Saturday, March 27, 2010

Reality check

Throughout my pregnancy I became very frustrated by how most doctors seemed to have what I perceived as an overly negative view of my health and potential for a successful pregnancy. At 16 weeks one doctor told me I was carrying too much weight to have a healthy pregnancy (a statement he later denied saying but I recorded and wrote about at the time), despite all my medical tests - including blood pressure, cholesterol and kidney function - all being well-within the normal range. The BMI figure seemed to rule above all. The fact I was in my late 30s, got pregnant through IVF and my mum died of a diabetes-related heart attack probably added to their concerns.

One woman I knew said that while she understood my frustration, I should take the view that if the doctors were so busy looking for something going wrong, if something did in fact go wrong, it would be picked up right away. I knew she was right but I struggled not to rile against the fat prejudice - the medical negativity only eased up once I had passed 30 weeks of pregnancy with perfectly healthy blood pressure and no gestational diabetes developing (much to the surprise of nearly every doctor I encountered).

Despite the dire predictions I ended up having the most boringly healthy pregnancy on record; the only medical issues - an iron deficiency, a vitamin D deficiency, and mild carpel tunnel in one hand towards the end of the pregnancy - were conditions common in pregnant women of all ages and weights. I went into labour naturally at just under 41 weeks and had a vaginal birth, albeit with the assistance of drugs and some light forceps work at the end, and delivered an extremely strong and healthy baby.

Three weeks later I decided I was really glad the doctors had watched me like a hawk. Another girl I knew - five years younger, physically fit and with a 'normal' BMI (for what that is worth), who had had a perfectly normal healthy pregnancy, went into labour at a well-known private hospital and things started to go very wrong. Am emergency Cesarean was required, for some reason there was a delay and her baby was born extremely ill. The baby was rushed to one of the big public hospitals while mum was stitched up. A few hours later mum was back for a second round of surgery due to a post-pregnancy complication. For the next week mum was recovering in the private hospital while her child was 20km away in the neonatal intensive care unit of the public hospital. The child is still in intensive care while mum is back home but dependent on others to take her to visit her kid as she is not able to drive due to her surgery.

For all the faults and complaints about public hospitals, they are definitely the place you want to be if something goes wrong. There are always numerous doctors around who can and will drop their non-emergency cases to attend to a real emergency. (That's why non-emergency patients always end up waiting so long to be seen.) I always said that I would rather give birth on a trolley in the corridor of Box Hill Hospital than in an architecturally-designed private hospital room because at least at Box Hill there would be experienced doctors available any time, day or night. Fortunately we live in the catchment zone for one of the best maternity hospitals in the state and during my pregnancy we confirmed that if something went wrong during the birth our baby could be treated in the same hospital as me.

I now fully appreciate that if the extremely rare unexpected birthing emergency after a textbook pregnancy case had happened to be me, having doctors who were constantly looking for something going wrong meant that it would have been picked up very early - and it would have been far less likely for there to be any delays in terms of conducting an emergency Cesarean or transferring a newborn to specialist intensive care.

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