Friday, April 24, 2009

A(nother) visit to the doctor.

I went for my thirty-two week check-up yesterday at the doctor's surgery. Since about a month ago I've been going every two weeks, and from thirty-six weeks I'll be going once a week instead. It's not a hardship now I've started working from home and most of the time I enjoy the visits. I like hearing my baby's little heartbeat and spending time in the waiting room in the company of other pregnant women. (We all check out each other's bumps to see how far along we are. It's competition time, ninja-style.)

Yesterday, however, I wasn't at all impressed with my visit. To start with, since we moved house my journey to the doctor's has been made considerably shorter, which I forgot about completely until I rolled up to the hospital almost an hour early. So I stayed in my car, rolled down the window and read The New Yorker for a bit, then waddled my huge stomach and backside up to the third floor about ten minutes before my appointment. I was then kept waiting for an astonishing FORTY minutes (unheard of in this insurance-driven country) because they've changed the layout a bit and were down to only two clinic rooms. Of course, it wasn't until I went back up to the counter and pouted with an English accent that things started moving, so naturally I was quite put out and needed to have a wee.

Ah, having a wee. Normally I'm quite skilled at this part, having peed into the little cup so many flipping times already. However, yesterday for the first time I realised that I am no longer able to SEE the cup underneath my big belly. In vain I tried scooting myself around on the toilet seat for a better angle, lifting my stomach to see if that would help and finally settled on the only option left to me: blind luck. I ended up weeing on my hand, the cup, the label on the cup and even on the seat (how the hell did it get there?!), but I'm a pro and didn't panic. I had already prepared my clean-up crew for this very event ahead of time and proceded to wipe everything down with what can only be described as one of those little handi-wipes you get from KFC when you order chicken.

Weeing test done? Check.

Blood pressure done? Check.

Listening to the baby's heartbeat? Check.

Doctor running late and nearly out the door...? Hang on a sec!

I'd been at the hospital since 3.10pm and only in to see the doctor for five measly minutes by 4.45pm, so I decided to milk my time with him for as much as possible. I decided to ask him what my options were for contraceptives after the baby is born, although I kinda wish I hadn't...

In his best high school sex-education teacher voice, my doctor lectured me on every single kind of contraceptive imaginable for the next ten minutes. He told me that abstinence was the only fool-proof method (in his words, "to my knowledge there's only been one failure, and that was 2,000 years ago."), explained the difference between progesterone-only hormones and combined hormones (progesterone and estrogen) and even told me the most cost-effective method (a ten-year IUD, provided you leave it in that long). Not once did he ask me whether I wanted any more children after this one and if so, when we planned on conceiving them. I felt like a careless teenager being given one of life's lessons too late.

It also bothered me that my options for contraception after the birth are so limited. My husband and I don't enjoy using condoms and are quite frankly NOT going to abstain from sex, so I wanted a hormonal method instead. Here's the lowdown: progesterone (p) only hormones are available as injections, implants, tablets and patches but they can mess up your periods, leading to heavier, irregular cycles and spotting or bleeding in between. Combined (c) hormones are available as pills, patches and IUDs, but while they give you shorter, lighter periods, they can also seriously limit the amount of breastmilk you produce, which is obviously less than ideal for nursing mothers. Both p- and c-pills leak hormones into breastmilk, which nursing babies then injest. It's not harmful to them, but I can't imagine it's beneficial either. Most new mothers therefore choose a p-only hormone and just put up with the crappy cycles and irregular bleeding, but I want more than that.

Why hasn't the medical industry come up with a better alternative yet? The c-pill has been around since the 1950s and yet we STILL can't offer women a third option? I want to breastfeed but I don't want to bleed. I also want to have sex on MY schedule, not on the whim of a pill that dictates if will be bleeding that night. Is that so hard to figure out? I also want to be able to pee into a little cup using a better method than blind luck. Why hasn't someone come up with a better option for this, too? Honestly, it's as though we're the last ones to take into consideration, even though pregnant women are clearly into sex and probably wee into cups more often than any other human beings in the space of nine months. Where is the medical industry now?

Failing us, that's where.


Sunday, April 19, 2009

The old abortion debate

Oddly enough, I've found myself becoming simultaneously both more pro-choice and more pro-life than I was before. Why is this?

I have always described myself as 'pro-life in theory, pro-choice in practice'. What I mean by this is that whilst, to me, the ending of a child's life before it has begun is theoretically abhorrent, I also live in the real world and recognise that easy access to free, safe, legal abortion is absolutely necessary to ensure women's freedom. In places where this is not available, women live in dreadful circumstances. I am not going to detail those here, it's all been done elsewhere.

