This is a blog post I’ve been meaning to write for a good month now. I feel like I can write from a more solid point-of-view now that Elliott is officially a month old this week, and will be five weeks old on Monday. He just had his month-old visit, and the pediatrician said he’s doing great — Elliott is on the cusp of 6 pounds, gaining at a rate of more than an ounce a day. Plus, he’s already turning his head and raising it, so he’s got that neck strength going on. As for sleeping, he’s doing better than I would have predicted — he goes down without too much protest at about 11 p.m. or midnight, and I generally have to wake up to feed him at 3 a.m. and 6 a.m. Speaking as a third-time mom, that’s pretty damn good four weeks in, y’all.
What I am writing about specifically is how my birthing and hospital experience went this third go-round. And it’s definitely a mixed review.
First, some background. Last fall, I surveyed my 300+ friends on Facebook (on a tangent, how did I get past 300 friends on Facebook? I’m going to have to do some cleaning up.) on who was a Kaiser Permanente member and how did they like it? Here’s what I heard back:
Full disclosure: I actually was born at a Kaiser hospital and was a member again when I got my first full-time job with health benefits. In fact, one of the nurses commented that I had a really early member ID, even earlier than hers, even though she’s been a member for 30 years. So, why did I feel the need to survey friends? Well, when I put out this survey, I didn’t add that I was pregnant, and Trinity had misgivings about changing health insurance mid-pregnancy. The change was partly spurred by the notification by my Ob-Gyn that I’d have to pre-pay $300 for my C-section, but also by the fact that I’d been advocating switching to Kaiser for a couple of years because, basically, it cost less than our existing health insurance. It is not unusual for me to need a few years to convince Trinity to make a financial change, but we were up against a deadline on this decision — not only were we having a third baby, but open enrollment was almost over. Finally, he told me to go ahead and make the switch, but don’t complain if I didn’t like it.
So I switched us. And I have complaints. Thankfully, Trinity hasn’t said “I told you so.”
First, an observation — coming in with a pre-existing condition like pregnancy, it was really difficult for me to 1) meet the Ob-Gyns so I could pick one and 2) see one person consistently throughout my pregnancy. I have a history of complicated pregnancies, which I let them know right off the bat, but I still saw a parade of nurse-midwives before one savvy nurse wisely scheduled my appointments two months in advance with a variety of doctors. Another observation — my first appointment, I was trying to make sure I saw a doctor, not a midwife, to give them my history, and that first doctor was immediately designated my Ob-Gyn. Um. Not that she seemed bad or anything, but she was so young it was like having one of my high school friends be my doctor. It was weird for me. It’s probably more of a sign that I’m getting older, but I’ve been accustomed to older, more experienced doctors overseeing my care throughout a pregnancy.
So, remember when I said I had a hard time seeing one person consistently? That didn’t stay the case for long. I’m sure all the pregnant women at Kaiser Woodland Hills all end up in her room eventually, but I ended up seeing the neonatologist most consistently during my pregnancy — and not by choice. Again, she seemed like a very nice lady. But at 33 weeks, I believe, after a particularly trying two weeks at work, she had me admitted because I had low amniotic fluid. It was not a condition I’d had before, and having to be admitted to the hospital for the weekend, away from my children, after such a stressful two weeks she said had nothing to do with the sudden condition (yeah right) — there are no words for the anguish I felt. And during that hospital stay, its not like anything happened — my blood pressure and the baby were monitored most of the stay, tapering off on the 3rd and 4th day, and I was allowed to go home Monday. I didn’t get any medication or treatment for the low amniotic fluid. I was simply observed, and I had to come out the pocket for the copay. So much for that $300 C-section fee I was trying to save.
And that was just the beginning. The Friday I was admitted, I was obviously put on bed rest and told to stop working. Over the next three weeks, my visits to Kaiser Woodland Hills were slowly ramped up — first non-stress tests twice a week, then three times a week, then every day, even on the weekends. I became famous among the labor and delivery staff for having to come in on Saturday and Sunday for non-stress tests. At least twice during my weekday non-stress tests, I’d have a few high-blood pressures (and with all this stuff going on, who wouldn’t?) and would be sent on for more time on the monitors in labor and delivery, extending my 1-hour non-stress test to 7 hours at one point. And I think my appointments with the neonatologist, who assured me she operates her ultrasound machine competently (um, why did you have to assure me of that?), were eventually scheduled for once a week. And at each appointment over those three weeks, she pressured me steadily to stay in the hospital. And each time, I resisted. Mightily.
