Alexandra (Alex) Anne was born last Monday, February 25. We have now entered into the realm of sleepless nights, endless diapers and gas pains!
Alexandra (Alex) Anne was born last Monday, February 25. We have now entered into the realm of sleepless nights, endless diapers and gas pains!
(Note: This is a description of my experiences. My experiences are no way meant to be used as a substitute for appropriate dialogue with a medical professional or for substitution of medical treatment..)
Last week I got my first taste of what it means to be a woman of ‘advanced maternal age’ (the term the doctors use in my file) on the verge of childbirth.Yes, I admit that I have gestational diabetes, but I have been very conscientious about observing my dietary restrictions, working out and taking care of myself. Both my overall weight gain and Alex’s weight are healthy and normal and I am truly aware of the issues that I face given my age and genetics. But, I also know that I am a healthy person in general who, pre-pregnancy, watched out for what I ate, avoided additives in my food, used all natural cleaners and body soaps. Awareness has been the key to my life — my whole life. I’ve been aware of how I should eat, exercise and take care of myself since I was little.
This, though, was put to the test the other day.
I have always known that I have a lot of anxiety about going to the doctor’s. When I was little I often had my blood drawn. Not with the small disposable needles, but with huge horse needles. In fact, my mom remembers me being strapped down to a table when I was 18 months old and having blood taken from my neck. Not a great way to instill trust in someone with a white coat, if you ask me. I also remember a nurse chasing me with a needle when I got my mumps vaccine. She was truly scary. I ran under a chair and hid. My mom had no idea what to do, and obviously this nurse had no bedside manner.
These are memories that are ingrained in my subconscious.
Until I got pregnant I so seldom went to the doctor that my anxiety wasn’t an issue. In fact, up until 3 weeks ago, it only manifested in my slightly elevated glucose levels the morning of my doctor’s appointments. Now that I have to see the doctor once or twice a week, though, I’ve gotten worse.It first began the visit after my first pelvic exam. The doctor came in all excited and worried asking me if I had a host of symptoms for preclampsia. Knowing that I didn’t and that my blood pressure is generally really good, I said no. Even so, there was a frenzy of activity. A few minutes later my blood pressure was checked again and it was fine.
Unfortunately, a pattern had been established.
This has happened every visit since then. Last week it precipitated a visit to the hospital with talks of emergency induction.I went to the hospital knowing full well that my BP would be lower soon (even saying this to the doctor). While our hospital is really nice and comfortable, it did mean lying on my side in a truly uncomfortable position, watching bad TV, not having anything to drink (on a day that was over 80 degrees) or eat (shooting off my glucose levels), and not being able to properly elevate my feet (to allow the heat & gravity-induced edema to go down).
I was glad to go for a trial run, but since the doctor couldn’t be paged for a good 3 hours, it wound up being more trouble than it was worth to me. And, of course, my BP was normal.
The day after this I got to thinking. I know that my doctor is just doing her job and being cautious, but can’t she see the pattern? Do they not discuss white coat hypertension in medical school? Is it not obvious that my BP goes down after my exam?No, instead she focuses on my initial BP readings, saying that they are dangerously high. Well, being anxious will make anyone’s BP spike. The key is whether or not it falls back to more normal levels.
I then had to go back on Friday. I was so upset about being packed off unnecessarily to the hospital again. The first visit was great as a trial run, but it took me two days to recover from the experience of almost being forced into induction, missing my oh-too-few and precious calories and trying to get my glucose levels back on track. Deep within myself I knew that another visit to the hospital unnecessarily would do nothing for me or for the kiddo.I then started to do some research and found out a lot of interesting information about white coat hypertension.
One study in JAMA talks about how white coat hypertensives tend to have more surgical births. Another source I found describes how it may be more prevalent in pregnant women than most doctors think. Not surprising given the personal nature of the examinations we go through.
So, on Friday I refused to go to the hospital.
Instead the day before I bought a BP monitor and started monitoring my BP along with my glucose. I noticed that right after my doctor’s visit my BP was little high, but within 24 hours, it was fine. My labwork all along has been fine — a strong indication to me that my levels reflect my inner fear of doctors more than my true BP.
The doctor wasn’t happy with my decision and I get the feeling that no one ever challenges her. That few people out there are aware of white coat hypertension and will instead allow the doctor to induce unnecessarily. The JAMA article talks about how 42% of the women with white coat hypertension wind up with surgical births. I wonder how many of those surgeries were truly necessary and how many were done simply because there was no awareness on both the part of the patient and doctor that some women experience acute anxiety during doctor’s visits at this point in their pregnancies?
Both Doug and I are aware of our decision, but it was a decision we made after much research and discussion. We know that if Alex’s health is an issue that there will be a possibility of induction and/or surgical birth, but we’d rather enter into such a situation educated, aware and accepting of it instead of from a place of fear and lack of understanding. But there are a few questions that I keep asking myself…
How can my doctor not see the pattern of my BP values?
Why doesn’t she ask me what’s going on emotionally to trigger this and make note of it in my file? (I always have to repeat that I have had this condition since I was little…)
How many other women go through this without question and wind up on the operating table?
How come there isn’t more information about how this condition affects pregnant women?
The other day I stayed true to my ideals. But, it was draining… I just don’t know if I’ll still have the energy to do so with my next visit. Precious energy that should be funneled into preparing emotionally, psychologically, spiritually and physically for Alex’s entrance into this world.
Technorati Tags: Pregnancy,White Coat Hypertension
One of Doug’s coworkers gave us a sling for Alex, which is great, because we’ve been sling shopping and have been daunted by the various choices out there.
