Ever see the movie Stardust? Well in it there are three Witches who see a Star fall and the set out to find it. Their ultimate goal is to cut out the star's heart so that the Witches can once more enjoy the beauty of their youth. Much more to the plot than that, but this is the concept that inspires the title of this post. Great film. Btw it's Tod's and my "movie" (vs. having a song).
So the pregnancy progressed well without a hitch. The was one detail which put this pregnancy into the high risk category, I had a fibroid that was about the size of a baseball on the outside of my uterus, but because of it's type and location it was a low "high risk" and was not expected to pose a problem, besides some possible discomfort for me.
As I said the pregnancy was really good. I felt I had the support that I needed, I learned a great deal about pregnancy, labour and delivery through good books and scholarly articles, and felt I was making informed choices that were supported by my Dr./CNMidwife team. At least until week 40. That's when this turned into what felt like an overly dramatic witch hunt.
Let me rewind a bit, at the week 37 appt with the midwife Laurie Holmes (the CNM part of the group at Rio Luna Family Care) Tod and I asked what happens if the pregnancy goes past the due date to which Laurie replied describing several options for induction such as cytotec and pitocin. She did make it sound like it would be a discussion at that future point of being overdue. Following the advice of our Doula, Stefanie, Tod asked what risks and alternatives there were. Laurie didn't talk about alternatives, but she did say that there were no risks to using cytotec, described its use and made it sound so easy and routine. Also at that appt Tod and I inquired what this office's c-section rate was to which Laurie stated "oh, we don't have time to find that number, in order to do so I'd have to stay here till 8:00pm after all the days appt's and phone calls to dig through all the past client files to even begin to find out what happened to who." This surprised me that they don't care enough about their clients to keep a record on a simple number to track their effectiveness as a group practise. I left that appt uneasy so I began to investigate those induction options that were described since I felt wasn't getting a straight answer.
At the week 40 appt. March 15th, I had not yet delivered. No surprise to me, most of my family's pregnancies have all been past due, the average 1st pregnancy for new moms is 10 days past the "due date", and I had no reason to worry about my little girl because she was acting normal inside my womb. That appt went seemingly fine but my Dr. changed my next weekly appt to the following Monday (so i'd be 40.5 weeks) so that we could do a non stress test and an ultra sound to measure baby's amniotic fluid. So monday's appt came and at that appt. Dr. Friedman talked about how her partnering Dr., Dr. Holmes, had to deliver 2 women in the wee hours of the morning over the weekend. That was followed up with how inconvenient it was for that Dr. b/c she has two young children at home and one can't just go home and expect the children to give mom some time to nap after a long night of work. I thought this terribly odd, especially since this family practise was in the business of prenatal and delivery care. If the Dr's don't want late nights why do they care for pregnant women?
After complaining about her partner's plight Dr. Friedman then jumps into a discussion about induction and starts suggesting the coming friday (my 41st week) as a great day that would work for her. I was put off even more by this comment because I did not want to be induced, and I had made my desires clear that I did not want to use Cytotec, which is a drug for ulcers, and this induction wasn't a discussion about my health it was a statement about her convenience.
Let me be clear about one thing here. I am not against induction nor am I against appropriate use of life saving interventions. I am for informed choice and against using medical intervention when it is unnecessary or shrouded with smoke and mirrors. I wasn't being well informed even with asking questions of my practioner, so I found information from reliable sources such as current scholarly research and quality books.
