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    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    May 26
    2011

    NOT a 'normal, healthy pregnancy'

    Archived User

    Hello,

    I've been trying do research to keep my pregnancy as intervention-free as possible.  Unfortunately, almost every resource I come across says something to the effect of "this is unecessary in normal, healthy pregnancies"  It would seem my pregnancy is not seen as normal or healthy and I'm having a hard time finding resources that fit my reality.

    I'm older, have a previous c/s, lost my last baby under debatable circumstances (depending on who you talk to, it was a late-term miscarriage (19wks) or an 'almost' missed miscarriage (baby died at approx. 10wks.)) and I suffer from PCOS, which has left me with impaired glucose tolerance (IGT) (but not yet diabetic) and overweight.

    I saw my midwife a couple of weeks ago and she told me IGT is treated the same as GD now (which is different than how I was treated with my son 5yrs ago) and I should be prepared to be induced by 38wks because of it, my PCOS and associated hormone profile is likely what led to my labour failure with my son, and she would be required to refer me to an OB because of my pre-existing conditions.  I fear I'm in for a lot of arguments as I move forward and I'm having a hard time finding resources that speak about: declining inductions if you have IGT and the affects of PCOS ON pregnancy as opposed to becoming pregnant.  My son was also macrosomic (4510g,) so I'm sure they're going to pull that out on me too.  (I believe he was just genetically destined to be large and it had nothing to do with my pregnancy... he's still at 5yo above the growth curve and the tallest kid in his class.)

    Can you offer any advice and/or resources to this conflicted mother?

    Thank you

    Henci Goer

    The way out of this thicket is to make sure you are making informed decisions about your care. Here is a page on the Childbirth Connection website with good information on making informed decisions. There is as well an acronym used by many childbirth educators that might prove helpful during information-gathering encounters:

    B  benefits
    R  risks
    A  alternatives (and the benefits vs. risks of the alternatives, including doing nothing)
    I   intuition or instinct (pay attention to your gut)
    N  no/not now (your right to informed refusal)

    You will want to find care providers who are willing to provide you balanced, complete information. Warning bells should go off if you are getting scare tactics ("Sure, we can do that if you don't care what happens to your baby"), anger ("And what medical school did you go to?"), or you are being patronized ("I bet you got that off the internet"). You also want someone who will provide you with evidence to back up their recommendations if you want it. For example, unless there is compelling medical reason to do otherwise, planned delivery before 39 completed weeks (the end of the week before your due date) is not recommended because the risk of newborn respiratory problems and difficulties with breastfeeding are greater.

    ~ Henci

    Archived User

    Thank you for your response!

    Posted By Henci Goer, BA on 27 May 2011 05:16 PM

    The way out of this thicket is to make sure you are making informed decisions about your care.

    This is hard to do when resources on not 'normal healthy pregnancy' are hard to come by (unless they're the sanctioned official policies.)   Since most of the evidence out there applies to 'normal healthy pregnancies', it doesn't apply to me, so I'm having an especially hard time becoming informed myself.

    ...unless there is compelling medical reason to do otherwise, planned delivery before 39 completed weeks (the end of the week before your due date) is not recommended...

    I don't know how *I* can know what a "compelling medical reason" is for any procedure.  Since I can't become as educated or experienced as a doctor or midwife during my pregnancy, they can make up any story they want to get me to comply (not saying they would, or that they would even deliberately mislead me.  They may honestly believe in what they're recommending - but whether that's for my or the baby's health or their own comfort/liability is another question.)  Their explanations always sound reasonable (I've not yet heard the "your baby will die" line) but upon researching it after the fact (for decisions where there is not time to research,) alternative options/opinions are always found.

    I wish there were more research options for those faced with pregnancy 'complications.'

    Thanks again for your time.

     

    Henci Goer

    Apologies for not putting things clearly enough, but what I was trying to say was that if you can find a care provider you can trust, you don't have to have all the answers yourself, and ascertaining this is within your scope. A care provider you can trust will share your philosophy of minimizing use of intervention, which means you can then rely on his or her judgment when intervention is recommended. "Having a Baby? Ten Questions to Ask" , put out by the Coalition for Improving Maternity Services, can help you determine this. A care provider you can trust will also provide you with answers to the BRAIN acronym questions without trying to manipulate you emotionally. And a care provider you can trust trusts you. He or she regards you as a full partner in any decisions made and respects your right to have the ultimate say. Whether these last two are the case will become clear during the interview. If you can find such a person, you can relax. 

    ~ Henci 


    All Times America/New_York

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