Monday, November 07, 2005


*Updated because somehow I turned off the comments and because some of it was too poorly written even for me.*

I am going off The Pill (because if you capitalize it, everybody knows that you're talking about THAT pill, right?). I wouldn't say we are officially trying to get pregnant, but we are getting close -- close enough that I don't want to pay $90 for a 3-month supply of pills. {Politely saves rant about prescription drugs and insurance companies for another time and place.}

Being this close has me thinking a lot about my pregnancy with Raisin -- what went well (almost everything)? What would I change (almost nothing, except it'd be great to gain less weight)? Will I go back to the same midwife practice (I think so)? That kind of thing.

I was very very very very blessed the first time around. From conception to delivery, we only had one major scare. And now that I have discovered the blogosphere and all the scary stories out there, it doesn't even seem that major anymore. However, I come from a long line of worriers, and I just wouldn't be me if I weren't thinking about it again now as I contemplate another go-round.

It started after our first ultrasound, so it must've been at about 20 weeks. The OB who reviewed the ultrasound results was concerned about one of Raisin's measurements. An approximation of the ensuing conversation with the midwife (not-my-favorite midwife, because of a decided lack of what I like to call "personality" and "compassion" -- she was, thankfully, not on call when Raisin was born):

Midwife: So, it looks like the baby has a prominent renal pelvis on the right side.

DH/Grape: {blank stares}

Midwife: See, this {indicates black spot amid many indistinguishable spots} is her kidney. And this is the renal pelvis.

Grape: {trying to be calm and not freak-the-flying-freak out} So, what does that mean?

Midwife: Well, you'll have to make an appointment at the perinatal clinic for a level-two ultrasound. Here's the clinic number and a bunch of other useless information, blah blah blah nothing about the BABY who is suffering from a prominent something-or-another RIGHT NOW in my uterus!!!!!!!!

Grape: OK, but what does that mean for the baby? {gives up and just freaks right out anyway}

Midwife: I can't really say.

And I left it at that.*

I went home and consulted Dr. Google right away. That was a GREAT idea. A prominent renal pelvis (Google tells me that's a tube that connects the kidney to the bladder. If it's too big, stuff can go the wrong way and cause infections) in a 20-week fetus can mean:
1. Absolutely nothing, because they measured wrong.
2. That the dumb thing is just growing fast, and will be normal by birth.
3. That the dumb thing is just growing fast, and will be normal by age 1.
4. That the dumb thing grew too fast, but can be corrected by surgery after birth if necessary.
5. DOWN SYNDROME!!!!!!!!

Yeah. Would it be redundant to point out the FREAKING OUT that was done at this point?

Now, to spare you all any further suspense, in Raisin's case, it turned out to be #2. We found this out to the tune of an additional level-one ultrasound and 2 level-twos with a perinatologist (who, by the way, was the opposite of not-my-favorite midwife, and who is my HERO). These are the sentences he uttered in order to be come Dr. Hero:

"Well, it is a little on the big side right now, but I don't think it's reason to be concerned."

"I see no indication that your baby has Down Syndrome."

"I just took part in a study at the Mayo Clinic about the correlation between this measurement and actual problems after birth. Come see me again at about 34 weeks; according to my study we can't tell anything positive until that point anyway."

And, of course, when we went back at 34 weeks the measurement was in the normal range, and Raisin has never suffered any kind of urinary tract issue. And they all lived happily ever after.

*This is the crucial part of the narrative to me. I don't think I was a passive patient -- I educated myself about pregnancy before and during my own. I asked questions. I tried to keep up-to-date with what was going on in my body and in the midwife practice. But when we hit our little mini-crisis, I let the midwife shuffle me out of the office without any answers.

I got the answers later; I'm OK with that. I got good care from those midwives, so I'm not apprehensive about trusting them again. And I believe that she probably had good reasons for NOT answering my question -- she just should have told me what the reason was. My guess is that as a nurse-midwife, not an MD, she felt she might be treading on iffy legal ground.

I just wish I had asked. I wish I didn't have to guess now. And I'd like, this time around, not to let go of questions to which I feel I deserve an answer.


Amy said...

Good luck with going off the Pill and all that entails :)

Your u/s story is one of the many reasons I don't believe in routine ultrasounds. Now, if I'd ever developed spotting or if I didn't feel movement for awhile, I'd be visiting a sonographer as fast as the next person, but I find that it's far more common for people to get scared over non-existent problems (or ones that resolve themselves) than for something useful to be found. I realize that some people would rather take the chance that they'd see something critical and deal with any false positives, but I'm not one of them.

Julie said...

I wanted an ultrasound just for the chance to see the baby -- to make it more real, I guess. And I think I would do it again.

But you're right -- I wish I had been better informed ahead of time about exactly how reliable the u/s and the person reading it really can be.