Thoughtful Consuming and Resentful Professionals

In my first “yeah, I’m back and how about that I’m pregnant” post I made mention of a new passionate subject for me.  Now, I have given fair warning that this would impact some of the subject matter of my blog, albeit not overwhelmingly, and this is a second one.  So, warning!  There is talk and commentary about my experience with a medical professional (without any of that “eeeeeewwwww” factor)!

As one who was raised with “trust your doctor” I found myself making a prenatal appointment with my ob/gyn for seven weeks into the pregnancy despite already considering, and being pretty sure, I would do a home birth.  Besides, what harm could it bring?  It would give me a bit of courage, some reassurance that all systems were go and I could go forth with absolute confidence.

I was so very wrong.

This was my second time with the practice, my prenatal care during my last pregnancy being with another practice, and I paid to have my records forwarded to this practice.  The first words out of the doctor’s mouth (different one than I had seen during the summer) when she saw me:  “Is this your first child?”

The physician then proceeded to talk about tests.  Things like amniocentesis and chronic villus sampling that are highly invasive and have a higher risk of miscarriage than the existing one of me having a child with the genetic disorders these tests can find.  The reason for the recommendation?  “The insurance companies are now covering it for people UNDER 35!”   Sadly, this is not an exaggeration of her exuberance nor even a shift in the words she used.

Blood work to ascertain disease in the baby were also encouraged despite me saying “no” twice and only ended conversing with when the doctor said, “How about if you sign up for it, then you can always say “no” later since we do that at a different appointment?”  The genetic workups I actually informed the doctor were in my chart from my previous records.  Again, it was a couple times before she listened and looked at the chart and said, “oh, yeah – no problems there”.

STD testing is mandatory in prenatal workups in my state and, oh so wonderfully, something that is billed to my insurance (with a high deductible this meant me) and so this was done at the first of FOUR visits they wanted me to have in the first trimester.  Lucky me, the doctor was so courteous as to insure I couldn’t get my lab results from the lab, only from the office, but the bill from the lab COULD and DID come to me.

Each question about tests I asked was greeted with a “well, I don’t know the cost – your insurance will take care of it”; relevance to the testing accuracies were cast aside and just stated that they would “give an idea” if there “might” be issues.  Asking about the odds of having a child with any of these issues and there was a redirection to the above without mention of the large chance of having false positives (these tests are not near 100% in accuracy – truly; they just give potentialities).  Without answers to any of these I felt the doctor was a salesperson, not someone to whom I should trust.  Trust would come from ready answers demonstrable of the physician’s knowledge; trust could also come from knowing the physician cared about what I wanted, what my views of birth are and what my experience had been; trust could be had from simply being listened to.  None of these things happened.

While it is easy for me to latch on to the hostilities of the situation, the frustration at feeling quite hopelessly like *I* had nothing to do with this process.  Me, the parent, the one with the occupied uterus, was not someone looking for care, but someone who was supposed to do what was told to her without question.  Prices, risks – all these things were not worth the physician knowing in order to help me make an informed decision; how can one help a patient be informed if you yourself are not any more so beyond a “this is the standard way we do things”?  It seemed as though her job was to market the product of tests and, in so doing, use fear to those ends.  My body was going to screw up this medical process, and it was my body which was to be measured and treated as incompetent.  And, barring that, it would fall upon the baby.

It is not an exaggeration to state that there was nothing of me in this despite me taking it so personally.  A biological, natural process that my body was doing was a pathology and not something bodies have been doing for millenia.  It was something to treat.

Sitting in an office, stripped down to nothing but the stylish gown the assistant gives you, and nothing was personal.  What is personal in this world if not having a child?

In the end, it wasn’t the lack of clothes under the gown that made me feel so naked and vulnerable, it was the gentle steamrolling of an industry that marched its way across me and seemed frustrated by my unwillingness to lay down before it and accept the fate they had chosen for me.  Each question showed me the frustrations of the physician, her inability to answer them somehow my fault all while the pure uniqueness of what I was doing was merely making her sit there for longer than she wanted/had time to be.  The doctor answered to herself, possibly her superiors, but she did not answer to me – the person who was paying for a service (my son’s birth with NO complications was over $10k) nor the body which would commit through action and intent to bringing another life into this world.

I walked from that room knowing that, in the hands of that woman (possibly others in the practice), labor that went longer than she wanted would end exactly how she decided.  And yet the child was mine.  The body to give birth to this hopefully healthy and robust child, also mine.

I started calling midwives that afternoon.