Even tho cytotec isn't approved or deemed safe to be used on pregnant women Dr's use it often in the United States, as they claim "off label" when really it is a contraindicated use of the drug, to "ripen the cervix" for delivery. The problem is that this contraindicated use of Cytotec is because it has not been deemed safe for use on pregnant women. The manufacturer has made a public statement stating that using Cytotec on pregnant women has not been researched enough to deem it safe. They actually says that the off-label use of Cytotec has resulted in reports of uterine rupture, hysterectomy, and the death of mothers and infants. Here's the link to that statement: http://www.aims.org.uk/Journal/Vol13No3/searle.htm
Additionally many professional organizations do not endorse it's use, such as the FDA, MANY other USA org's, and MANY international org's a well. Here's a link to some informative information on the risks of Cytotec. http://www.midwiferytoday.com/cytotec/
When I cited information to Dr. Friedman about Cytotec's lack of safety, it's lack of supported use, and the lack of efficacy research done on the drug, Dr. Friedman finally admitted that yes Cytotec is questioned for it's safety but that's because it causes labour to start (and she conveniently omitted ANY risks about abortion, maternal death, or uterine rupture).
Ok, tangent on Cytotec is over. You can make your own informed or uninformed decision regarding it's use.
I did not consent to being induced in my 41st week of pregnancy, so Dr. Friedman tried to pull info from the non stress test and the in office ultrasound to coerce me into induction. Overstating the risks of waiting Dr. Friedman tried to say that the placenta gets old and stops working after 40 weeks and other (very generic) risk factors increase (she didn't say at what rate, which i already knew was less than 5% of all pregnancies these days). Also, she tried to throw in the argument of "low-normal levels of amniotic fluid" (she "measured" 7 cm of fluid) as a reason to induce, and sent me to the hospital for a Bio Physical Profile to get a second opinion on the ultrasound that she performed in office. Well, our little girl scored well with flying colours on the BPP (with 9 cm of fluid) so there was no risk to my baby or me at this point in being "over due" by three days.
Again I went home and looked up scholarly articles on the subject and found that low levels of amniotic fluid is not a valid reason to induce because it does not improve neonatal outcomes. So, Dr. Friedman was pushing her agenda again by down playing the risks involved with her choice of care for me and overstating the risks.
There was another appt that was in their system, which should have been cancelled b/c of monday's appt, which was for wednesday so when they called to remind me of the wed appt I cancelled it.
On wed night, March 20th, the clutch in the car started to go. Our only vehicle, we were still waiting for labour to start, and our only car was breaking down. Hopefully if we went into labour the car would make it 10 minutes to the hospital.
Then thursday there was an appt created by Rio Luna which I also cancelled, but Dr. Friedman pressured me into getting into her office asap. All she did again was try to push the induction. I mentioned that I'd like to try Acupuncture first, since it is a safe way to induce labour, and Dr. Friedman started to criticize me for not having started the appts already. Then she asks what reservations I have against going into labour trying to psycho analyze me and what is going on in my mind. I reiterate to her things I had been saying all long, that I'm not afraid of labour and I have a "work with the pain" attitude, if baby needs a few more days that is fine by me, I am not desperate to be un-pregnant, I feel that the baby can take the time she safely needs.
Again another pressure appointment on Friday that I either come into their office or go to the hospital for more testing. Ugh. So I go to her office and refuse unnecessary induction again. This appointment was similar to the others. More pressure.
The Dr. started to judge me and tell me that I was basically buying a c-section because I was being so inflexible. She told me a story about herself and how she sees many characteristics in me that she had at the first time of her first birth which ended in a c-section because she was inflexible. I told her that she was incorrect in her assertion of me because she was seeing me in one isolated situation in my life and in a short period of time in her office. She did say that she could be wrong, with sarcasm in her voice. The Dr. also mentioned that she tried not to let the litigation play a role in her actions, but it was totally an overarching influence in her actions. Additionally she coldly stated that it would be horrible if my baby died before I was induced. Seriously? That's what you're telling a first time mother a week after my due date--invoke fear into the situation to coerce me into induction? That's the worst thing a caregiver could do, to introduce fear and break trust at the last moments of pregnancy. Dr. Friedman tried to suggest that I had signs of pre-eclampsia (which I didn't) and told us as we left that if I developed any pains or headaches to head to the hospital immediately. Good advice to follow, if I had the illness. I felt this was just another fear tactic, trying to paint this situation with any hint of a complication.
