families, and have excellent outcomes for mothers and babies. Good luck with at least achieveing a satisfactory hospital experience.

LJ: Nineveh_uk

Matushka Anna said...

I am soooo sorry. This sounds like a perfectly dreadful situation. In your particular circumstances it looks like an unassisted home birth is out of the question. Fascinatingly, my next pregnancy would be considered high risk...just because I would be a "grand-multiparia" - in other words, I already have had five children. Not that I have ever had any problems during pregnancy. I have also had trouble with dates. Some of my children were "late" who were probably on time.

I am so sorry and will keep you in my prayers.

momto9 said...

I feel for you! Often so much stress is involved in getting to all the checkups. I always had to find a sitter...and then pack up all the kids and get them to the sitter then go to my appointment. Those days were long!
Why are you high risk...is it simply because of the dates?

Star said...

You shouldn't have to stand in the heat with a child in your arms. If I was you, I'd stay at home now and keep calm. That will do you more good than the heat and the prodding around. Nature will take its course when it's ready and I should imagine there is some sort of emergency vehicle you could call on if you need to?
I notice you have the annoying photobucket floater on your Blog. I had that too recently. I got rid of it by changing the template design and now, thank God, it has disappeared.
Blessings, Star
http://stitching-stars.blogspot.com

MacKenzie said...

I'm so sorry you are struggling with this. Having spent the first part of my pregnancy with a physician then moving to a new state (in the US) and seeing a midwife, I can say that my care was much better with a midwife. I too, needed to adjust my due date but the doctor wouldn't listen to me or my chart but kept referring to "the due date calculating wheel". I wanted to scream sometimes that "The wheel wasn't the one actually having the baby! My midwife did listen to me and our little one ended up arriving on the very day I predicted :-)But since midwifery isn't an option for you, I'd just lie and get through their system with as little hassle as possible.

mwoolfenden said...

God truly is aware of us all. he knows you and your trials, he knows the limits of what you can handle.
All these trials will have been worth it once your baby is in you arms. and dare i say you would be willing to go through many more trials if it was required to get you baby there in you arms.

Mrs. Anna T said...

Adam, you do have a point; what I meant was since in Israel, you don't have to pay to give birth in a hospital but have to pay an arm and a leg to be attended by a private midwife, hospitals will continue to be the overwhelming choice for most women.

Of course, it doesn't mean hospitals are "free". Quite simply, we were already forced to pay for them through our health tax which is automatically deduced without giving us any choice. Now, if there was some change made in that... but I frankly don't see it happening.

Momto9,

The reason to all the hoopla is that my baby is small for gestational age, according to ultrasounds - which is of course calculated wrongly, but no one has listened to me so far.

Not that ultrasounds are all THAT precise, either.

Amy said...

I'm sorry for what you're going through, Anna. I had to do the same frequest non-stress tests when I was pregnant last summer. They thought that my daughter was very big for her gestational age, and they were concerned. (Turns out they were wrong!) I'll pray for you, Anna. (By the way, that's my daughter's name!) I know what it's like to be in a similar situation as yours.

Erela said...

I believe that my daughter's gestational age was miscalculated (based on nothing but intuition)but no one seemed to care.

I had to make numerous hospital, laboratory and specialist visits because I was high risk (mainly due to a uterus issue) and the staff I dealt with throughout were for the most part wonderful. There was great concern over her smallness, and mine, but what they kept missing it seemed was I am small so why wouldn't she be and why is it assumed one has to gain all kinds of weight when pregnant? I was induced at 37 weeks and she was perfectly fine all around.

Anyway, I'm sorry you seem to be stuck with such dunderheads. :(

Kelly said...

Oh Anna, I'm so sorry that the doctors that are supposed to be helping are causing you more frustration than anything. Unfortunately here in the US they treat pregnancy as if its a sickness and seem so quick to lump any woman into the high risk category, which I personally think they do to scare us all and force us into more tests. Three fetal monitorings is nuts, considering your length of trip to get there. Tell them it's their problem if they're wrong about the gestational age and you'll come to the hospital when you NEED to and at no other time!

Anonymous said...

Im so sorry. It sounds like a total pain the way they are treating you. Its strange how in this day and age, a pregnant woman is treated like it is a medical phenomenon and not something which is and has been happening all over the world throughout history! Try to relax and remember that it is not long now until your little baby comes to the world. Then when you are out of hospital you can nest peacefully back at your home and forget all the troubles from before.
Wishing you the best of luck,
Jules, Norway

Anonymous said...

