Monday, August 31, 2009

"A Birth Story" observations

TLC has this show called "A Birth Story" with women giving birth. I've been watching it all morning. Every single one of them was in a hospital, and every single one of them had an epidural. Every single one of them had problems after the epidural, such as fetal distress or a sudden, drastic drop in fetal heart rate, or labor just stopping progressing. Every single one of them so far have ended in a c-section. Every. Single. One.

Most of them were induced before their due dates. Only one of them was induced because a problem was suspected (low amniotic fluid). The one who wasn't induced had a planned c-section because of having triplets. A few of them have said very plainly that they were going to just do what the doctors said because "the doctors are the experts and always know what's best." (What's best for their insurance, at least, as they don't get sued for doing c-sections, only for not doing c-sections....)

The only one who was doing everything possible to avoid a c-section is the one who was induced for low amniotic fluid.

Not a single one of them have planned to try a natural un-medicated birth, instead talking ahead of time about the interventions they were counting on. And each time it was after pre-planned interventions that problems started very quickly.

I guess I'm posting this because I just can't understand how women can watch shows like this, see that it's after interventions that the problems start, and want to still do the same things. There is a place and time when these things are needed. I'm very very concerned that women are planning these things ahead of time, sometimes regardless of the risks, sometimes without being informed of any risks.


ETA: "Birth Day" came on after this mini-marathon, and the woman has the EXACT condition I have that led the doctors to try forcing me to agree to a c-section, despite research showing j-pouches not needing to be of obstetric concern. For her, she went right with the c-section she was told to and her baby had breathing problems BECAUSE of it, and due to that, she got to visit her new baby in the NICU for only a few minutes at a time. Her first sight of him was a picture, and she got to see him in person hours after birth. The early bonding time was with nurses.

Of course the entire thing was made out that childbirth must be sooooooo dramatic.

If the extent of my research went to a tv show, like it seems to be for many women, I'd be terrified right now. Yup, the show mentioned death many times. The actual stats show something quite different. I'm so much more comfortable with our planned water birth wit a midwife. So much. Because the extent of my research didn't end at what those who'd benefit from cutting me open had to say.

Friday, August 28, 2009

Midwife it is!

Without doubt we are going with a midwife for delivery now. No doubt. Just deciding between the birthing center and home.

A list of states where midwifery is illegal.
http://mana.org/statechart.html

I promise to try not to go all hyper-activist on this issue. I'm newly broken free of the belief that my own delivery absolutely must be in a hospital and must be c-section. Years of being told it had to be one way made me feel like there was no control, made being pregnant something I wasn't able to enjoy due to the fear of death if I didn't do it the way the doctors said, newly free of the fear that no matter what, I would probably die, but the chance of life was increased most by letting them cut me open. It's been so freeing breaking loose of that, and for the first time, my fiance and I are both looking forward to our daughter being born instead of me crying from sickness and grief that I might not get to see her grow up and him being in tears often from fear that I'd die, and possibly our baby with me. Now the tears for us both are from relief and release from the fear, and we're able to lay down together and actually watch her move around, karate-chopping me from the inside, and we can laugh instead of wondering if this was the only family time we could look forward to together.

I'm still sad, but for the countless women made to feel that the only safe option for them, the ONLY safe option, no matter what, is in a cold, impersonal hospital being pumped full of drugs with doctors who only now are being "kind" enough to allow them more than a few ice chips during labor, though still no food, lest they need a c-section from exhaustion brought on by lack of nutrition. It's just...it's sickening.

The doctor backing our midwife (makes it harder for the state to shut down her birth center by having a doctor-affiliation) is under threat of disciplinary action for practicing what he preaches about women being given the information they need to decide for themselves which birth is best for them rather than censoring himself and only giving them pieces of information to sway them to hospital births. Yes, a pro-midwife, pro-unassisted birth, pro-information doctor! But, you see, he's violated a VBAC ban by attending them. So for being in support of women who don't want to be cut open again, he's under peer review, may lose his staff privileges, and may face disciplinary action. This is sickening. If the review is successful, my midwife (one of the first licensed by the state) would come under fire as well. It's damned near impossible in this area to find doctors willing to provide the back-up service needed to keep a midwife from being disallowed to practice.

