Of all the difficult things about pregnancy, the insomnia can be the hardest. The middle of the night is a very lonely time. There is nothing to distract you from yourself, no way to turn off the ticker tape of worries that keeps rolling through your brain like an old film reel. I’ve tried podcasts, noise machines, iPhone games, trolling social media, reading, movies, getting up and doing something, changing positions, counting sheep (counting sheep!), doing nothing and hoping for the best. Despite my best efforts, I usually wake up 4-5 times a night, and am usually awake for one long stretch between 2am and 5am; the no-man’s land of sleep.
Every night is like this, but last night was the worst night like this I’ve ever had.
When I found out I was pregnant, I decided to seek the care of a midwife rather than an OB. There is a lot of evidence out there to support that midwives are safer than OBs for low risk births, with less chance for surgical or other intervention during labor. I also didn’t want to have an anxious pregnancy, which I felt I’d have with an OB. Doctors are trained to diagnose medical problems, and I don’t believe that a pregnancy is a “medical problem.” I didn’t want to spend 9 months chasing the next screwy chromosome, or right femur bone that may be slightly longer than the left, or other types of medical insights that cause stress and worry and offer no result besides fear, because I’m going to have this baby. I’m going to love her. I don’t need to medically scope every potential, scary imperfection. I’m going to love her.
I have nothing against science or doctors. My day job is running clinical trials for one of the largest cancer treatment centers in the country. I work with brilliant doctors and nurses every day, who save lives with solid, evidence-based, often brutal (chemo, radiation) medical intervention. I don’t believe you can treat cancer with herbs, I will absolutely vaccinate my daughter, and I want to give birth in a hospital so that any medical intervention that may become essential is very close by. But I want a vaginal birth, and I want the option to labor for as long as I want without medical intervention. Also, I want a fucking epidural.
(I talk about cancer and birth in the same paragraph because this is how the stereotypes work: people who use midwives are anti-science hippies who all want a home birth so they can tend to their pagan rituals during labor and have their partners rub basil on their vaginas for pain relief. Like most stereotypes, the ones about midwives and low-intervention care for low risk pregnancies are complete bullshit.)
Please note that these are MY choices about MY birth, and nobody else’s. Let me state plainly that I applaud the woman brave enough to birth at home without so much as a tylenol, the woman in the ER having a scheduled cesarian, and the woman squatting in a labor tub or the desert or the back of a pick up truck. I don’t get to have an opinion about how anyone else gives birth, and neither do you.
A few weeks ago I went to see my midwife for a regular visit. Part of the low intervention care model is that they don’t order a lot of tests that are medically unnecessary (doctors love to order tests; after all, hospitals are big business, and medical testing is big money). I’ve had three sonograms throughout my pregnancy, at 8 weeks, 12 weeks, and the 20 week anatomy scan. I asked the midwife about getting another ultrasound. “I just want to see her,” I said. “It’s been a hard pregnancy and I just need something, like seeing her little face, to get me through this last stretch.” Sure, she said, and gave me the prescription.
I procrastinated for a few weeks with a busy schedule, and went in for my appointment yesterday. I was so excited on the drive over; thinking about seeing her, wondering who’s nose she got.
After checking in and waiting a while, the ultrasound tech called my name and invited us back for the sonogram. I wobbled up onto the table, got a towel tucked into my crotch, a squirt of warm jelly on the stomach, and we were rolling. “Wow,” the tech said, “your baby is HUGE.”
I told her that all the women in my family have fat babies. “Yeah, but this baby is huge. She’s 7 pounds, 9 ounces, and you still have 4 weeks to go. She’s in the 87th percentile for weight.”
“You’re officially high-risk. You’ll need to be induced to get this baby out,” she continued.
I lay there in shock. I told her that my midwife said she was normal in size.
“Well, that’s why you shouldn’t trust midwives. They just don’t provide the same level of care as OBs. I would never trust a midwife.”
At this point, my husband, seated behind her, was openly making faces and giving her the middle finger.
