Hello, soul mate.

Somebody found this site by using the terms “hate prenatal appointments”. Ah, finally! A soul mate…

I’ve been for my 36 week appointment at the OB yesterday. And would you know it: Baby has suddenly turned breech! I know there’s still time to turn back to vertex, but I need this added worry like I need a hole in the head. Strangest thing is that the baby was vertex when I got up that morning, because I remember him/her hiccoughing violently at some point and also kicks in the upper right quadrant of my tummy.

I wanted to go off today on maternity leave, but we’ve been forced to leave early on a couple of occasions with the strike, I’m battling to see my General Manager and I know that when I leave, I’m basically locking up the library without anybody to do my work for four months. So, I’ll come back on Monday and Tuesday and see how far I get. It’s still going to be a mess when I return, but I’m beyond caring.

Dirk and I are disagreeing about the birth again and, really! Neither of us needs this right now. I am relatively at peace to do the VBAC – knowing that it could become an emergency c-section – in hospital. But there are standards of care which are routinely used and are not really favourable for a successful VBAC. They are either used because they protect the doctor and nursing staff in the event of a malpractice suit, or they are used because they make things easier for the hospital staff. In a minority of cases they are used because they constitute the least risk. And the problem with this is that there’s always a trade-off. There may be less risk in some area. But they compromise another. I don’t want to allow them and I am prepared to use the “informed refusal” route for some and negotiate about the others.

Dirk disagrees. He feels that I’m unnecessarily confrontational. Maybe I am, but I’ve learned that you don’t stand a chance unless you are. And that if you aren’t very specific and stick to your guns at all times, you are going to end up with things you don’t want or regret later.

The problem is that the medical model of care does not take into account anything other than somebody just deferring to it. Even if the medical model of care is highly suspect. It is no secret that in the field of obstetrics there are many things left to be desired all over the world. Developed countries (such as the US) have a c-section rate of 30+ %. C-section rates in a homebirth setting is 4%…In our own country the WHO says that women giving birth in hospital stand a very high chance of intervention in birth, yet the infant mortality rate has not dropped. And we’re supposed to have some of the best doctors in the world.

I don’t want to hammer on the care Loren received but there were things that were forced on him and us because that it how somebody thought it should be done rather than because it was the best. And he suffered and maybe even died because of it.

The placing of his PEG (G-tube) was wrong because we let ourselves be talked into having it done before the doctor would let him go home. As if he had any right to dictate the terms…If we had a more experienced surgeon advising us and fitting it afterwards and had the Nissen done at the same time, he might not have had the propensity for developing ulcers and he would not have been weakened by weight loss and pain before he died. It is water under the bridge and he may have died anyway, but things like these are just a confirmation that doctors aren’t always right and that we, as parents, should have been more vigilant.

The only thing is: Most people don’t see it this way. They think that they are not responsible if anything goes wrong because the responsibility is carried by the doctors or midwives or whoever. It is very hard to admit that if you allow a particular treatment and something goes wrong YOU are still the one who allowed it. It does not make sense to then want to sue the doctor…I’m not saying that somebody is to blame in all cases of something going wrong. Sometimes bad things just happen. But medical care constitute making a conscious choice – acting or witholding action and the infinite number of variables inbetween.

My trust in doctors has never been good. But after Loren, it is truly nonexistent. I find it extremely hard to submit to any medical procedure. I’m not sure if it is just an issue of trust or because of the abuse by the nurses after Loren’s birth. Could be both and I truly don’t think I can be blamed for my feelings. Obviously I will have to overcome this to some degree, but it is hard.

The OB would not want anything to go wrong with this birth. I’m sure she firstly does not wish anything bad on us, but the main thing is that she needs to cover herself. Unfortunately her field is highly litigious and somehow the impression exists that OBs only get sued for the c/sections they don’t do, because there is a mistaken perception that a c/section is the best care. Which, I can assure you, is only half the story.

If I do agree to a c/section and something goes wrong with that – as there is a bigger chance of happening (c/sections being major surgery) – the results may be just as dire as when something goes wrong with a VBAC. Either way, we have to live with our choices…

But in the end it is not just about deciding between a VBAC or a c/section. Although I know that the former is considered safer overall if you look at stats. But it is between deciding what myriad of choices are safer for a particular person or birth. And to know that, you’d have to be clairvoyant. Even the most experienced doctors can make mistakes.

In the last week I’ve made contact with two people who have been through very similar situations as we have. And I’ve come once again to the realization that there are no guarantees, that this is a tough road and that many people who have not faced it walk around with blindfolds most of the time.

I wish we could just spend the last few weeks in peace and filled with joy and anticipation. I wish we didn’t have to make these decisions while mourning a child we love and miss and with all the emotional baggage of his birth still lingering in our minds. I wish we could just go to sleep and when we wake up Loren is back and the new baby is born and all is well. I am strong, I was strong, but I can sense the end of my strength approaching fast. I’ve really had enough.

Is it too much to ask that things go the way we would want it? Just once.