I'm so angry about this. Thrilled to have broken free from the belief I had to go be cut open, and angry that those willing to give women the right to not birth in hospitals with ice chips are coming under such fire. How dare the medical community use fear to coerce medical decisions toward the direction that will make them the most money with a total disregard for our health?

Sorry, I'll stop ranting now.

Wednesday, August 19, 2009

More good news!

United has gap-exception for when there are of providers of a covered service within 30 miles. If there are none covered in network in that area, you get to pick from any of them and call with the provider's info, and they'll set up gap-exception to cover them at in-network. Midwives ARE a covered service, covered at 100% after a co-pay of $20. Holy crap. I was expecting, at best, to have to switch us to a more expensive plan and then get covered at the out-of-network rate of 70%. So...WOW.

So now, if United holds up, then we'll just need to find a midwife who will cover me, and we got a couple personal referrals. This part could still be tricky, I know.

Anyway, the last doctor we did see stated be felt that the risks for a vaginal delivery would definitely be lower than a c/s if the baby's five or six pounds, and since I'm so very likely to deliver early, this will likely be the case. Combined with what I stayed up all night reading, testimony from actual real women who've been through the same thing I have, it does sound like vaginal carries fewer risks. No complications among the vaginal delivery moms (one's had babies over nine pounds!!), and the c-section moms had a good rate of intestinal blockage afterward, and one case of twisting. So we're leaning even more toward natural.

What we've talked about is, if we can find a midwife, of course continuing to see a doctor. If the baby is estimated to be under a certain weight/size at the time of spontaneous labor, then going with a natural delivery, but giving it a deadline of whenever the doctor would want to schedule a c-section. So basically natural happens before a c-section date or not at all. We're trying to balance many things here and two sides of risks. Of course we will talk to the doctor about this too, as well as the midwife. But I'm far more comfortable at this point with a natural delivery.

And
more good news that I had to call the insurance company to double-check because it's so good is that, as there are no in-network birthing centers around either (within 30 miles), I can choose the one I want, get the gap-exception, ad have it covered at the in-patient hospital rate (100% minus a $200-co-pay).

For me, once bad stuff starts, it's an avalanche for a while, and when good starts, it comes all at once too. So let's hope this good streak lasts and that there aren't any problems with anything. I deserve good for a while!!

Tuesday, August 18, 2009

J-pouch support!

This has no relevance to anyone here but me, but it has me so happy I have tears in my eyes. I found a j-pouch support forum complete with a section dedicated to women's health and pregnancy, complete with women who've been through exactly what I went through, my same medical background!! Most of the ones who've had babies did have a c-section right off the bat, but the ones who had vagina births have all been just fine. There are some women too who've had to have permanent ileostomies before pregnancy, but none of the ones with a j-pouch have yet gone on to have any problems. This is thrilling to me. Cody and I had almost decided on a method of delivery (which will be outlined in another post later), dependent on two factors, but what I've been reading, the links to things I didn't find, have given me a new hope. This is seriously major for me, and so good.

Saturday, August 15, 2009

ARGH!

It would make sense that the ONE box lost in this move is also the one most expensive to replace. In addition to my WEDDING RING and other wedding jewelry, not only for me, but my bridesmaids, but other things in it included one of a kind cufflinks and all eight of my Gingher scissors (about $50 a pop), as well as a $400-doll that is no longer made. I am VERY pissed off. VERY.

I wish now I hadn't left a day early and had stayed until loading the UHaul was complete.

ETA: Box found!

The business of birth

I've been wondering a good deal more over the last couple months just how much a c-section is really and truly needed versus how much of it comes down to doctors worried either about liability or it being more difficult for them for me to have a natural birth. It's a lot harder to sue a doctor over a problem in a c-section (how often do you hear, "Well, maybe if it had been vaginal, it would have been okay!") than a problem that occurs without one. It's like medical intervention is a way to counter the claim that nothing was done. But it's not always that something should be done.

Now there are undoubtedly risks either way.

The major risk to a c-section is that my small intestine, the only set I still have, is adhered to my uterus, which will require separating them. Problem is that they're gray (usually they're pink), and so is the scar tissue, making it very difficult to tell which is what. So if my intestine gets nicked instead, that would be VERY bad to the point that it would probably kill me. At Stanford, the GI surgery team was going to not only be on-call, but IN the delivery room in the case that this happens. Minutes can be the difference between life and death or me.

