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Saturday, April 24, 2010

Do-It-Yourself Pregnancy

*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.

10 comments:

Anonymous said...

I love it. That's my exact same train of thought when it comes to how ridiculous our medical system has gotten when it comes to pregnancy and birth. Wonderfully well written!

Anonymous said...

hi, I am back. I am the lady that had the chat with you about homeschooling your son. Remember??

I just loved this post here. That is exactly how I think. And that is exactly what I did with my 3rd baby. When the doctor kept pushing for unnecessary tests I decided to have my baby at home. I quit the doctor at 21 weeks and did all my prenatal care at home and had an unassisted home birth. Just like you described on your post. It was the best experience of my life. :)

With my 4th baby, I hired a doctor that was ok with me having an unassisted home birth. Went to see him every 8 weeks just because. Didn't do any of the tests that are routine with prenatal care. Again did my own prenatal care at home. Ended up having the baby at the hospital because I had a little bit more bleeding during labor. I was concerned for my baby so decided to go to the hospital.

the nurses and doctors were astonished with my performance, since I delivered the baby without any drugs and on my knees. It was a teaching hospital so there were about 10 people in my room, mostly students. :)

They had fun. I had to keep fighting them off the whole time so I could have my baby the way I wanted: without interventions. It's ridiculous. There is no peace for a woman to have a baby at a hospital. No wonder so many births go wrong there.

My baby was born healthy and I left the next day. Routinely they make you stay at least 48 hours after a vaginal delivery at a hospital. But one can't rest or be left alone at a hospital room. They knock at your door and invade your room every hour of the fricking night or day. I left the next day to finally rest in my own bed and home.

You stole the words out of my mind and mouth with this post. :) It's the truth.

Heather Griffith Brewer said...

You are so right! What kills me too is all the extra tests that have high rates of false positives.
While being tormented with the thought of having my second baby in the hospital and reliving my first experience, I read a book about unassisted birth...not something I wanted, but the book confirmed many of my feelings.
I had a doula, a midwife, and I got prenatal care...I loved my midwife, but the hospital she worked at was an hour away. So I opted for home, and my midwife arrived in time for the placenta. It was THE defining time of my life. I will never in a million lifetimes forget the look on my husbands face when he caught his new daughter.
I prefer to have someone there just in case, but an OB in a hospital seems like overkill for the majority of women.
Awesome post!

The Deranged Housewife said...

Anonymous #2, I think you need a new name. ;)

Your story reminded me of how I was watching some show on birth - can't even remember what it was - and the lady who came in to have her baby only recently found out she was pregnant or something. She had no prenatal care whatsoever, and the baby was completely healthy and a good birth weight. Somehow I remember the medical team being concerned, but really, if you can have a baby without even knowing it, think how you can do it when you do know and are taking care of yourself, just not according to their guidelines (which are often completely unnecessary). Many of you, if not all, have probably read the studies regarding prenatal care and how the average low-risk woman could probably do with fewer visits to the OB during the course of her pregnancy.

It irritates me to the core that in pregnancy, we constantly dismiss the 'old wives tales' of our elderly relatives, weird old ladies and neighbors who offer advice and whatnot. Yet our OBs and their nurses continue to perpetuate a lasting form of old wives' tale with things like "You have to lie flat on your back, you have to cut the cord immediately or your baby will die!, you can't go past 40 weeks with this pregnancy or your baby will die!, you have to have regular ultrasounds or your baby could die!, you could have a baby that's too big and your baby will die!" The list goes on and on. Honestly, sometimes I think I'd rather have one of those little old ladies delivering my baby ...!

And how is it any different for an unfortunate mom who has to transfer during a homebirth when she's told that her pregnancy care with a homebirth midwife amounts to "no prenatal care"? Give me a freaking break.

Anonymous said...

how about anonymous #2?? ;) then you will know it's me... or wild pregnant lady?? :) LOL

PS my 3rd baby was 42 weeks and 10 lbs when I delivered her at home unassisted. It was the easiest and most pleasant labor and delivery I have ever had. :) My DH caught the baby. She is the apple of his eye. :)

The Deranged Housewife said...

