Wednesday, January 25, 2006

Tell me there's a better way

I didn't post about my follow-up appointment with my midwife yesterday. I think, honestly, I just needed a little time to digest the whole thing. If I were a person of few words, I would sum it up like this: "It was bad." But I'm not a person of few words. So here goes:

It was a dreadful appointment. I knew it would be the minute I saw the midwife come around the corner with a big grin. Instantly, I thought: "She doesn't know that I lost the baby." Bingo. I had hit the nail on the head. Her first words to me: "How's baby doing today?"

Clearly not the way to start an appointment designed to make sure I was recovering from a miscarriage.

In her defense, the midwife works in a large hospital's "Midwifery Center." My options in this state are severely limited as to who will offer my ob care; I am too high a risk for a regular independent midwife (large babies, pre-term issues) and I refuse to go to one of those McObstetrics clinics where you rotate through the doctors like a sandwich in a vending machine. Somehow, seeing a *midwife* in a big practice seemed o.k. Somehow, I was wrong. own hang-up, I know ....) and Midwife C. Now, forgive me if I'm wrong, but that's a lot of people to talk to about one tiny little life. It's also a lot of people to explain your life story to--which I did, every single time I had to have contact with someone. It was like starting from scratch with every conversation: my background, medical history, date of In the course of my 8 week pregnancy with Gloria, I saw one midwife. We'll call her Midwife A. I had two ultrasounds, each performed by a different technician. I spoke on the phone with their office three times: to Midwife B (male, which makes me uncomfortable in gynLMP, u/s dates ... the whole thing.

Apparently what had happened was that Midwife C, who spoke to me on the day I began miscarrying, neglected to make any notes in my chart. As far as Midwife A knew, I had had an ultrasound, spoken to Midwife B about the less-than-positive results but was still carrying a healthy pregnancy.

After I informed Midwife A of the miscarriage, she apologized vaguely about "the system," but seemed unflustered. I got the impression that while I had avoided McObstetrics, I had stumbled into Baby King.

During the physical exam, Midwife A introduced the topic of birth control. When I declined her offer of a three-month supply of pills to ensure that any subsequent pregnancy had "the best possible chance," she looked at me like I had six heads. I told her that my husband and I were comfortable with abstaining. I think this was the first time she had heard such things, and also that she didn't fully trust me to be responsible enough to actually keep my word on this. She told me that I had to have at least one period before trying again, and we left it at that.

Lessons here ... oh, they are so many. I could go on and on about the state of healthcare. The double-edged sword of HMOs and insurance giants. But I think the thing I will take from this experience is that before I sign on with another healthcare professional to walk by my side during a pregnancy, I will make sure it is someone who shares my values, who believes that life can not be reduced to terms like "tissue," and who looks to truly keep abreast of changes in patients' status. Who knows. Maybe I'll even find someone who returns their own calls.

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