The risks to a vaginal birth are that, in the extremely common lithotomy position (on the back), gravity narrows the pelvic cavity and puts all the pressure toward the back, and I have an internal j-pouch rather than a large intestine that is surgically stapled rather than naturaly attached. There's the risk that this could push the j-pouch away from where it's connected, or that I tear. A preineal tear would be very back news for my j-pouch as well. It's been repaired once, but it took four years of surgeries and hospitalizations to fix after the accident (I was a pedestrian in a cross-walk, and a driver ran a red and hit me, with the bunt impact rupturing my intestine).

Both carry risks to my intestine, only one of these options guarantees my intestine being touched. So I'm considering a natual childbirth, but rather than dry or on my back, in water. Water helps prevent tearing, and being more upright or forward would alleviate a lot of the pressure from my intestine and back.

I really want as few medical interventions as necessary, and I HATE drugs. I've only taken Tylenol twice in the last two years, once for one of my migraines, and once after the first egg retrieval. I really try to not take ANYTHING unless necessary, and when I would be in the hospital, I'd be in pain but not ask for pain meds, so when they realized it was making my vitals go up, I'd get put on a PC pump that automatically administered 10cc of Demerol an hour with a pump I could hit twice more, at least 15 minutes apart, per hour for an additional 15cc each hit. They generally don't like to automatically administer pain drugs, but I wouldn't ask otherwise...even though Demerol is awesome. But still.

I want as few drugs as necessary going into this baby. The drugs from a c-section do go into the baby. It doesn't seem so coincidental that there has been such a noticeable rate in certain childhood illnesses since pain drugs and c-sections suddenly exploded in popularity. I'm not blaming the mothers. Not exactly. The side effects of drugs don't always come out until many years later. There have been many drugs over the last century that would be routine to use for several years, until there was suddenly a connection between the drug and birth defects of mental impairments. Now I understand than not 100% of deformities and retardation come about from drugs, and that both have been around far longer than any drugs we use today, but the rates should't be rising right along with the rate of use of drugs. I wouldn't doubt if, in 10 years, a lot of our routine drugs are banned. It's nice to think that they're all tested and tested and are completely safe, but this isn't the case. It's really not. Look at how often new drugs are being recalled while the older drugs remain. The older drugs have been thoroughly tested with time. The new ones don't undergo 15 years of testing, what are the effects of use 15 years later. They're rigorously tested, yes, but what happens to the users 15, 20 years down the road? There was...oh god what was the name of that one drug...anyway a very common drug used in the 50's that was later found to be resulting in infertile babies. Earlier in the century another drug used during pregnancy was leading to babies being born without arms and legs, but deformed hands and feet.

A good effect of the insurance worries we had was forcing me to have to research these things far more in depth on my own to try to figure out different options and risks aside from what doctors had to say that would ultimately be in THEIR best interest.

Yikes!!

I already decided to go with a different doctors than the one* I met with, one of the several reasons being that the wife-half of the team no longer accepts any insurance, and so she would have been covered at 30%, and since she's half the appointments and possibly delivery, this would have amounted to a LOT of money.

Well, I decided to double-check how much out-of-network is covered, and I was thinking about the wrong Apple plan (Apple has its own "special" plans through United, and it's large enough that it has its own customer service department, though this doesn't really mean jack). Our plan covers 0% for out-of-network, completely negating the point of having insurance when it comes to her. If she were to deliver, we'd be responsible for 100%!! What the hell is insurance for if it covers nada?!

* I met with the husband-half of the duo, which is why it's plural, then suddenly a one.

Friday, August 14, 2009

DAMMIT!!

It's a substantial pay-cut we can't afford, but we can't afford to turn it down either. FUCK! We HAVE to have the insurance, but the pay isn't going to be enough for us to get by without a part-time job added in. I don't have the energy but I can't have Cody getting a job on top of working full-time. This really sucks for us. I need to see if I can find a work-from-home position.

Three things

1) He was invited to go in on Wednesday and spend the day, and at the end of the day was told that they're considering someone else too. This didn't sit too well with me. See, the GM here originally said he wanted to firm things up by last Tuesday, then put off talking to Cody until Friday. I said at that time that it probably meant they were also considering someone else, and keeping him strung along on retainer. And I was right. So we were on pins and needles waiting for a call back. Stressed and sick. Why tell him at the END of the day unless they were preparing him for bad news? The other person hasn't even worked at Apple. Anyway, he did get the call yesterday after what felt like forever and he got the job. We don't know what his pay will be yet. It's not the same position he has now, and his pay was at the very top of the pay for this position. But we should know sometime today hopefully.

