*Disclaimer: I am not suggesting anyone be reckless, especially when it comes to their health or the health of their unborn baby. However, it is your body, and your baby, and you can - and should - essentially be able to do with it what you want. (Although try arguing that in a court of law...)
Anyway, I don't know what got me thinking about this lately, but while I was pregnant with my last I often would sit and daydream while waiting in the OB's office. What if I didn't seek prenatal "care"? Granted, I'm not exactly a good low-risk candidate, at least by my doctor's standards. After waiting upwards of an hour for one freaking five-minute visit where he just blows me off and his nurses do most of the work, I'd think, Why the hell can't I do that?!
Play along with me here for a moment. No one (usually) is there when you conceive. And you can walk into any drug store - even The Dollar Tree, if you're patient enough - and get a run-of-the-mill pregnancy test as cheap as ... well, a dollar. The ones your doctor's office uses really aren't any different (in fact, they probably got a better deal by ordering in bulk). So bam ... you're pregnant! You found out that information all by yourself, without any help!
Playing Devil's advocate, let's assume you have a healthy, normal pregnancy. No problems, no indications for a c-section. You've found out you're pregnant; the next step is to start taking your $4.99 a bottle prenatal vitamins from Walmart (or Target, if you prefer). While you're there, you can pick up a pretty good quality automatic blood pressure cuff for about $80 and you're set to take your blood pressure each month (heck, every day, if you want!) from here to eternity. Doing it yourself means you can get comfy in any position of your choosing, in the comfort of your own home, not having to worry about a nurse breathing down your neck asking you stupid questions like "Did you have a bad day?" when your readings are a little on the high side. (Whenever mine were, no doctor of mine ever offered me to lie down on my left side and rest for a few moments, which can sometimes help lower your BP.)
If you're like almost every woman in America, you have a bathroom scale. You'll be able to tell, just like anyone who can read numbers, if you're gaining weight and how fast you've gained. A good one will probably run you $30 or so, so chuck one in the cart while you're at Walmart. You can even get a fancy one that tells you body mass index and all that crap. Even your doctor's scale can't tell you that!
When it comes time to do the sugar test for gestational diabetes, you can go back to Walmart and pick up a home glucose monitoring system with test strips, if you choose. Diabetics do this all the time, and you can argue that really, if your pregnancy is uncomplicated, you'd only have to do it once if you were seeing a doctor. For probably less than $20, a box of urine glucose strips can detect protein in your urine, the same as it does at the doctor's office. (Tests you can take yourself, "in the privacy of your own home," touts the advertisement...)
Some argue that home glucose monitoring kits aren't as accurate, but in the case of the diabetic patient, they seem to work just fine for millions of people on a daily basis. They do have to follow certain manufacturing and accuracy standards and really, some would argue that perhaps the doctor's test isn't that much better. (Many women are often asked to repeat the one-hour test with a three-hour followup, often when the results are 'borderline' or even negative; one woman I know told me her doctor routinely ordered the three-hour test immediately, regardless.) While many doctors order the traditional nauseating 'flat orange soda' drink before a lab test, many OBs tell the patient to eat a candy bar or drink a glass of orange juice beforehand. Candy bar - less than a buck. Orange juice - around $3. Glucose tolerance screening test - $75-$85 (or more, probably depending on where you are). Think of the savings!
By now you're probably far enough along that you could, if you wanted to, have an ultrasound. Whether it's for fun, to check the gender, or look for fetal anomalies, you can have them done at "special" ultrasound places for a few hundred bucks. Normally I wouldn't recommend doing this because it's not a professional medical technician, and if they do see something wrong, they are not equipped to tell you so. But if you want to know that it's a boy, there you go. Maybe a quick check of baby's positioning just to make sure, even though Bub could still turn at the last minute. (But this is a normal, uncomplicated pregnancy, remember.)
If you're patient, you can just refuse the ultrasound and wait until the baby's born. After all, many reason that there are really very few things that can be done prenatally as far as birth defects are concerned, and many people just like to be prepared ahead of time. Assuming that you're having a normal, healthy pregnancy, this probably wouldn't even be a concern for the majority of the population. And you don't have to worry about hearing pressure from a care provider about what you'd plan on "doing" should something appear to be wrong with your baby. Added bonus!
The rest of the time is spent waiting. You can cruise through Babies 'R Us and while you're picking up the last-minute essentials, splurge on a fetal doppler monitor. Granted, some question the accuracy of these devices too, so remember it's just in fun. After about five months, you can even use a stethoscope to possibly hear the heartbeat, so maybe look for one at a garage sale in your spare time.
Now comes the hard part: labor and delivery. If you're smart, you'll stay home as long as possible until you feel that labor is imminent. If you're really brave, you'll have a do-it-yourself labor too, which many people have done. (My neighbors, a couple who are probably in their 50s, were planning an assisted homebirth in the 1970s and waited patiently for their doctor to arrive. When she didn't, dad had to step in, catching a healthy baby boy who lived to re-tell the tale.) Lots of people have unplanned unassisted births, spontaneously delivering while on the toilet, on the bathroom floor, in the car, on airplanes, and other random locations and do okay at it. (Notice how you'll never hear people tell you how dangerous unassisted birth is it were by accident: why not suggest confining a pregnant woman to a hospital bed once she hits 36 weeks, just in case?)
Option B would be to labor at home and call the fire squad. No doubt they have basic medical training when it comes to delivering babies, and they even get a fancy badge if they've done so, too. They also have quick access to medical equipment, just in case, but remember - this is a normal spontaneous delivery.
Option C would be to rush to the hospital when birth was imminent, ready to push. No time to argue over the over-administration of Pitocin, pushing flat on your back, or threatening to cut an episiotomy - just push that baby out! I'm sure this'll make you popular with caregivers, so beware.
If you should choose option A or B, you'll eat your own food, wear your own clothes, and sleep in your own bed. No free formula feeding bag, no blood pressure checks every hour on the hour when you're told to "rest." No Pitocin to induce contractions of the uterus; you've got boobs that can do that automatically, and for free!
Sure, I'm being facetious. But we've all heard stories of women who didn't know they were pregnant quite far into a pregnancy, sometimes even up until delivery, and manage, somehow, to have healthy babies. How does that happen?! They didn't see a doctor! Now that basically everyone is labeled high-risk (even though they really aren't), how can we possibly be trusted to care for our own bodies? If diabetics can do it, and people with other illnesses, (and pregnancy isn't even an illness) then why can't we?
I know we can't see into our crystal ball, but really, what percentage of pregnancies and deliveries are basically complication-free, spontaneous vaginal deliveries with *really* no need for intervention? Probably more than your doctor would like to admit.
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