[Up Wednesday is my review of “Game of Thrones” – please come back and let me know your thoughts.]


10 responses to “Thoughtful Consuming and Resentful Professionals

  • martha drummond

    No matter what the condition for which we are seeking medical help, we find ourselves in situations that we are vulnerable, and having to sort through a reasoned analysis of advice that is being presented. It is difficult to do this in the face of crippling fears or disabling illness. The doctors find themselves influenced by malpractice threats and, revenue demands of their businesses. It is interesting that there is a move on for doctors to start providing services out of their home for “concierge” service, that may be less influenced by insurance patterns and more by need for improved one on one communication needs. Technology offers us information that can be miraculously vital or unmeaningful in terms of treatment plans.

    Keep us up to date regarding your experiences with midwifery. There are doctors out there who really listen. Loved your commentary. Marth

  • laurelrainsnow

    Oh, I recall my frustrations with doctors who, in their “godlike” wisdom, try to determine the course of care without the patient’s input.

    I often wonder if they do anything besides order tests or prescribe medications?

    At other times, they don’t order tests that turn out to be absolutely necessary…because they cost more.

    Hope you win out in this situation. Follow your instincts.

  • Carol Kilgore

    My grandfather was a doctor. I am THE world’s worst patient. I question everything – more than once if I don’t understand or the question is avoided. Good for you.

  • Jan Loomis

    I am so in awe of your quiet determination to make sense out of what is happening in your approach to this experience. I suspect that until doctors kick insurance out of their practices they will be not much more than mechanics going through the motions of providing care. I also realize as I write this that there are wonderful, caring and dedicated physicians in all fields of medicine.
    Working with the doctors I currently work with I am aware of how few options are available to doctors. But what it does to health care is criminal even with the best intentioned doctors.
    It is ironic that something that humans have been doing almost effortlessly for millenia has now become an “illness” in the way it is treated. All of this goes back to the idea that our bodies are machines and parts are replace-able or alterable if only we know exactly what is going on. The body/mind connection is hardly ever considered and if it is, there are still some physicians who are insulted by the notion. The idea that we are miracles has been completely lost in an attempt to categorize and understand. In short it appears that “modern medicine” has lost its way.
    So glad you are doing home birth!
    Your body is magnificently wise. Trust it!

  • Litlove

    Don’t you wonder how the human race ever survived before all these tests were invented? They simply scare the living daylights out of the mother-to-be, who has only one choice: have the child, or miscarry it. If you know what side of that fence you’re on, then the tests are pointless. Have you read Naomi Wolf’s book on pregnancy in America, Misconceptions? I thought it was really good. She goes into all this madness. You should go with your instincts, and be as fussed and bothered as little as possible.

    And I haven’t even said congratulations yet!
    CONGRATULATIONS! It’s wonderful news.

  • Jessica Mauldin

    Kim- Darling! You make me so proud. I love your Question Everything Attitude! It’s a sad state of affairs that one must do that in this day and age.

    Cheers to a Happy Healthy Belly Dweller!

  • Hart

    Oh, Kimberly, this is so frustrating. I guess I should start with CONGRATULATIONS about the pregnancy! That is truly wonderful!

    But I hear you on the frustrating medical professionals! I can’t necessarily get behind home birth, as I just know complications are much more tragic if they happen, but my 2nd baby I had a midwife (nurse practitioner) who was in a practice with another midwife and three OB/GYNs (who all delivered at a hospital, so any emergency cold be handled), and I felt like the midwife spent FAR more time with me, took me completely seriously. She didn’t know every answer, but she took the time to look up or find out everything she didn’t know. There is no reason AT ALL to get tests that won’t change what you do, especially when the test risk is higher than the ‘abnormality’ risk, and any doctor who doesn’t listen to you deserves to be LEFT.

    I really hope you find someone who recognizes YOUR role in the process.

  • Anne

    You’re pregnant! Did I miss that announcement somewhere? Congratulations! And, I’m sorry for your terrible doctor experience 😦

    • kimberlyloomis

      Thanks, Anne! Sorry I’ve been so neglectful in my blogging, etc… That was my first announcement of the pregnancy (I think) so you didn’t miss anything! Honestly, the experience got me thinking and researching which I can’t help but view as ultimately a good thing.

  • A Journey to Homebirth -Part I « The Elephant in the Womb

    […] birth as quickly as possible afterward.  There’s more about that experience at my other blog, but here was what I considered to be the most damning thing of the whole ordeal: Dear Expectant […]

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