Oh, I don't know, Wild Pregnant Lady sounds pretty good. :D

Amy W. said...

Well, actually I would bet that the percentage of uncomplicated, vaginal births is a lot lower than it *should* be since doctors just can't stop themselves from intervening unnecessarily, thus causing a plethora of problems. But you already knew that :)

I am hoping with my next pregnancy I can convince my doctor to be even more hands-off and have less prenatal visits. They are pretty much pointless since as you've said, we can all weigh ourselves, check our blood pressure, and pee in cups at home.

As for the gestational diabetes test, it is true that blood sugar readings are different when they are taken from blood samples as opposed to finger pricks, but it is not enough to make much of a difference.

I seriously get so annoyed with doctors who act like your life and baby's life depends on them, your lives are just hanging in the balance every second of pregnancy...or something like that. What would we ever do with the doctor, right? Excuse me while I go barf. I got so fed up with the doctors who saw me while I was in the hospital for "pre-term labor" (I don't like calling it that because I know I just dilate early, but you know since they act like no woman could ever deviate from the "norm" I had to sit in the hospital for 10 days). I was given a steroid shot when it was first found out that I was dilated to 4cm at 34 weeks (I was also having contractions that I could not even feel). I did not know at the time that steroids seriously mess up your blood sugar (or that by 34 weeks these shots are not shown to be very helpful at all) and so my blood sugar was very messed up for several days. And of course it was all my fault. You know, since I am so used to injecting steroids into my body I should know how to effectively control my blood sugar while using them. Not to mention the disgusting food I had to eat. At home I make all our food (for the most part) or at least know the carbs of what I am eating so that I can give myself the right amount of insulin. I had no idea at the hospital. I kept telling them to just send me HOME and my blood sugar would be fine (and it actually was once I finally got home!). I hated having the doctor come in every morning to tell me what a terrible job I was doing and telling me how to control my diabetes when he had only just met me and I am the one who has been taking care of my diabetes for the past 5 years. But of course I could not be trusted to take care of myself.

Then he tried to scare me into getting the flu shot (I don't get vaccines while pregnant, or really any other time, but that a different subject). I said I would not be getting it and he said "I've seen women almost die from the flu while pregnant". Great, I almost died from a terrible car accident when I was 16 but you don't see me not driving around anymore, do you?? I think I can be the judge of how I will care of my body and what vaccines I will or will not get. Then he said "well there is a woman on this floor with the flu", so I said "well I guess you should probably send me home then, so I don't catch it". Then he asked me if I would be having the baby vaccinated. Which of course is not even any of his business.

On a side note, while in the hospital for 10 days I watched a show on TLC about women who were pregnant and didn't know it. A fair amount of them labored and delivered their babies by themselves, at home and all of the babies were just fine. I'm not sure an unassisted birth would be a good choice in my case though. Don't think hubby would go for it either.

Ah doctors, how did maternity care ever get this way! I am seriously sickened to read about all that happens. And the worst part about it is that I think a lot of the doctors actually believe that what they are doing is really the best thing (it is probably what they have been taught).

Amy

TracyKM said...

Makes me think of back before it became normal to have so many tests, etc. Were pregnancies really less complicated 50 years ago? Or what about other countries that rely on midwives and home births and have lower neonatal fatalities? Mmmm...

The Deranged Housewife said...

Sadly, the 'maternity system' has been flawed and broken virtually from the moment doctors started stepping in. That's not to say that a) all midwives were perfect and error-free up to that point, or even now or b) that all doctors are bad, but if you look at the history of maternity care you'll see that doctors considered themselves superior to midwives even when their knowledge was limited and/or suspect, and in some ways still do, which undermines the system completely. There is a time and a place, but unfortunately people think that means "all the time and every place."

You should read Tina Cassidy's book "Birth" and Jennifer Block's "Pushed." Both are excellent books that go into detail the derailment of women's reproductive rights and how it affects us today.

Anonymous said...

I love this.... this what we plan to do when we get pregnant!!!! My first three pregnancies were traumatic... this is exactly what I'd do this time around.