Monday, November 24, 2008

The most valuable thing my mother taught me was to read. You'll always get smarter if you keep reading. Something else my mother taught me was that you should never wear make up to visit the doctor, because they might not realize how sick you really are if you look too pretty.

Equipped with this knowledge I entered the adult world of diagnosis and MD's (I think) a person reasonably well versed about her own body and health and, trying not to be too be too bossy about self diagnosis, a self awareness that has impressed most medical personnel. I think working in medical administration also helped develop this, as I often heard how frustrated doctors were by 'dumb people' who knew nothing about their own bodies, had little self awareness, and apparently, little knowledge about basic anatomy. When they had a patient who was even a little bit educated about what was going on with their own body, they rejoiced.

So you can imagine I was quite delighted to be able to (with what I would call a pretty basic understanding of the reproductive system) inform my doctor of the date of conception of each of my children. In every instance an ultrasound confirmed that date exactly, which he said he found very helpful. In fact, at the first appointment with my second child, he didn't even ask me the date of my LMP, he went entirely off my conception date to determine a due date (which is good because the other calculation would have been off by two weeks).

Imagine my surprise when, after having to go into the office today at 19 wks 4 days pregnant to have a check because of some abnormalities, a new doctor tells me that I am 20 weeks and 1 day pregnant.

I recheck the dates and ask her, I'm pretty sure I'm only 19 weeks 4 days, do you know if my due date was changed?

She checks the baby first. "Growth is right on track for 20 weeks 1 day, she's measuring 19 weeks, 4 days!"

I am puzzled by this information. By what she has just said, the baby is behind. By my caculations and the measurement she gave, the baby is right on track with her age being 19 weeks 4 days!

As I'm given 20 minutes of peace during a non-stress test, I review my first meeting with the midwife. As per my other visits, the assistant wants to figure out my due date using the date of my LMP. I reluctantly give it to her, and ask her to please calculate using my other date, as my cycle was not a typical 28-day cycle. She won't. Based on that (incorrect) date, she gives me a due date of April 12th. According to my dates I should be due April 17th. (But wait, you say, that's only 5 days different! So what? Bear with me friend...)
Enter the midwife, a jolly, down-to-earth woman who is bright and cheerful. "What was your LMP?"
I give her the date, but say, "My cycle was long that time, and I didn't ovulate until xdate. I know conception was on ydate."
"Oh good!" she says, apparently delighted by this information, "You know the date of conception! Well that would give you a due date of April 17th!"
She makes a note in my chart. She does the ultrasound. The baby is measuring correctly to the date. Turning to me, she smiles. "You were right, Mama!"

Back in the waiting room today, as I make inane observations about the room (the fluff that has gathered on one corner of the ceiling tile maybe be an over exuberance of ceiling insulation... the net at the top of the curtain was attached to the fabric using a serger - interesting choice) I jump as the new doctor sticks her head in the door.
"Yeah, your LMP was zdate, so your due date is April 12th. That makes you 20 weeks, 1 day."
Dumbly, I say, "But my cycle was long that month, we didn't conceive the baby until after I ovulated, and by the conception date they told me I was due April 17th."
She smiles with no emotion. "We don't use those dates. We always go by LMP. Your due date is April 12th." And then she is gone.

I want my regular doctor back. I want the midwife. I want anyone who will realize that come April 12th, and I'm warned about the dangers of being overdue, big babies, inhalation of meconium, and the general disasters that await you if you pass the magical date, that this baby is awaiting her own time to enter the world, and I don't have to be the slightest bit worried until sometime after the 17th. I wonder if, because it's relatively easy to frighten a heavily pregnant woman about the safety of her unborn child, I will feel pressure to have an induction, which may then (according to well documented research) lead to all kinds of other interventions if indeed she is not ready to be in the world. I wonder if my fate has changed at all because a doctor who doesn't believe in using conception dates (that have been verified multiple times by early ultrasound), has given me an incorrect due date.

I lie there, wondering, wishing there was an alternative we could afford, and anyone who even cares. I think about my daughter, flexing and twisting in my belly, so wanted and loved already and blissfully unaware of all that lies ahead of her.

It seems she is staying put for now. It was infection that caused me to fear her early arrival, something easily treatable because I paid attention to my body, was reasonably well informed and sought help from someone more educated than myself. There is a lot of relief in that.

But I should have worn make-up. At least then I could feel dumb AND pretty.