We live in the US and use an "underground" midwife, a women who has almsot as many years of experience as I've been alive and is wonderful and caring. Independant homebirth midwives are not allowed to practice yet where we live and I had our first four children in hospitals.
Are there any midwives like this in Isreal? I really had to do some searching to find one and I travel a distance to see her but it is so worth it.

(and just becaue of the nature of this post, I'm using anonymous. )

Mrs. Anna T said...

mwoolfenden,

I have no doubt any mother would do anything to get her baby safe and healthy in her arms at the end. It's really not the question; the annoying part of this is that these "trials" are 100% man-made and caused by faulty calculations and a system that values numbers more than common sense.

Erela,

Well, that's what we were (unofficially, of course) told by a nurse/midwife who came to take my blood pressure. She looked us over and said, "you are both small, one can hardly expect you to have a BIG baby!". To be exact we are on the tall, lean side. Our first child is on the tall, lean side as well. We got a lot of pain for that from the pediatrician when she was a baby.

Anon,

Private midwifery is legal in Israel, but most people can't make the choice to pay an arm and a leg for a midwife when they don't have to pay anything for doctors and hospitals. See my comment above to Adam.

Amy said...

Hi Anna,

I'm a longtime reader (very long time! I found your blog back when you were still single!) but I've never commented until now. I was single too when I first started reading your blog, and now I'm married with a 13 month old. My how things change!

I am delighted that you're pregnant with your second child and am looking forward to the announcement from way down here in Texas.

Anyway, I wanted to say I, too, was miscalculated on my due date. My last menstrual period was 3 weeks before conception, and they just ignored it. I had to do all those tests too, and then ultimately had to have a c-section. :(

I'm sorry you're having to go through that, though. I've considered the idea of a home birth (not unassisted) if I'm blessed with another baby. I do pray that you will at least have a nice, natural, calm hospital birth. It's not long now!

Take care,

Amy

Anonymous said...

Anna,

What will they do to you if you refuse to attend all of these appointments? Theortically, you could stop going to the doctor all together and just show up at the hospital when you go into labor, right?

The Whites said...

I'm in the same situation here regarding hospital vs. homebirth. My husband is military so part of his pay is the medical benefits. We had to pay $30 to have our baby in the hospital (using the midwife I wanted, it would have been free if I had used military care-providers)... $30! No way could we justify paying $2000+ for a homebirth even though that is what I so badly wanted. I've found a few midwifes here that will work with me so I can have prenatal appointments with military doctors and have any labs done so that it will all be covered and that drastically reduces their fee, so it will only end up being $1000. Maybe a midwife in Israel would be willing to do the same?

Stealth Jew said...

I live in Canada. I've had one high risk pregnancy and two high risk deliveries (the last was a successful VBA2C). My experience with an OB has been nothing like what you describe. He moved my due date at least once, and came in (after a 12 hour shift) to deliver my baby so that I wouldn't have to have another c-section. A professional to his bones.

There have been several studies recently that suggest that homebirth and independent midwifery are not nearly as safe as their hype suggests, even in low risk pregnancies.

I'm sure it would be easier and more pleasant to birth in a less hospital-oriented environment, but it does come with a higher risk to do so.

Anonymous said...

So sorry about the troubles you are having, Anna. You know we are all praying for you!

Katie V. said...

I'm so sorry you have to go through all of this Anna. I will be praying for you. I wish midwives were more available to you. It's makes me so sad when so many doctors (and nurses) lose their sense of vocation/calling to serve those who are in need of healthcare, especially the most vunerable and weak. We must pray for a conversion of heart of people. And yes, God has you in the palm of His hands.

Laura Angelika said...

My thoughts and prayers are with you, Anna...my son was suspected to be "small for gestational age". He ended up being 7lbs 10oz - a very good size for a child.

All the best to you in the rest of your pregnancy!

Mrs. Anna T said...

Anon, of course I don't *have* to go to all the appointments. Actually I *don't* go to all the appointments, nor do I do all the recommended tests. For example I didn't do OGTT. However, as I know from previous experience, this comes with the price of doctors being over-worried because there "isn't enough follow-up", and putting more pressure on you to agree to various interventions (to which, again, I don't have to agree, but it's very stressful to have to stand up to a doctor's authority when you're already dealing with labor).

hannah @A Mother in Israel said...