After this apointment I called my Doula and her mentor, Meria, balling my eyes out because I could not stand to think that this woman would be the one being at the delivery of my child. Meria, being a counsellor, was a great help at this time because she had some very wise things to say to comfort me, and supported my feelings and helped to calm my desire to just give the Dr. the boot. She reminded me that I am the one delivering my child and that i have the strength within me to accomplish this task. I asserted that the Dr. was projecting her c-section and inflexibile experience upon me and that it was not actually my truth and Meria agreed because she had gotten to know Tod and I in our home setting.
As an additional note I was told at a later appointment after my baby's birth by the midwife, Laurie, that if anything were to happen to Miranda the local medical community would blame Dr. Friedman because she should "know better" than to let a pregnancy go past due. More indication that my Dr. was acting with her reputation on the line instead of my health. I feel that is VERY Frustrating with a capital F.
Friday morning and Saturday Morning I had an appointment with an acupuncturist who was kind enough to have a sliding scale (we can't afford $125 payments each session) so we could pay what we were able and she came to our home so I didn't have to worry about making another appointment with a broken car. The car finally gave out friday night as we went to get Dominoes Pizza because I was too stressed to cook. Gratefully we have good friends in town and Britt came to our rescue even tho she was waiting for her husband to leave work (she left him there to come get us!).
Saturday night contractions started before bed. They were a good set about 4minutes apart, happening regularly, and going for more than 2 hours. We stayed up till about 1am, but decided to go to bed because it wasn't intense enough to go the hospital.
Sunday morning we skipped church because I didn't want everyone's comments "You're STILL pregnant?!" Not what I needed after the week our little family had been having. A friend noted that we weren't at church and sent me an innocent text asking if we went to the hospital. I started balling because that txt connected with all the stress from the previous week of not giving birth with massive unnecessary pressure from the doctor.
Sunday night brought more contractions that were more intense than Saturday. An interesting note, petting Banner's fluffy fur made my contractions stronger. However they subsided when we finally went to bed. I am certain that the baby would have been born that weekend if I wasn't put through such a heavy stress load by my Dr. and if I didn't feel as if my Dr. had turned her fear up to the tenth degree making this situation unnecessarily unsafe.
Monday's appointment came and I invited our doula to come with us so that she could hear the craziness that was coming out of Dr. Friedman's mouth. The nurse brought us into the little room, took my blood pressure and saw that it was high. She didn't make much conversation, wasn't warm or caring like some of the other nursing staff. She didn't say a word to me jsut gave me a dirty look after she took my blood pressure and left the room. I again had high blood pressure in their office. When Dr. Friedman came into the room she was more tame with our doula around. I decided finally to be induced the next morning because my body was starting (and stopping) labour on it's own and I wanted to get Dr. Friedman out of my life. Since my blood pressure was high again she requested that I go to the hospital for further testing.
Tod and I went to the hospital around 5pm. Stefanie joined us as well. Everything was looking fine for the 1 hour that I was requested to stay there so the nurse in triage, Ashley, called Dr. Friedman to report and the Dr. said keep me for 30 more minutes. In those 30 minutes my blood sugar started to drop because I had not eaten since noon. Pregnant lady and no food=not a happy body. So with this turn of events I was kept for another 2 hours to monitor mine and baby's progress. The Triage nurse Ashley tried to help by bringing me some apple juice and yogurt b/c their cafeteria closed at 6pm and it was appreciated, but it didn't do much, primarily because the apple juice was all high fructose corn syrup which is no good for the body. With no significant sign of improvement the triage nurse Ashley called my Dr. who recommended that I induce that night. I said no, I need REAL food and sleep, and I need to go home. Triage nurse Ashley didn't seem to agree with my Dr. she wasn't encouraging me to stay at all, and agreeing that I needed food, though she didn't come right out and contradict my Dr.'s orders. After a short discussion with Stefanie and Tod I signed an AMA (a legal document that states I am leaving Against Medical Advice) got myself out of there and got myself a huge subway sandwich (Tod got one too) and we went home.
