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    Jan 20

    Older Mothers & The Medical System

    Archived User


    I am 36 weeks pregnant and 40 years old (first time mom).  I went into my pregnancy healthy (I am a runner) and continue to experience a healthy pregnancy with minimal issues. 
    I have noticed that one of the ob-gyns in the office (I have one main OB-GYN but women typically see at least some of the other ob-gyns in the office as any one of these doctors could end of delivering our babies) tends to send me for extra tests.  I don't really mind, but it is interesting (amusing even).  Her usual line is "Well, everything looks good.  But, because of your age, to be on the safe side..."  So she has sent me for (ex) gestational diabetes screening (came back negative) and now I am going for a fetal biophysical profile (my main ob-gyn now feels it is a good idea because the baby is breech & this would be a way to "monitor" the situation).  Any thoughts/tips/suggestions on "mature moms" and the medical system?
    Henci Goer

    Your ob's attitude, i.e.  "because of your age, to be on the safe side..." makes me very uneasy. Many obs regard older mothers, especially 1st-time older mothers, as "X marks the spot where something could go wrong at any moment." They then recommend extra tests and procedures such as induction of labor or cesarean surgery in the belief that this will avert the dangers. It won't. The truth is just the opposite. The safest, healthiest birth is the one with the least use of medical intervention given the individual woman's case, which in the case of a healthy woman who isn't experiencing obstetric complications, is zero. Testing isn't harmless either. Fetal surveillance testing such as the biophysical profile has an extremely high false-positive rate (the test says there is a problem, but it is wrong). In fact, in the case of a healthy woman, a positive bio-physical profile is much more likely to be wrong than right, but once you have a test that says the baby might be having a problem, no ob is going to shrug his shoulders and dismiss it and neither are you. Giving you repeated messages that instill doubt and fear take their toll as well. They lay you open to agreeing to tests and interventions without questioning them and undercut your confidence in your ability to birth this baby. You say you are a runner: how well would you do in a race if you went into it thinking you weren't really strong or capable enough to complete it and you were likely to seriously injure yourself at any moment? 

    I am also concerned that you are at 36 weeks and your obs aren't talking to you about getting your baby turned. There are alternative therapies: the Webster technique, a chiropractic maneuver, and moxibustion, which uses the heat from a burning herb to stimulate an acupressure point, but at this point, you should be scheduled for an external cephalic version. If you can't get the baby turned, you are almost certainly looking at a cesarean section. Planned vaginal breech birth is a perfectly reasonable option for most women, but obs who will do one are as scarce as hens' teeth, and I doubt your group is among them.

    My advice to you is to get going on getting that baby turned and make sure you are making informed decisions about your care. In discussions with your obs about your options, ask yourself, "Am I getting feelings or information?" You should be getting objective, complete information about the harms vs. benefits and how likely harms are to occur for all your options, including doing nothing. If all you get is the feeling that you had better go along with what they propose or something bad could happen to your baby, but no rational basis on which to decide what to do, do not allow yourself to be stampeded. Frankly, where this is the case, I would recommend seeking a different care provider and advise you on how to go about that, but while it might be worth a try, the reality is that few care providers these days will take a new client so late in pregnancy.

    -- Henci

    -- Henci 

    All Times America/New_York

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