You might remember that Dr. Pippi-Poisson told me not to worry about it. I've done a very good job of that up until now, actually. But, as Thomas Kuhn described, contrary evidence has been accumulating until it can no longer be ignored:
—The lovely doctor in British Columbia who simply didn't assume that births would take place in a hospital, and who felt it necessary to explain exactly why various tests were done—in the sense of, explaining just how much the knowledge gained reduced the risk of particular poor outcomes.
—My new doctor here, who believes IVF pregnancies are automatically at higher risk of preeclampsia and who says she'll induce at 41 weeks, should we get that far. (Can anyone provide data for the former assertion? I found some papers agreeing for IVF multiple pregnancies, but nothing for singleton. And yes, I know the infertility blogosphere has seen some horribly difficult cases in the last year or so. I know several normally fertile people IRL who got it, too, and I think every case I know of has involved more risk factors than I have.)
—The one-day childbirth class we went to last weekend. Run by the giant teaching hospital we'll be going to, which has a 35 percent c-section rate and an 80 percent epidural rate. Yet natural was still presented as, well, what to strive for.
—The good women of Granolaton, who appear to have been doing it without drugs since 1950. (Although at least one doesn't think it was worth it.)
So here's where I used to be: modern medicine is groovy, okay? It's kept Beaker alive for the last 35 years, it got me pregnant, yada yada yada.
But, dumb intervention, i.e. intervention where broad evidence shows it's dumb, annoys the fuck out of me. Especially when "broad evidence" means huge interational comparisons. And the more I read, the more I learn that commonly used interventions might be dumb.
The cascades that can get started bother me, too: the decisions aren't independent. Nil by mouth goes to dehydration goes to IV set goes to glucose drip goes to hyperglycemia goes to hypoglycemia goes to baby in nursery with a bottle of formula. Induction to epidural to uncoordinated pushing to stalled labor to c-section. Et cetera.
So I get angry, but I don't want to be angry. I don't want to be bitter after the birth, either. I just want to have the damn baby.
To the extent that there's a plan, here's what it is. First, find a doula. Second (a), see if it's too late at 35 weeks to switch to the midwife group at the hospital we've chosen (I'm guessing yes). Second (b), get a list of questions ready for my next doctor's appointment. Third, get everyone I know to retell me their birth stories: I listened to a friend tonight who did a calm and respectable job of managing her own care at a large research hospital (ate normally during early labor, refused continuous monitoring until they convinced her to start a pit drip at 6 cm, etc.), and that calmed me down a lot.
Note: that means you, too! I'll be doing a bunch of reading around the blogs, but please feel free to post a link to your story. Or throw random advice. This healthy, but totally paranoid, woman approaching labor is willing to be a dartboard: I've let a lot of decisions slide, what with the travel and all that wasn't over until very very recently, but now is the time to think.
A reasonable question to ask: why are we going to the giant hospital? Answer: because I am a fucking snob, that's why, and simply don't trust medical professionals around here who don't work there. Look, it's hard enough finding a good hairdresser out in the sticks; if anything goes wrong at all, I want to be at the huge place with the nationally-renowned NICU. (And it's not like I'm not worried about this hospital, too, after having had the pregnancy monitored for various periods at three separate institutions elsewhere that were, each in their own way, better.)
Meanwhile: smaller sharper body parts have become visible when "kicking" (are they feet? like I can tell). There's indigestion after every meal, and I'm only sleeping about 6 hours a night. At least one out of every three days is totally chewed up by fatigue. The dizzy spells (clearly inner ear—my left ear goes somewhat deaf and vertigo sets in; resolves in less than 10 minutes, but leaves me very tired) that no one can explain continue to pop up every week or so, with a nasty one happening earlier this evening; the most recent guess is that they might be connected to my migraines? but no one knows. And yesterday I assembled our overpriced Dutch stroller, dragged home a changing table that folks a block away had put out in their trash, and considered submitting myself to David Brooks as a case study.