More contractions started after I got a good meal. I tried to sleep Monday night. The contractions would wake me, but they eventually tapered off. I did get a few hours of sleep, but was also too filled with irritation to sleep well. I may have gotten 4 hours of sleep. Better than being co-erced into an induction that night. I was grateful to get in one more night in my own bed with the support and love of my husband.
So the pregnancy progressed well without a hitch. The was one detail which put this pregnancy into the high risk category, I had a fibroid that was about the size of a baseball on the outside of my uterus, but because of it's type and location it was a low "high risk" and was not expected to pose a problem, besides some possible discomfort for me.
As I said the pregnancy was really good. I felt I had the support that I needed, I learned a great deal about pregnancy, labour and delivery through good books and scholarly articles, and felt I was making informed choices that were supported by my Dr./CNMidwife team. At least until week 40. That's when this turned into what felt like an overly dramatic witch hunt.
Let me rewind a bit, at the week 37 appt with the midwife Laurie Holmes (the CNM part of the group at Rio Luna Family Care) Tod and I asked what happens if the pregnancy goes past the due date to which Laurie replied describing several options for induction such as cytotec and pitocin. She did make it sound like it would be a discussion at that future point of being overdue. Following the advice of our Doula, Stefanie, Tod asked what risks and alternatives there were. Laurie didn't talk about alternatives, but she did say that there were no risks to using cytotec, described its use and made it sound so easy and routine. Also at that appt Tod and I inquired what this office's c-section rate was to which Laurie stated "oh, we don't have time to find that number, in order to do so I'd have to stay here till 8:00pm after all the days appt's and phone calls to dig through all the past client files to even begin to find out what happened to who." This surprised me that they don't care enough about their clients to keep a record on a simple number to track their effectiveness as a group practise. I left that appt uneasy so I began to investigate those induction options that were described since I felt wasn't getting a straight answer.
At the week 40 appt. March 15th, I had not yet delivered. No surprise to me, most of my family's pregnancies have all been past due, the average 1st pregnancy for new moms is 10 days past the "due date", and I had no reason to worry about my little girl because she was acting normal inside my womb. That appt went seemingly fine but my Dr. changed my next weekly appt to the following Monday (so i'd be 40.5 weeks) so that we could do a non stress test and an ultra sound to measure baby's amniotic fluid. So monday's appt came and at that appt. Dr. Friedman talked about how her partnering Dr., Dr. Holmes, had to deliver 2 women in the wee hours of the morning over the weekend. That was followed up with how inconvenient it was for that Dr. b/c she has two young children at home and one can't just go home and expect the children to give mom some time to nap after a long night of work. I thought this terribly odd, especially since this family practise was in the business of prenatal and delivery care. If the Dr's don't want late nights why do they care for pregnant women?
After complaining about her partner's plight Dr. Friedman then jumps into a discussion about induction and starts suggesting the coming friday (my 41st week) as a great day that would work for her. I was put off even more by this comment because I did not want to be induced, and I had made my desires clear that I did not want to use Cytotec, which is a drug for ulcers, and this induction wasn't a discussion about my health it was a statement about her convenience.
Let me be clear about one thing here. I am not against induction nor am I against appropriate use of life saving interventions. I am for informed choice and against using medical intervention when it is unnecessary or shrouded with smoke and mirrors. I wasn't being well informed even with asking questions of my practioner, so I found information from reliable sources such as current scholarly research and quality books.
Even tho cytotec isn't approved or deemed safe to be used on pregnant women Dr's use it often in the United States, as they claim "off label" when really it is a contraindicated use of the drug, to "ripen the cervix" for delivery. The problem is that this contraindicated use of Cytotec is because it has not been deemed safe for use on pregnant women. The manufacturer has made a public statement stating that using Cytotec on pregnant women has not been researched enough to deem it safe. They actually says that the off-label use of Cytotec has resulted in reports of uterine rupture, hysterectomy, and the death of mothers and infants. Here's the link to that statement: http://www.aims.org.uk/Journal/Vol13No3/searle.htm
When I cited information to Dr. Friedman about Cytotec's lack of safety, it's lack of supported use, and the lack of efficacy research done on the drug, Dr. Friedman finally admitted that yes Cytotec is questioned for it's safety but that's because it causes labour to start (and she conveniently omitted ANY risks about abortion, maternal death, or uterine rupture).
