When pregnancy is too clinical

Here’s an blog post by a grandmother, and the over-medicalisation of pregnancies.

Jun 09, 2014

Worry when pregnancy turns clinical

BECOMING a mother was so simple when I became a mother. Pregnancy was treated as a natural experience. You peed in a cup and then, once a month, the obstetrician pressed his stethoscope against your belly and you watched his face for a smile.

“We’re going to have a baby,” my son, Peter, says in a call. I think about being a grandma and the grand continuum. I think about the wondrous ways my boy’s life is going to change. I do not think about sonograms, DNA testing and pre-eclampsia. I do not think about the endless foreboding stream of foetal data.

My son is stuck at work, so I get to take my daughter-in-law for her first prenatal visit. The doctor squeezes gel on Erika’s belly and rubs it in with a paddle. A white watermelon seed pops up on the screen.

“Your baby is seven weeks and five days old,” she says.

Wow, I think. Yes, but will it get into Harvard?

Erika’s blood is drawn to test for three birth defects. Taking a personal history, the doctor discovers the watermelon seed will be half Jewish.

“We’ll be needing 18 tests now,” she says.

We pretend not to be anxious waiting for the results. From that first visit on, every time I accompany Erika for an ultrasound, we leave guardedly happy. “Normal” becomes our favourite word.

I’m not a Luddite. Prenatal science has helped a lot of people and people-to-be. But just because a patient can know something, must she? There’s so much information available now. Pregnancy is treated like a nine-month illness cured by childbirth. Odds are in this baby’s favour, yet every sonogram adds something scary. What is one of the most joyous times of life has turned into something ominous and fraught, loaded with the potential to go wrong.

Three months before Erika’s due date, the tech turns to us with a caliper in her hands. “The baby has a short long bone,” she says. “Its long bone” – aka femur – “is two weeks behind schedule”.

We leave the office and head for lunch. Holding hands, we wait for the lights to change. I look down at the white parallel lines on the crosswalk.

I’m not a religious person. Yet when the lights change, I make a promise to something somewhere. I make a pledge that is the opposite of modern science: “If I only step on the white lines, the baby will be okay.” I hit every white line from the hospital to the coffee shop.

On the way, I tell Erika about an article I’d read: “This couple, based on a sonogram, were told their baby had a club foot. They did their homework. They interviewed specialists. They were prepared. And guess what. The baby was born with perfect feet!”

Home after lunch, I perform the new masochistic ritual. I Google “short long bone” and find: “Short FL may be a part of a malformation such as a skeletal dysplasia.”

I decide nothing good can come from researching the long list of conditions associated with short FL, including aneuploidies, pyelectasis, enlarged nuchal translucency.

When Erika is in her eighth month, the tech says: “This baby is very, very small.”

That’s when I go a little nuts. Peter was about 4kg when he was born. Erika was 4.4kg. Peter is 1.85m. Erika is 1.68m. How can this baby be “very, very small”?

I renew my white line vow. I don’t miss a single one. My unofficial survey reveals three kinds of striped pedestrian crossings in New York: continental (parallel, no sides), ladder (parallel plus sides) and zebra (angled with sides). I begin humming “Because you’re mine, I walk the line”. One day, heading for Costco on 117th Street, Peter looks at me and smiles. “Mum, are you only walking on the white lines?” “Yup,” I say. “Try it. It’s fun.”

On the following visit, we learn the baby is lodged in breech position. Erika is offered a procedure called an external cephalic version. During an ECV, doctors try to manipulate the foetus into a favourable position by kneading the abdomen. Erika declines. (Watch one on YouTube, you’ll see why.) I become a white line connoisseur.

Knowing you’re going to deliver an undersize, breech baby with short long bones is not relaxing news. Erika’s blood pressure soars. Her ankles swell. To avoid pre-eclampsia, she has the baby delivered two weeks early by C-section. That morning’s sonogram predicts the baby will weigh less than 2.3kg. The baby weighs about 3kg.

I look at his legs first. They look like they’re supposed to, like a plucked chicken’s. They plump up fast. Soon his creases have creases. You have to wash his legs, then wash inside the folds. Legs like this in Jewish families and even half-Jewish families are referred to as “pulkies”. Pulkies are a fierce source of pride.

The baby is two now. I still walk the lines. Jack runs everywhere.

NEW YORK TIMES

 

What she wrote is good to know. I don’t think we are going to go overboard with tests. I don’t think Singapore’s healthcare and maternity care or ante-natal care has gone over board.

But in case I’m wrong, I’m going to re-read this if it ever becomes overwhelming, if there is too much information at some point.

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