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Wednesday
Aug042010

Comment of the Week: Not Letting an Algorithm Diagnose You

 

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By Jill—Unnecesarean

 

After suffering a 20 week loss to GBS chorioamnionitis in March of 2009, I became obsessed with learning as much as I could about pregnancy and birth.  Along the way, I found your website.  I want to thank you profusely for creating it.  38 weeks into my second pregnancy (which was textbook, despite being classified high risk for preterm labor following my previous loss), I was sent for an ultrasound to estimate the baby’s weight.  The baby had measured average-sized up to that point in the pregnancy. At this ultrasound, she measured in the 95th percentile and was estimated to be 9.5 lbs at full term. The report was sent to my OB’s office, which is a group practice that delivers at a hospital with a 40% C-section rate.  The first time it was read was at 38w6d by a doctor I had never met before.  She said it was no big deal.  A few days later (39w3d), another OB called me at 8:30am.  She told us that combined with my BMI (I am 30 lbs overweight) and height of 5’4, my OB’s computer program had labeled me high risk for shoulder dystocia and recommended an elective C-section.  I had hired a doula, taken Bradley method classes, and planned an unmedicated delivery.  Armed with information, I refused the C-section over the phone, but was told I would have to sign paperwork formally stating my choice.

At 39w5d, I had another prenatal appointment.  A third OB checked me for dilation and said my cervix was 1.5cm dilated and soft.  I wasn’t having any contractions and was resigned that I would go overdue.  The OB gave us another lecture about how huge our baby would be and how all anyone wanted was for us to have a happy ending after our loss.  She told us scary stories of shoulder dystocia and then handed me the paperwork.  Sitting on the exam table with only a drape on my lower half and in tears, I signed a form stating that I had chosen to attempt a “trial of labor” and that I would not sue the OBs if my baby was injured during delivery.  She did a good enough job scaring us that my husband went along with her suggestion to induce me the following week and convinced me to agree to it.  The induction was scheduled for 40w5d, which I knew was way too early for a first-time full term mom and would likely end with me failing to achieve my unmedicated delivery or even a C-section.  I felt like I had fought my way to full term only to be given up on at the end by everyone.  I called my doula and we started talking about how to deal with the induction.  I was defeated.

God smiled on me that night, though.  I woke up the next morning in spontaneous labor.  After 8 hours of mild contractions, active labor began at 2pm.  I labored at home until 5pm, was 7cm at my first cervical check at the hospital, and delivered at 7:42pm.  I pushed for 30 minutes and in the end, she popped out like a cork.  I had a minor second degree tear (my OB did nothing to stretch or support my perineum), but otherwise felt great the next day.  And after all their scare tactics, guess how much my baby weighed? 8 lbs, 1 oz!

Seven weeks later, I can’t help but wonder what would have happened to me if I hadn’t found your website.  I don’t know if I would have had the courage to stand up to all those doctors or the belief that my body would only grow a baby that I could birth.  I am stubborn by nature, but it took a lot of strength for me to look my OB in the eye and tell her that I couldn’t give up without trying.  I needed that perfect birth to heal my wounds from losing my son and despite everyone’s attempts to thwart me, I got it.

 

This “comment” came via e-mail; therefore, it’s technically not a comment.


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Reader Comments (36)

Oh what a wonderful and courageous story! Thanks for sharing!

August 4, 2010 | Unregistered Commentercileag

I'm curious if the doctor said anything about the baby's weight after the birth...

August 4, 2010 | Unregistered CommenterA

It is shameful that there is no real recourse for patients who agree to a cesarean based on the diagnosis that their baby is too big to deliver and find that their baby didn't even meet the lower threshold for macrosomia. Where is the accountability for this kind of medical error?

August 4, 2010 | Registered CommenterJill

my friend gave birth at home to a baby that was 22 inches and over 10 lbs.

Gj Momma! So happy for you that you found your voice!

August 4, 2010 | Unregistered CommenterKat

Thank you for sharing your story! And I'm happy that it ended the way it did.

I didn't have an ultrasound late in pregnancy and even though I suspected a big baby (I only gained 27lb, but they run big in my husband's family), I was as surprised as anybody when after 15 hours of unmedicated labor, I delivered a 11lb/23in girl. At my postpartum checkup the doctor implied (but dodged my subsequent direct question) that everything would be different if he knew beforehand.

I'll be looking for a different provider next time around.

But several times since, I've been wondering, what would I have done if I had the ultrasound and they estimated the weight correctly...

August 4, 2010 | Unregistered CommenterIva

I should clarify that there's probably no legal recourse for an unnecessary surgery for a macrosomic fetus who turns out to be a very not macrosomic baby. There are steps that can be taken to document and complain about the medical error.

August 4, 2010 | Registered CommenterJill

Wow, way to go, mama! Thank you for sharing your story.

August 4, 2010 | Unregistered CommenterAnother Rachel

What a great story!

I was just reading on another forum about a woman induced at 38 weeks for suspected macrosomia, and the baby came out at 5 lbs. 10 oz.

August 4, 2010 | Unregistered CommenterKK

Iva -- that's the great thing about Ultrasounds, there is no way to "estimate correctly." They've been known to be off 1-2 pounds in either direction.

Congrats to the "commenter." It's so hard to stand up for what you know is right when you're going against "experts" but you did it! Awesome!

August 4, 2010 | Unregistered CommenterJessie

Jessie - yes, I know. That was my reasoning for not having it in the first place. But if I actually did, and they told me I was carrying an 11lb baby (which in this case turned out to be true), I honestly don't know what would I do (even with the knowledge that they might be a pound or two off).

Looking back, I only have a huge respect for my own body, but I didn't have that at that time.

August 4, 2010 | Unregistered CommenterIva
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