Each time I saw her, she pushed me to be admitted to the hospital until delivery (which was at least two weeks away, since they wanted to wait until 36 weeks). First time I said no, she increased my non-stress tests to three times a week. Second time, all the while saying she just wants to make sure the baby is OK and that I don’t end up with a stillbirth (even though I kept telling her the baby was very active and why are you talking about a stillbirth????), she then increased my non-stress tests to every day.
Let me also add that the amniotic fluid measurements that she got and that were found by the non-stress test staff differed wildly on any given day. On one of my Sunday non-stress tests, the labor and delivery doctor on duty that day dismissed the measurement and said that it is generally unreliable. Great.
Finally, on the first day of my 36th week, the day after I’d gotten the news that the amniotic fluid index is unreliable, the neonatologist finally said she’d have me delivered that day. I was thankful, partly because I wouldn’t have to see her anymore or have her directing my care anymore — apparently, everyone defers to her when it comes to a woman’s pregnancy care, which is incomprehensible to me.
In the birthing class I took, what, more than four years ago, I still remember very clearly the admonishment that a successful birthing experience is a healthy baby. I am grateful that that’s what I’ve got — a healthy, thriving baby — but I also feel that we’re fed that line to keep us obedient to our doctors. My first hospital stay this third pregnancy, the labor and delivery doctor on duty mentioned that one of the ways they treat pre-eclampsia — which I have a history of — is administering magnesium sulfate. I was vehement and adamant that I did NOT want magnesium and he seemed taken aback. I felt like asking, “what? I don’t get a say in my health care decisions?” I later reminded Trinity that I needed him to back me up on this. I think pregnant women tend to forget that they actually do get a say in their health care decisions even as the doctors are saying, “but the baby!” They can get away with this with first-time moms, but I am a veteran and I have a baseline experience.
Let me try to summarize my dissatisfaction with this third pregnancy. First, I am unhappy that I was so suddenly and abruptly forced to stay in the hospital for a weekend of basically monitoring. It was more stressful than anything else, having to stay away from my kids, having to try to sleep while not dislodging the monitors on my belly — yeah, that didn’t work very well, seeing as how I got like 4 hours of sleep my first night — and then having to pay an extra copay I didn’t anticipate. Having to pay an unanticipated copay is definitely stressful, as we all know. Second, I am unhappy that the neonatologist was allowed so much power over my care and that it wasn’t more measured — how about first putting me on bed rest, and seeing how that helps, rather than jumping immediately to hospitalization? Third, I disliked the pressure she put on me to be hospitalized and the subsequent increases in non-stress test appointments, which quite frankly felt like retaliation for resisting the hospitalization.
All of this is not to say I was unhappy with my Kaiser experience. Oh no. I was definitely happy with the nursing staff, especially two of the nurses in labor and delivery — one, Danielle, who assisted my surgery was so sweet and the second, Michelle, was so no-nonsense — she’d seen me during at least three extended non-stress tests. Michelle was also the one who told me I was not the only pregnant woman the neonatologist tried to get hospitalized — that poor lady spent three weeks in the hospital before delivery for her high blood pressure. And surprise, surprise — she didn’t get any treatment in the hospital either, she was simply monitored.
The food was fine, and I was truly surprised the hospital sent us a congratulatory dinner for Trinity and I because we were new parents — complete with sparkling apple cider. I didn’t drink it, because I didn’t want to worsen my gas issues, and gave it to Trinity, who honestly had the greater burden with having to drive me to endless non-stress tests. The least I could do was give him sparkling apple cider.
The hospital was extremely supportive of my intentions to breastfeed, and actually sent me home with a hospital-grade breastpump on loan for a month. When I told them a few days later I didn’t like it and had a hard time using it, they sent over the fancier version — a Medela Symphony. That’s in addition to the double electric Ameda Purely Yours I got through my health insurance.
A lot is said about Kaiser’s DMV-like efficiency, but I actually don’t mind that — when it comes to getting through labs, getting a prescription, etc., the more efficient, the better.
So, yeah — Kaiser’s fine. Dealing with that neonatologist was not. Add dealing with that doctor as another reason why Elliott will be my final baby.