The post in which I am belligerent

I'm still at home. I had my weekly ultrasound yesterday, and our girl looks great. Everything went fine at the ultrasound - the placenta looks the same (it's still in the way), the baby's growth and development seems perfect, and my fluid levels are right where they should be. Good news.

After the ultrasound, though, I spent some time talking to the perinatologist. Not my usual perinatologist that I've been seeing for the last eleven weeks. I was seen by a different doctor whom I have only met once before, a week ago. And he spent quite a bit of time telling me why he thinks that the way my doctors and I have been dealing with the details of our baby's upcoming delivery is not the right approach (he literally rolled his eyes when I told him that my doc is taking it week by week and we will likely schedule the c-section as late as 38 weeks if nothing changes).

He wanted me to make an appointment for amniocentesis and subsequent delivery a week from today, at 36 weeks. He detailed all the reasons for his opinion, which I appreciated, but I felt very pressured and uncomfortable, which I did not appreciate - and worse, I felt that he was laying a guilt trip on me when I didn't want to immediately commit to doing things his way. ("It's not just about you - you have to think of your baby!") I won't go into all the ways I felt unhappy and overwhelmed during this appointment, but I will just say that by the end of our conversation I was angry, stressed, and felt as though no one in his office thought I had a brain in my head. I was pissed.

I had an appointment with my OB doctor for first thing in the morning, and all I wanted was to get the heck out of the perinatologist's office, and discuss everything that had happened with Ed (he wasn't with me at the appointment) and my own doctor in the morning. Before I left, though, the doctor said he wanted to put me on the monitor for 20 minutes and get a non-stress test, since I am no longer having them twice a day in the hospital.

In hindsight, I should have just declined to stay and do it, but it didn't even occur to me. I let them hook me up to the monitors (one measures the baby's heartbeat, and one measures any contractions I may be having) and - surprise - I was having contractions. They didn't hurt, they were mostly mild, and I might not have even noticed them if I wasn't on my back lying still with the monitor on my belly. But they registered on the monitor, so the doctor instructed me to go check myself back into the hospital and get hooked up to the monitors and hydrated via IV.

I pointed out that I'm on strict bed rest at home, that just coming into the office for an ultrasound is more activity than I am accustomed to, and that after being out and about for a couple of hours and having an ultrasound, it wasn't surprising that I was having a few contractions - I am 35 weeks pregnant, after all, and some contractions are normal for this stage of pregnancy. I wasn't bleeding, I wasn't in pain, the ultrasound had JUST SHOWN that I am absolutely not dilating at all. I said that I would prefer to go home, get back in bed, drink plenty of water, and if there were no other causes for concern, simply follow up with my doctor at the appointment I had already made for first thing in the morning. That sounded quite reasonable to me, but not to the doctor. He made horrible dire predictions and laid on the guilt, saying that contractions could cause bleeding, which could cause serious problems for me and for my unborn baby, problems that "we might not be able to fix." He said that he knows I don't like the hospital, but that I should be there anyway, and that it's not just about me, but also about my baby. Sigh.

He scared my mom to death (she had taken me to my appointment), and by the time we left she was ready to lock me up in the hospital and throw away the key. At this point she was continually reminding me that when I checked out of the hospital last week, I'd promised to go back to the hospital if that was the recommendation at my next ultrasound. Although the doctor called over to the hospital when we left and told them I was on my way, I was not prepared to go straight there. I convinced my mom to take me home and let Ed meet us at the house. He packed up some essentials, and drove me back to the hospital once I'd had a chance to eat something (I'd missed lunch) and relax for a few minutes.

I was adamant that I was going to the hospital to be monitored only. I wasn't consenting to having an IV. I knew I wasn't dehydrated, and I didn't want IV fluids, and I certainly didn't want any of the drugs they give me when I'm having contractions. They make me sick, and none of them have ever been successful in actually stopping my contractions. I wasn't planning on staying more than one night if the contractions went away as I expected. I will admit that I arrived at the hospital belligerent and ready to take on the first person to approach me with a needle.

Ah, but like a breath of fresh air, my own doctor arrived to check on me. She listened to me pour out my frustration, and then she said that she felt fine just monitoring me for an hour or two, and then sending me home if there was no cause for concern. She said she'd set up another ultrasound with my regular perinatologist for next Wednesday (the 36 week mark) and make an appointment to see her immediately afterward, and we'd just talk about what to do then. No pressure. I wanted to hug her. I felt calmer just feeling like I had been heard and that she didn't think I was an idiot. (She may in fact think I'm an idiot, but if so, she hides it well. I'm fine with that.)

By the end of a couple of hours, my contractions were nonexistent, I had no bleeding or other warning signs, and I was free to go.

So yesterday was pretty stressful. I will say that it was probably at least as stressful for the members of my family as it was for me. I did a lot of venting, and by the end of the day, everyone who lives with me (and a couple of unfortunate friends via phone call) had heard at least seventeen times my views on pushy doctors, guilt trips, alarmism, the modern obstetrical model of care, and every other halfway-related topic I could think of to sound off about. I had to apologize to my poor besieged mother for just about taking her head off several times both during and after my appointment with the perinatologist. She reminded me that when I was a small child, I used to hate doctors and say mean things to them when they tried to examine me. Hmm.

I love my baby. I don't want anything bad to happen to my baby. I'm trying to balance a lot of things: my need to be in a calm, restful environment; my need to make sure the baby and I are safe; my baby's need to grow and develop as long as possible before being born; my family's need to see that I'm willing to be careful and listen to the doctors' advice; my need to be an active participant in my own care and not just a passive observer.

I'm having a hard time balancing. Honestly, it's tempting to just throw up my hands and schedule the amnio right away and deliver the first day my doctor is willing to do the surgery. Because it would be "safe" and I would have my baby, and I wouldn't have to deal with the hovering and the threat of another bleed, and the constant conversations about whether or not I am taking all of this seriously. A nurse came into the room where I was being monitored yesterday while at the perinatologist's office JUST TO SAY TO ME that she has been a L&D nurse for 17 years and she is concerned that I am not aware of the seriousness of my condition. Yes, she did.

What's keeping me from delivering this baby in the next week is that I love my baby and I want her to be as healthy as possible before making her appearance. Babies born before 39 weeks are at an increased risk for all kinds of problems, and while I don't want to take chances with my baby's health, I feel that delivering early is taking a chance in and of itself. Here's an article from the New York Times that gives details about the risks of delivering before 39 weeks:  http://www.nytimes.com/2011/08/09/health/09brody.html. Yes, I have placenta previa, and there is a risk of bleeding, and I want to be safe, but part of being safe is giving her as much time as we can reasonably allow. And I feel like someone needs to be an advocate for letting the baby bake.

Between the doctors' push to get her born (obviously some doctors more so than others) and my push to let her bake, we will hopefully find a middle ground that will result in a healthy baby born late enough to be well-developed and early enough to avoid a dangerous situation resulting from bleeding or cervical dilation. Of course, the hard part is that we can't KNOW in advance what will happen day-to-day. But in the words of my friend Jeanne - you know what? It's been one more day.