Saturday, August 20

Preconception issues

After having to reschedule due to my sudden trip out of town, I finally got into see my new OB/GYN for a preconception consultation. You may ask why I’m not using a midwife and I’ll tell you. The progressive city of Austin's hospitals, not the state of Texas or the city of Austin, make it impossible to use a midwife for a hospital delivery. Due to my age and history, I am just high risk enough that a home delivery really isn’t recommended. It's times like this that really make me miss New York. New York is one of the most midwife friendly states that there is. May I please go back home now?

When I used the midwives at Strong Hospital in Rochester, New York, I received exemplary care. I guess, I'm just not comfortable with using an OB/GYN and this first visit really hasn’t helped endeared me to the idea. It started out bad and just got worse. Instead of seeing the doctor I made my appointment with I discover two minutes before she walked into the room that I would be seeing a different doctor today. I was not amused. She spend five minutes with me in consultation during which time she explains to me a woman’s fertility cycle. Thanks I learned that when I was sixteen and was trying not to get pregnant. She then hands me a bag of samples for 7 different kinds of prenatal vitamins. She says “Let me know which one you like the best and call me when you get pregnant. If you aren’t pregnant is six months we’ll take more aggressive measures. See you then.”

She seemed to have no concern about my general wellness, eating habits, weight, or job duties. In fact I don’t know if she even knew my name. The thing that really bugged me is that she didn’t even ask one question about my previous pregnancy. Not one question! If I hadn’t written stillborn in big visible letters right near the to of the page I might understand this oversight, but I did and I don’t. Included with the bag of prenatal vitamins was a pharmacy written pamphlet emphasizing the importance of not doing drugs, smoking, or drinking excessively while pregnant and, of course, the importance of taking a prenatal vitamin.

I really feel like this lesson was designed for the lowest common denominator. This is preconception care watered down for the masses, not preconception care for somebody that is actually concerned about having a healthy, alive, baby and a safe delivery.

So being the nerd that I am, I went and did a spread sheet comparing the contents of each of the prenatal vitamins she gave me and my current multivitamin with the US RDA recommendations for pregnant women and the guidelines in my preconception book. I found that my current multivitamin is my best choice. I’ll need a little extra iron after my twelfth week, but a little conscious effort with my diet or a seperate supplement should make up that difference. All of these prenatal vitamins gave you more than is considered healthy in some areas and not enough in others. I don’t decide my preferred vitamin based on the packaging, I look at the nutritional benefit it provides.

A tribute to the proactive nature of having a blog: After originally writing this post up, I thought I would just double check and see if there were any midwives in town permitted to do hospital deliveries. There aren’t. However, I did talk to a very reputable midwife in town who listened to my concerns, gave me some information on where to get excellent care that I would be more comfortable with. She did also mention that I might consider talking to a therapist about these issues. What me? Sound a little anxious? I’m not even pregnant yet, just wait!


Heather said...

I'm concerned about this doctor. Please, PLEASE do not see her again. If she's like this now imagine what she's going to be like when you do have problems. RUN AWAY. There has to be someone better out there. As for vitamins... prenatal is the same as a multi-vitamin, take the one that doesn't make you heave.

Kel said...

oh Lora, it sounds like you got the doctor who won the worst bedside manner competition

and given your history, her behaviour was atrocious enough to rank in the Guiness book of world records

hope you can find a carer in the full sense of the word

gypsy said...

I'm so sorry to hear this; pregnancy -- before, during and after -- can be the most important health issue a woman even encounters, both physically and mentally. Is there a nearby town or an alternative birthing center you can investigate?

My heartfelt best wishes to you on this journey.

Anvilcloud said...

Good luck with this. The fertility issue is also affecting our family these days.

Sue said...

Goodness, how awful. I hope you can find a better doctor. All this post makes me realise how far apart our cultures are... I've never even heard of a prenatal consultation, although it makes sense to chat with a doctor if you had a stillbirth previously. But in the UK we'd just see our GP - she was the person who did all my pre-natal blood pressure checks and gave me vitamins etc once I was actually pregnant.

I'm also amazed that midwives don't deliver babies in hospitals in your State. Is it just ordinary nurses without the extra midwifery training, then? In the UK midwives do all deliveries other than C-sections or others with medical difficulties, when they would call in a doctor with the relevant training. But we wouldn't have met the midwife in advance, we'd just be allocated to whoever was on duty when labour started.

