I should start with a disclaimer - this piece is a bit of a rant. Because of my "complex" medical history regarding child rearing, I've had the pleasure of being under the care of an obgyn, endocrinologist, general practitioner, reproductive endocrinologist and perinatologist. And yes at any given point, I've been under the care of more than one of them. So here's what inspired today's post:
Yesterday I went to see my peri to get my cervix measured and make sure I'm not going into pre-term labor. Due to some mixup, the nurse at the front desk gave me my medical file. Since I had to wait almost an hour to see the doctor, and I've read every brochure in that doctor's office thrice already, I decided to browse my file. The most interesting thing I found was a note from my perinatologist to my reproductive endocrinologist and obgyn. It was regarding my cerclage. Apparently there was extensive debate over my case. One doctor didn't want to give me a cerclage - and my peri went to defend the right to give me a cerclage. And get the reason why the one doctor didn't want to give me one : He preferred that I get 3 second-trimester losses BEFORE I qualify for a cerclage. Now how on earth does that make sense? Will I even have the mental wherewithal to still try to get pregnant after losing 3 babies in the second trimester? I'm PCOS, I had to have IVF to have my baby, should I pay for 3 IVF cycles to earn the right to try and save my pregnancy? Who makes up these rules???
Anyway - I digress :) So here's what happened in my first pregnancy - and why I'm very anti OBGYNs. When I got pregnant the first time - I was set up on a monthly appointment schedule. The average appointment consisted of a urine sample, bloodwork, and a quick abdominal ultrasound. That's not so bad. Except, one day at 20 weeks, I walked into my monthly obgyn appointment and was 4 cm dilated. Hmm... someone missed something. I know incompetent cervix is often asymptomatic - so at this point - I gave them a pass. A year later when I was ready to conceive, I had no periods. I didn't get a PCOS diagnosis from my obgyn. What I got was 3 failed unmonitored clomid cycles and then advice to go speak to a specialist.
Fast forward a few years, after finally becoming an IVF graduate, I get released to my OB. Wow.... after spending 2 years with a specialist, you realize how low-grade OB facilities are! My first appointment didn't include an ultrasound or a doppler - because my RE had done one the week before. Of course, every pregnant woman in the first trimester wants an ultrasound or at least doppler to confirm her baby is still there. Needless to say I went on amazon and bought a doppler immediately afterwards! Every monthly appointment afterwards pretty much consisted of a 10 second doppler, bloodwork, and urine samples. And that's it. Now how could you possibly catch anything wrong if that's all you look at ? They have yet to give me an ultrasound. One of my coworkers didn't get her first ultrasound until 20 weeks!! I'm probably just very biased, but with the number of premature babies born in the USA, and the whole range of pregnancy complications, I wonder if a more aggressive screening approach could help a lot of us. Also, why is it people want to see recurrent pregnancy loss to believe you might really have a problem. At my OB office, one doctor tried to categorize my 20 week miscarriage as fetal demise - instead of incompetent cervix. That one statement could have disqualified me for the pregnancy saving cerclage I have right now.
It just seems to me that there's an expectation that if a pregnancy fails.... oh well stuff happens. But no one wants to take it seriously unless it happens over and over. That's fine (I guess?) for women who can get pregnant at will. However, for those of us who have to literally fight and spend insane amounts of money to get our ONE chance at having a baby - that kind of attitude is just appalling. Anyway rant over... that's just my 5 am thought for the day.
So begins day 8 of bed rest!!!!
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