Ok, tangent on Cytotec is over. You can make your own informed or uninformed decision regarding it's use.
I did not consent to being induced in my 41st week of pregnancy, so Dr. Friedman tried to pull info from the non stress test and the in office ultrasound to coerce me into induction. Overstating the risks of waiting Dr. Friedman tried to say that the placenta gets old and stops working after 40 weeks and other (very generic) risk factors increase (she didn't say at what rate, which i already knew was less than 5% of all pregnancies these days). Also, she tried to throw in the argument of "low-normal levels of amniotic fluid" (she "measured" 7 cm of fluid) as a reason to induce, and sent me to the hospital for a Bio Physical Profile to get a second opinion on the ultrasound that she performed in office. Well, our little girl scored well with flying colours on the BPP (with 9 cm of fluid) so there was no risk to my baby or me at this point in being "over due" by three days.
Again I went home and looked up scholarly articles on the subject and found that low levels of amniotic fluid is not a valid reason to induce because it does not improve neonatal outcomes. So, Dr. Friedman was pushing her agenda again by down playing the risks involved with her choice of care for me and overstating the risks.
There was another appt that was in their system, which should have been cancelled b/c of monday's appt, which was for wednesday so when they called to remind me of the wed appt I cancelled it.
On wed night, March 20th, the clutch in the car started to go. Our only vehicle, we were still waiting for labour to start, and our only car was breaking down. Hopefully if we went into labour the car would make it 10 minutes to the hospital.
Then thursday there was an appt created by Rio Luna which I also cancelled, but Dr. Friedman pressured me into getting into her office asap. All she did again was try to push the induction. I mentioned that I'd like to try Acupuncture first, since it is a safe way to induce labour, and Dr. Friedman started to criticize me for not having started the appts already. Then she asks what reservations I have against going into labour trying to psycho analyze me and what is going on in my mind. I reiterate to her things I had been saying all long, that I'm not afraid of labour and I have a "work with the pain" attitude, if baby needs a few more days that is fine by me, I am not desperate to be un-pregnant, I feel that the baby can take the time she safely needs.
Again another pressure appointment on Friday that I either come into their office or go to the hospital for more testing. Ugh. So I go to her office and refuse unnecessary induction again. This appointment was similar to the others. More pressure.
The Dr. started to judge me and tell me that I was basically buying a c-section because I was being so inflexible. She told me a story about herself and how she sees many characteristics in me that she had at the first time of her first birth which ended in a c-section because she was inflexible. I told her that she was incorrect in her assertion of me because she was seeing me in one isolated situation in my life and in a short period of time in her office. She did say that she could be wrong, with sarcasm in her voice. The Dr. also mentioned that she tried not to let the litigation play a role in her actions, but it was totally an overarching influence in her actions. Additionally she coldly stated that it would be horrible if my baby died before I was induced. Seriously? That's what you're telling a first time mother a week after my due date--invoke fear into the situation to coerce me into induction? That's the worst thing a caregiver could do, to introduce fear and break trust at the last moments of pregnancy. Dr. Friedman tried to suggest that I had signs of pre-eclampsia (which I didn't) and told us as we left that if I developed any pains or headaches to head to the hospital immediately. Good advice to follow, if I had the illness. I felt this was just another fear tactic, trying to paint this situation with any hint of a complication.