You always have the option of saying no. No to so many monitors. No to three days in the hospital. Whenever you say no in this country, my experience is they threaten you with hospitalization and death, that is just the way they stay in control. In other countries, they monitor much less and the outcome isn't necessarily worse. Do your own research, consult with professionals (pay a private doctor if you find one you trust) and remember that it's your choice. You don't have to lie,but you don't have to be compliant either.
You can also leave the hospital whenever you want. The hospital gets paid for every day you stay, and they will almost certainly warn you that your baby will die if you leave (God forbid). Yes, it's unpleasant to go against medical advice. But it's always your choice.

Anonymous said...

my daughter gave birth 7 months ago to a beautiful, 100% healthy baby boy, who has grown to be an incredibly happy and intelligent little guy -- just a total joy!!

when she had her first ultrasound during pregnancy, the technician told her there was something wrong with the baby's kidneys and heart. this scared the life out of my daughter.

i suggested she have another ultrasound, which she did, at the same doctor's office. the technician once again said there were questionable findings.

a month or so later, my daughter moved to a different state (in the U.S.), and had more ultrasounds. the doctors did not agree with the interpretation of the previous ultrasounds, and said the baby was normal.

which, of course, he was.

my point is: ultrasounds can look different to different technicians. while they are images, they still must be "interpreted".

another case: my friend was told while pregnant that her baby would be downes syndrome. she took various tests and the doctors agreed that the probability was very high. needless to say, my friend was worried for the last few months of her pregnancy.

but of course, the doctors and tests were wrong. her baby girl is now almost two years old, perfectly normal in intelligence and with no health problems whatsoever.

we should never count too much on technology. it has been wrong many, many times.

anna, do what you feel is right, between you, your husband, and God. don't let doctors or other people scare you.

take care!

Mrs. Anna T said...

Hannah, I'm usually a meek person, but my previous birth experience taught me that I absolutely can't do without knowing how to say NO. And "no" is the answer in the better situations, when they actually tell you what they are doing. Sometimes you have to ask, "hey, wait a minute, what are you doing?" ("oh, nothing special, just preparing your pitocin i.v."... WHAT??)

I do hope, of course depending on how I feel, to get discharged early. I stayed 3 nights last time and the last one was definitely too much.

Bethany Hudson said...

Oh, Anna, my dear, hugs!! I'll say a prayer for you. Beauracracy can really be so stress-inducing.

Stealth Jew said...

Anna, when you choose to live far from large centres (and save money that way) and you choose not to drive (and save money that way), surely it is not the fault of the Israeli healthcare system that they will not provide someone to accept that inconvenience in the opposite direction.

I would be shocked if you are a net taxpayer, even in Israel -- are you aware that even in the United States, midwife care will cost several thousand dollars?

Ann S M said...

Hi Anna, in Israel are there Doulas? (labor coaches and advocates?) You could hire one and she could accompany you to appointments and be with you during the birth, so at least one familiar person would for sure be there.

jean said...

Come to NZ Anna! My daughter went into labour with her 4th child about 1 pm. Went into the hospital at 6pm and was home with her brand new daughter at 10pm! It was all free and she felt totally in charge. An hour after baby was born she said "Can I go home now?" and they said "Sure". All government funded too.

Mrs. Anna T said...

Stealth Jew,

I'm not exactly sure what you mean. All I meant to say was that a health care provider should see a bit beyond the protocol. The choice is mine of course. But many women do *exactly* what the doctor recommends. They will go and spend hours traveling to and from tests and faint in the heat and be stuck without a bus for hours. Is it good for their health? I don't think so. Perhaps in such cases a bit less monitoring and a bit more rest will do far more good for mom and baby.

Ann S M,

There are doulas and I had one with me last time, but frankly, I prefer to see no one but my husband during labor and birth.

Karen said...

I know what you mean!! I'm right there too...the farther along in the pregnancy I get, the more I wish I had the option of a midwife.
It's pretty much the same here.

I actually didn't know my LMP date but I did know my conception date. So I figured 2 weeks before that and that's the date I gave. You don't want to mess with allowing them to have the wrong date, trust me!

Buffy said...

I really feel for you and quite understand how all this is causing unnecessary stress.

I think you are wise to stick with the hospital rather than go for unassisted childbirth.

However, it would be nice if you had someone who actually listened to you! Is there any way you can change your doctor? We can do that in the UK but not sure if possible in Israel?