But the major upside is we keep our insurance.

2) On Monday we had an appointment with the new doctor. All reviews speak highly of the ability of these two doctors. They're a husband and wife team who apparently cater to higher-end patients. Actually, I found out they have to. We met with the husband on Monday.

I first must metion something. When I called to make this appointment a month ago, I obviously asked if they took our insurance, and was assured they do. Then I asked if there is anything else I need to know, fees, etc., aside from medical records. I was told no.

Well, we get smacked with a $400-fee right off the bat for walking in the door (plus our expected $20-co-pay). We weren't expecting to walk out of there owing $420. Out of "courtesy," they're willing to bill us at our next appointment.*

Also we found out that the wife-half of this team doesn't accept ANY insurance, so she's out of network for EVERYONE. Since appointments alternate between husband and wife, half of everything would happen with someone who isn't covered by insurance. Costs for her would be reimbursed at 30%, leaving is 70%. Heaven help us if she were to be the one to deliver our baby. 70% of it would fall to us to pay out of pocket. We can't afford that!! Which is why I look for a doctor who accepts our insurance.

As you night imagine, I was NOT thrilled.

When we met with the husband-half, well, he has the bedside manner of a brick, as Cody put it later. I can tell the guy's knowledgeable, but he's cocky as hell for it. He definitely caters to snobby, high-end clients. Hell, his attitude might have been to counter the snobbiness rich people can have sometimes. He's not concerned with only gaining 15 pounds if you're thin, like me, as his clients are the types who probably have personal chefs and nutritionists who can make sure they get all the vitamins they need with a minimal number of calories. So my only gaining four pounds in 24 weeks is what he likes to see.

We did get to see the baby again, and either he has the smallest penis known to mankind, or she's definitely still a girl. So third time gender's been checked, and third time she's a girl.

*But, needless to say, we aren't going back for another appointment. Even if he is highly-recommended in terms of skill, we just can't afford to be hit with hundreds of dollars in unexpected fees and have then due on the spot. We can't afford to pay what would be a substantial sum of money for us when visits are with his wife and if she's the one to deliver.

3) I had been trying to figure out why I was getting replies in this blog and my prior Wordpress account about the location of fertility drugs and karma with demands to "contact me," but no e-mail address given or other way to contact. I couldn't do anything except ignore that because I couldn't contact someone who wouldn't leave a method of contact. Today I finally got an e-mail through my website e-mail with a link. Oh my god I was furious. Someone's been using my name to hock fertility drugs then not sending them. I didn't get all the way through it. But it's infuriated me. It's probably the clearest attempt at assassinating my character I've seen, someone actually using my name and impersonating me. (FFS, thieves aren't going to use their own real names!!) And the dates listed are right around when someone hacked into a bunch of my e-mail accounts. I'm so sick and tired of this. I'm trying to live my life and a group of people, and I know who, just can't get lives of their own and leave me to live mine. Sad and pathetic when this is someone's idea of fun.

Monday, August 10, 2009

Cody will know more on Wednesday about the job situation. As of right now, he's still employed by the old Apple as he has vacation time to burn, though we had hoped to use that for when the baby's born. But it buys is time now and it's needed now. He had to go around his managers in Palo Alto to get anything done. His position isn't open anywhere as of this moment, but there are lateral moves he may be able to make for the same income.

Cody was supposed to put the crib together tonight. He couldn't figure out part of it, so I went to help, and what do I find? He managed to screw the damned thing up. Now part of it's broken, though at least it's just in such a way that adding a couple screws, while unsightly, is still stable enough to be safe. So then I told him a long hinge was on wrong. It's not a drop-side, but rather a drop-gate (top 8" or so drops out forward on a long hinge). It was backward, but he insisted it was fine. So going on a dozen screws later that I put in, he realizes I was right but then tries to insist he was the one who said it was backward. *face-palm*

So I left the nursery and told him to finish. Which he eventually did.

Saturday, August 8, 2009

Well, we've moved. Lots of new stuff to report, but no time right this moment. Still no job firmly lined up, but a couple good prospects. Will update in the ext few days.