After this apointment I called my Doula and her mentor, Meria, balling my eyes out because I could not stand to think that this woman would be the one being at the delivery of my child. Meria, being a counsellor, was a great help at this time because she had some very wise things to say to comfort me, and supported my feelings and helped to calm my desire to just give the Dr. the boot. She reminded me that I am the one delivering my child and that i have the strength within me to accomplish this task. I asserted that the Dr. was projecting her c-section and inflexibile experience upon me and that it was not actually my truth and Meria agreed because she had gotten to know Tod and I in our home setting.
As an additional note I was told at a later appointment after my baby's birth by the midwife, Laurie, that if anything were to happen to Miranda the local medical community would blame Dr. Friedman because she should "know better" than to let a pregnancy go past due. More indication that my Dr. was acting with her reputation on the line instead of my health. I feel that is VERY Frustrating with a capital F.
Friday morning and Saturday Morning I had an appointment with an acupuncturist who was kind enough to have a sliding scale (we can't afford $125 payments each session) so we could pay what we were able and she came to our home so I didn't have to worry about making another appointment with a broken car. The car finally gave out friday night as we went to get Dominoes Pizza because I was too stressed to cook. Gratefully we have good friends in town and Britt came to our rescue even tho she was waiting for her husband to leave work (she left him there to come get us!).
Saturday night contractions started before bed. They were a good set about 4minutes apart, happening regularly, and going for more than 2 hours. We stayed up till about 1am, but decided to go to bed because it wasn't intense enough to go the hospital.
Sunday morning we skipped church because I didn't want everyone's comments "You're STILL pregnant?!" Not what I needed after the week our little family had been having. A friend noted that we weren't at church and sent me an innocent text asking if we went to the hospital. I started balling because that txt connected with all the stress from the previous week of not giving birth with massive unnecessary pressure from the doctor.
Sunday night brought more contractions that were more intense than Saturday. An interesting note, petting Banner's fluffy fur made my contractions stronger. However they subsided when we finally went to bed. I am certain that the baby would have been born that weekend if I wasn't put through such a heavy stress load by my Dr. and if I didn't feel as if my Dr. had turned her fear up to the tenth degree making this situation unnecessarily unsafe.
Tod and I went to the hospital around 5pm. Stefanie joined us as well. Everything was looking fine for the 1 hour that I was requested to stay there so the nurse in triage, Ashley, called Dr. Friedman to report and the Dr. said keep me for 30 more minutes. In those 30 minutes my blood sugar started to drop because I had not eaten since noon. Pregnant lady and no food=not a happy body. So with this turn of events I was kept for another 2 hours to monitor mine and baby's progress. The Triage nurse Ashley tried to help by bringing me some apple juice and yogurt b/c their cafeteria closed at 6pm and it was appreciated, but it didn't do much, primarily because the apple juice was all high fructose corn syrup which is no good for the body. With no significant sign of improvement the triage nurse Ashley called my Dr. who recommended that I induce that night. I said no, I need REAL food and sleep, and I need to go home. Triage nurse Ashley didn't seem to agree with my Dr. she wasn't encouraging me to stay at all, and agreeing that I needed food, though she didn't come right out and contradict my Dr.'s orders. After a short discussion with Stefanie and Tod I signed an AMA (a legal document that states I am leaving Against Medical Advice) got myself out of there and got myself a huge subway sandwich (Tod got one too) and we went home.
More contractions started after I got a good meal. I tried to sleep Monday night. The contractions would wake me, but they eventually tapered off. I did get a few hours of sleep, but was also too filled with irritation to sleep well. I may have gotten 4 hours of sleep. Better than being co-erced into an induction that night. I was grateful to get in one more night in my own bed with the support and love of my husband.
1 comment:
Did you ever write a letter to the head state medical college that oversees this dreadful doctor? (In Alberta it's called the College of Physicians and Surgeons). You still should if you never did - you could list in point form each pressure tactic that she used to try to coerce you into being induced after only 3 days. It was pretty clear why she was, since she also had just complained of her partner's late nights, and you should mention that in your letter as well....Is there anything online you can post to warn other women - a "rate the MD" site?
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