Anyway... I do hope all goes well at what must be a very stressful time, particularly having just started a new and demanding job.

andrea said...

I feel for you here. I am the subscriber to a major hmo, and through both pregnancies, had to endure sooo many different doctors (some of them great, some of them not so great). and nothing makes you feel less confident, less valued than a doctor who doesn't really seem 'present'. at least you are doing your homework, doing all that you can by taking care of yourself and making sure that you're getting the best care. I wish you all the best...

Ellen said...

It's fantastic, Lora, that you're being proactive about your health and the health of your future little one. The doctor you met with sounds AWFUL. It's inexcusable that she didn't ask about your history. Absolutely inexcusable. I'm a huge fan of midwives (have thought of becoming one, actually!), and am really surprised that midwives don't do hospital deliveries in Austin. Good luck with finding a provider that you're comfortable with! (Oh, and I'm also a big fan of seeing therapists...I think everyone could benefit from a little bit of therapy.)

Juliet said...

I'll keep you and in my prayers. A doctor who understands your needs and is concerned enough to take his/her time is very important when dealing with pregnancy.

Lora said...

Thanks to all for your concern and giving voice to my outrage. I am going to look for a different doctor, but I'm also going to go in a little better prepared with all my questions written down so I can get them answered.

Anvilcloud- Good luck to Butterfly. The best advice of been given about fertility, which I'm not worried about yet, is relax, have fun, and tumble in the hay frequently. It's guaranteed to take time.

Sue- It's kind of funny how different our healthcare systems operate. In England the government determines things with some perks for private pay. My younger brother was born there, and as private pay patients my mother was really impressed.

In the US it's insurance and lawsuits and liability in addition to the doctors union, aka the medical association and pharmaceutical companies. However, we Americans are use to being able to make an educated choice and to get what we want with little complications. It doesn't always work that well in the world of medicine, which is very frustrating. The usual standard in England would not be as interventive enough for the usual American’s comfort level.

colleen said...

I feel for you. This post hit a nerve and reminded me of my own past bad experiences with doctors. I bet the midwives can give you a good recommendation.

terrilynn said...

Lora, what an absolutely infuriating experience. Good luck in finding someone who is a better fit.

I am so very sorry to learn that you lost a child. I can't even imagine how one moves on from that. I wish you and your husband an easy journey this time.

J Bo said...

Oh, Lora! What a nightmare! The fact that this healthcare provider overlooked your history, never touching on it is absolutely abhorent.

Do you see a naturopath for your regular care? I only ask because the recommendations my ND has made for care that she cannot provide have been wonderful.

Good luck in finding a provider who actually cares about you!

Oh, I would tell the clinic where you went about your experience. I am sure that would love to hear how they can improve their services!

Libby said...

I too think you should get a new ob/gyn. I've met some very sweet ones, men and women. This ob you described sounds careless.

Getting counseling is an excellent idea. I've been through counseling, and it made a huge difference for me.

Keep us posted!

jane said...

Lora, I didn't know you had been pregnant before and had a stillborn. I can't imagine the anguish you experienced. You are courageous to start the process again. I will certainly keep you and your soon to be conceived in my prayers.

∙Ϊ®!§ђ∙©ћịℓÐ∙ said...

Hi Lora -

I'm so sorry you had this experience. How awful. Here in Oregon midwives are able to deliver babies in the hospital. ... I wonder why they can't in Texas.

I hope that you find a better provider with a better "bedside manner." Jeez, that just makes me so mad.

By the way, you probably already know this - but have a look at the amount of folic acid you are getting in your vitamin - that's the one that helps to prevent neural tube defects...

Do they have any doulas in Austin? I had one with my first son (at the hospital). They are a great support person - basically your ADVOCATE... You can hire one & she will be there with you & your husband in the hospital. She is with you the ENTIRE time you are in labor/delivering, etc... Here's a link to DONA international: You can click around and look for doulas in Austin (It looks like there are at least 10 to choose from)

-Beth :o)

oceanskies79 said...

Hi Lora, yes, the doctor isn't quite a right one. The doctor seems not to have any "F" traits.

Marla spoke my sentiments. I couldn't have said better.