Can I see her face? I asked. The tech laughed. “Is that what the midwife told you? You can’t see her face. She’s head-down, face-down. You can’t see anything at this point.”
She finished up her measurements, toweled me off, and left the room.
While no pregnant woman is a stranger to unwanted questions, opinions, and statements about their bodies and choices (a daily occurrence during pregnancy), this tech’s opinions were particularly horrifying. I’m a rational woman, but when someone in a very medical-looking office who is looking at my unborn baby with a magic wand tells me that I’ve made shitty choices for myself and my baby, that my baby is not safe, that something is terribly wrong, it is deeply, horrifyingly unnerving.
I left the building in a state of shock, unable to process this information. My baby is not okay. I am not okay. This is not going to be okay.
Once we got in the car, I called my mom and started sobbing. Everything just fell apart.
I called the office for my midwives, and had them leave a message for the midwife on call. I told the girl at the answering service what I was calling about. “I’m 36 weeks and my baby is 8 pounds.” “Wow,” she said, “Sounds like they’re gonna have to induce.”
Waiting for a call back, with no idea what to do with myself, we drove to a nearby mall. There’s something about the predictability and sterility of a mall (the inevitable Macy’s and Starbucks) that was vaguely comforting. I found a kiosk where I could get my eyebrows threaded. We waited.
Somewhere between the Express and the food court, I got the call. She listened to my story in disbelief. She told me, first of all, that ultrasounds at this point were wildly inaccurate assessments of weight (up to 1.5 pounds off in either direction). She was most likely not 8 pounds: the statistical model the machines use to predict weight just isn’t very good. The only thing an ultrasound can tell you this far along in the pregnancy (36 weeks) is whether the baby was in the right position for labor (she is). There is no medical reason to start discussing induction or C-sections. There is no evidence to support better outcomes for early induction of “big babies,” particularly when the tools used to measure babies’ size in utero are not accurate. Further, ultrasound technicians are not obstetricians, gynecologists, nurses, or any other kind of licensed care provider. The only thing they’re qualified to do is squirt jelly on your stomach and click the buttons on their machine.
This woman had absolutely no right whatsoever to insert her opinion about the state of my pregnancy, or the type of care and support I’ve chosen for my pregnancy and delivery.
Even though I believe my midwife, and had a couple of comforting phone calls with my mom and texts with my best friend who’s an L&D nurse (who agreed completely with the midwife), and talked to other friends who provided comfort, support, and distraction: I am still scared. Labor is already a totally, scary unknowable thing. It can happen at any time, under any circumstances, and you can’t know how it’s going to go. I want to face it and be brave, be secure with my choices, believe with everything in me that I can survive the experience, hopefully without trauma, and meet my daughter at the end of it. Someone will hand her to me and we’ll both be alive and okay. I’ll get to see her face for the very first time. My husband will finally get to fall in love with her the way that I have.
This little web of expectations and support is so fragile. It’s so easily pierced by a sociopathic tech with a very limited medical background and a squeeze bottle full of warm goop, despite knowing better. There is too much to fear.
Heading to bed last night, I knew it was going to be rough. I knew I’d wake up around two, and stay awake until five. Last night, the insomnia had a fresh batch of terror to exploit. Even the soothing balm of a 5-row match in Candy Crush was not enough to relieve the gnawing anxiety produced by this woman’s comments.
Please, let’s all make our own choices about how we want to handle our bodies, pregnancies and deliveries. There are as many ways to do this as there are women on this earth. Let’s support each other, even though we are bound to disagree. Let’s not make statements about things under the guise of medicine that we are not qualified to make. Let’s not assume that the choices we might make for ourselves are the best fit for someone else. Let’s take care of each other, because deep down, all pregnant women are scared.
A special thanks to my friend Nicole, who came over yesterday afternoon in the midst of all this panic. Thank you for listening to me, and then feeding me that delicious eclair, for the arepas stuffed with black beans, sweet plantains, and queso fresco, and the little tacos and churros dipped in caramel sauce. My big, fat baby is grateful, too.
We’ll be okay.