I have become more pro-life in that I do not understand how, after seeing scan pictures (as early as 8 weeks) and feeling movements (as early as 16 weeks) any woman could possibly contemplate the ending of that little, helpless life inside her (abortion in this country is legal up to 24 weeks). I suppose that the vast majority of terminations happen much earlier than this and that someone who was going to have one would not have a scan or reach the stage where she felt movements, but the overwhelming urge I have to protect the fetus inside me really makes me question how anyone could choose to terminate a pregnancy.

On the other hand, this pregnancy is the single biggest upheaval I've experienced in my life. I was dreadfully sick in the early stages and am sufferering just as badly in the late stages with heartburn. I've had interrupted sleep throughout the last 7 months, constipation, alarming mood swings, swollen ankles and tiredness at all sorts of strange times. It is no exaggeration that a pregnancy takes over your entire body and by extension your whole life: I no longer play in my music group due to exhaustion, I can't travel easily, various fun activities (e.g. rollercoasters, certain sports) are off-limits and I've had to cut out some of my favourite foods, such as mouldy cheeses (a big deal for a vegetarian!!). This is before we even come to the pain and trauma of the birth, and the trials and responsiblities of being a parent. As strongly as I feel about fetal rights, I now feel more strongly than ever that no woman should ever, ever be forced to go through what I've been going through or am about to experience - and I'm having a fairly straightforward preganancy! So yes, I could say that I'm more pro-choice these days.

And that is how I come to be both more pro-life and more pro-choice as a result of experiencing pregnancy for myself. Thank you and good night.


But... aren't you supposed to get fat?

All the medical professionals - midwives, doctors - I've dealt with so far have been women. I've liked some more than others. Some were reassuring, some were rude, some were funny, some were know-it-alls, several had had children of their own. Where I live, one's antenatal care is shared between the hospital (where one is seen by midwives and if necessary a consultant) and your GP. At my GP's surgery, in common with many others, the doctor you actually see will not necessarily be your own registered GP, but whoever can fit you in, so until recently both my antenatal appointments at my doctor's had been with a female GP (and mother, incidently).

This week, I saw my own GP instead. We hadn't met before and I liked him very much. He's in his 40s, I suppose, and I couldn't tell whether he had any children of his own. He carried out a couple of the usual tests and asked the usual questions. Then he asked me to step on the scales - something I hadn't done since my initial booking appointment. The first time I did this, in about th eighth week of my pregnancy, I had a Body Mass Index (BMI) of 27 which made me overweight. I am 5'2" and a size 10-12, and I've always known I've weighed a lot. I must just have dense bones or something. The point is, I was, and always have been, in good shape - and I am not the first person to have noticed that shorter people are disadvantaged by BMI calculations. The midwife was surprised at the BMI but looked me up and down and decided there was clearly no problem with my weight. I have never owned a set of scales and have always eaten sensibly but still according to what I want rather than how I look. Besides, I read in my pregnancy book that weight gain is no longer seen as an accurate measure of how a pregnancy is progressing so is not usually monitored these days.

So, this week, for my GP, I got on the scales for the first time since October. I weighed about 11st, which means I've put on about a stone and a quarter. Given that my baby is due in 8 weeks, I think this is a reasonable amount. Added to which, my face has got no fatter than it was and is always the first place to show whenever my weight fluctuates, so I'm confident that the weight gain is temporary and that I'll have little difficulty losing it once the baby's born. Being the liberated woman that I am, I stepped off the scales seeing the weight gain as of little consequence. Mr GP, however, had other ideas. "That's quite a good weight gain," he said. I was pleased. I thought this meant that the weight gain was just right for the health of my baby and me. He and I clearly have different ideas of what the word 'good' means, as he then went on to make it clear that he thought I'd put too much on. "You know, it's OK to diet during late pregnancy," he continued, "I think it's due to hormones. The women in my family tell me they want to eat more during pregnancy and their periods, so they eat too much. Don't cut out just one food group, just cut down generally so you're still getting some of everything."

I was stunned! I nodded and made noises of assent, but all the time I was wondering what the hell he thought he was saying. I simply cannot contemplate eating any less right now. I need vast amounts of energy just to get through the day (I teach small children for a living) and what's more, I eat when I'm hungry - not just for the hell of it but when I'm hungry! Does he expect me to continue being hungry? Why?? Would he go through the day being hungry? Nope, he would eat! I cannot help but wonder if I would have received the same advice from a female professional - particularly one who had been through pregnancy herself. Is this sexist of me? Quite possibly. But I also think there was implicit sexism in his use of the word 'diet', especially as a verb. I have never dieted in my life and I got the feeling that he thought he was asking me to do something which would be no problem for me.

Needless to say, I am ignoring that particular nugget of advice. As usual, I am eating what I want and keeping it pretty sensible. And to me, eating sensibly means never, ever going hungry if you can avoid it. Which would probably be good advice for everyone.