So, wanting to make certain I had the thing put together right (they can be quite complex if your hormonal brain is not able to process anything!), I tried the sling out. I used it first with the Abominable Snowman stuffed animal Doug bought for Alex since it’s just about the size of a newborn. While it worked, I discovered that it wasn’t really a good substitute for a squirmy kid. Then I hit upon an idea…
Use Machan the cat.
Machan loves it when I pick her up and is exactly the same weight as a newborn. I put her in the sling and she loved it! She stayed in it purring for a good 40 minutes or more and even let me put her in again later so that Doug could take a picture.
I think this baby is gonna be a little sad when kiddo comes along!
Okay. I was warned. People will ask and say really annoying things while you’re pregnant. It’s like the bigger my belly gets the more people think they have carte blanch to say whatever they like. (And from what I hear it gets worse with child-rearing — sigh!)
But I have to say that there is one question that is super amazing annoying, and it’s the first question that most people here in LA ask.
“So, do you have the baby’s room decorated yet?”
Room? Are these people crazy? Do they not read the LA Times? Do they not realize that in LA we have had an affordable housing shortage for at least the past 7 or 8 years? Not just that, but are they not aware of the idea of attachment parenting and how awful it would be for a little one who’s been nice and cozy in her mama’s belly for 9 months to be all alone in her own room!
My response to this question is…
“Well, um… we have the baby’s corner set up.”
For that’s how it is here in LA.
I never really thought I’d write a post like this — mostly because of my post-modernist feminist tendencies. But one thing I’ve noticed while being pregnant is the dirth of information aimed at expectant partners. I mean, no one else really ever asks Doug how he’s feeling, it’s always all about me. (Which, I admit truthfully is fun and — especially when I’m feeling funky, warranted — but still, it would be nice if others took a greater interest in this whole thing from his perspective too.)
See, all the books I’ve read and most of my friends have said that the partner’s job is to completely support his/her pregnant partner.
But here’s the rub, if you’re in a relationship, it takes two to go through this together in a healthy way.
We both talk about this a bit. When we found out we were expecting, I made it a point to look for books that would be interesting for Doug to read, but from a male perspective. I mean, face it, it’s totally weird seeing your wife/partner go up and down the hormonal scale, go off her food (making romantic dinners out passe since she’s too sick to even think about eating anything) and see such massive physical changes happen over the course of just a few months. (Not to even mention the sporadic and often waning desires for intimacy…) As women most of us talk these things over with girlfriends, moms, people in our prenatal classes.
But who do the guys turn to?
Yes, now there are a few books out there that address these issues. But, it’s often from a really stereotypically male point of view, peppered with cartoons about missing the latest game and such. Luckily there are blogs that touch on these issues (like New Father Blog), but you have to hunt for them. Male/female differences aside, I still think that it’s important these days to recognize and really acknowledge our partners — particularly since women recently have put men into the primary position of being our main support person not just during pregnancy but during the birthing process as well.
We expect a lot from our guys these days and, at least from the perspective of childbirth in western countries, there’s little or no schema for men to hold onto. Historically they’ve not been a part of this whole process, and now we expect so much for them without giving them the same kind of positive support we give women. Just think about it, how many books on pregnancy and childbirth are aimed at women? How many classes are offered that are just for guys?
Parenting is hard, there’s no doubt about it. But, in our nuclear families, it’s really important for expecting moms to take a few moments and realize that their partners may be going through a lot too — they just might not be articulating it in the same way. Sure, there are many days when I feel that Doug should tend to me, but I’m always conscious of the fact that there are times when he really needs some TLC too. My changes are so much more apparent than his are, but it doesn’t mean that he isn’t going through things that are just as intense.
So, for you expecting moms out there, I hope this post starts a greater dialogue with you and your partner about how you both can support each other. Your partner may be giving more during this time, but in truth, it’s about both of you. For expectant dads, I hope that this generates more blogs and discussion about how you all can network and help one another in a way that works best for you.
God, how did this happen? I used to be a pesco-ovo-sometimes lacto vegetarian and now…
I’m eating Korean BBQ like there’s no tomorrow!
I guess I always intuitively knew that when I got pregnant my ideas about diet and what my body needs would change. I’ve tried being vegan, was hoping to make most of my vegetarian diet (keeping wild-caught fish in because of the benefits to my hereditary high cholesterol) raw this year, but that all has changed.
This topic comes up with some of my friends who were vegetarian (or mostly vegetarian) and then become pregnant. What does a person do?
I have to say I have a few friends/acquaintances who remained on a strict vegetarian diet throughout their whole pregnancy. This is really admirable. But a lot of them are like me — there is just something inside of me that needs meat. So much so that it’s very rare that I’ll get that “my god, I’m eating meat” feeling. In fact, yesterday at lunch was the first time I’ve had that feeling in a while. This quickly went away after Doug and I decided to go to Korean BBQ last night.
At first it wasn’t easy going back to meat. I really try to still keep as much of my protein based on eggs, beans, nuts and grains. But, with gestational diabetes that’s been hard because of the carb load beans, nuts and grains tend to have.
I think a few of my friends felt guilty at first eating meat. I know I felt strange, but not really guilty. Just less healthy. I initially gave up meat for health reasons 9 years ago (high fat content, BGH, method of killing). I don’t necessarily feel badly for going back to meat in term of eating an animal, it’s more in terms of what other things I’m putting into my body and the heaviness it makes me feel after a meal.
But, such is life. I think that there are definitely times when some of us need to revisit our diets and take an open view of what we need to eat but to do so with greater awareness. Honestly I would rather not have the craving for a huge hamburger, but when I do, I know that it’s not an everyday thing and that my first priority is to listen to my body and see what it (and of course, kiddo) truly needs. Sometimes it’s just a bunch of nice leafy green veggies with some nuts and avocado, but other times it’s a big hamburger loaded with dijon mustard.