Pissed! but Accepting?

Wednesday was a banner shite day.  My midwife had been encouraging me to maintain a relationship with an OB, and I knew this necessitated a change.  Friends and L&D nurses urged me to try this one doc, Dr. A (we shall call him), stating that if anyone was going to give me a chance at VBA2C, it would be him.

So, I naively went to my 9:50am interview/appointment with Dr. A.  I was nervous – didn’t really sleep the night before – but hopeful.  The staff was very nice; the nurse was nice.  (I had previously talked with her.)  I had previously met this doc, so at least I wasn’t worried about that.

He was interested to know why I was there since obviously I had been seeing another OB for the 1st three-quarters of my pregnancy.  I told him I had 4 reasons:

  1. I am very motivated for a VBA2C

He interrupts . . . “Don’t do it.”  Shaking head.  Patronizing tone.

I cry.

The rest of the appointment was him trying to scare me out of it, and by the time I told him I’d been diagnosed with a thin lower uterine segment (LUS) during the RCS, he was certain that I am a nut.  Actually, he recognized that I had done a lot of thinking and researching, but he didn’t think I had given enough thought to permanent damage to the baby and permanent damage to me.  (Like, DUH!  What else have I been thinking about the past 7 months.  FFS!!!!!!!)

What was scary is that he’s familiar with the same research I’ve studied.  He mentioned the Cochrane library.  He refuted the opinion of the NIH VBAC Consensus Panel (because most of them don’t deliver babies).  The research doesn’t point to maternal death from uterine rupture but he’s seen it.  Fetal demise begins within 8 minutes of the onset of bradycardia associated with rupture which is too short a time to get a cesarean performed.  Yada yada.

Terrifying.  And I’ve done my research.  I’ve been researching this since 2007.  I have a PhD.  I have fantastic research and analytical skills.  And I was still terrified.  And I still doubted myself, my support system, everything.  And I resented my baby.

And I freaked the hell out.  Couldn’t go to work. 

So, you probably see the “pissed” part.

Here’s the “accepting” part.

Of course he’s going to do “his job” and dissuade me from VBA2C.  In his experience, it’s too  risky to justify.  He’s not going to understand why I disagree.  I’ll never be able to “educate” him here either.  When I don’t rupture and have this baby at home without incident, he’ll assume I got lucky.  I accept that he views birth with a completely different lense.

However, he’s agreed to take me and said he won’t drop me either even if I go forward with the VBAC.  He’d rather babysit me through this poor choice than turn me away.  I’ll have to sign an AMA (against medical advice) waiver just to cover his butt.  Fine; whatever.  So, for now . . . I’m planning to continue my concurrent care with him.  If it becomes a regular thing for him to try and terrorize me, then I’ll drop him.

Although he really shook me to the core on Wednesday, thanks to the amazing support of ICAN and Birth After Cesarean, I’m back on track and actually feeling more solid about my birth plans.  I just don’t “see” the hospital figuring into this experience.  Perhaps God or my baby or some 6th sense will change things, but for now, I’m back to planning a peaceful birth at home.

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5 responses to “Pissed! but Accepting?

  1. you rock. I have so much hope for you and a good outcome…it’s not just a matter of “you can do it!” but you are strong enough to fight this fight…you are doing everything possible to birth this baby the safest way you know how, for you and for baby…you know the stats, you know the research, you are facing it head on…hear momma lion roar! :) {{hugs}}

  2. I’m so sorry he was so negative! It’s so frustrating to hear how willing some doctors are to just cut a patient down without thinking about her feelings. Oncologists deliver truly horrible news all the time, but they do it with more compassion. I think most obs could take a lesson from them.

    It’s very wise of you to acknowledge that he’s never going to understand your choice because it just isn’t within his sphere of experience. I’m a few weeks from – hopefully! -my first homebirth. But I’m outside the range of normal because I have epilepsy. Fortunately my mw has said, several times, that we’re probably never going to get an ob to sign off on a homebirth because it’s so far outside their range of experience. So rather than disappointing ourselves, we just didn’t bother asking that question in our consult.

    It sounds like you are really well prepared, very well researched and confident in your choices. That, more than anything, makes you an excellent candidate for a good, happy, HBA2C. I admire you.

  3. Thank you for writing so honestly about your experiences. You *are* a good researcher and very knowledgeable about yourself, your body, your family, your circumstances, and your options. sending you hugs and support from B’ton.

  4. Glad to hear you’re starting to feel in a better space about this.

    Bottom line, it sounds to me like he’s had a personal experience with a poor outcome and that is flavoring his perceptions. If he can just brush aside the majority of evidence and a big thing like the NIH conference like that, it’s not a rational response. It’s an emotional response, one that’s not conducive to being reasoned with.

    Consider what he says, but understand where he is coming from and why. And consider carefully about letting that kind of fear in the room with you, whispering to your own fears.

    You are your own person, a well-educated person, and can make your own evaluation of risk/benefit tradeoffs. Go read Silver 2006 on the risks of multiple cesareans if you want some balancing perspective.

    Hang in there, hon.

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