Monday, August 4, 2008

manipulation

So, I decided not to go in today for induction. Derrick was sick all weekend, I didn't sleep well last night, and I'm pretty sure I'm not physically ready to go into labor anyway. I'm amazed at how easy it was to reschedule once I was dealing with my doctor, and not the nurse practitioners or OB nurses. Last week I tried to reschedule--twice--because I didn't think my body was ready (which, after today, I think is no longer the case--I feel like she's very low in my belly, and the ligaments in my pelvis feel like they're stretching every time I walk). Both times I was told no, the first time because I might not be able to get on my doctor's schedule again, the second time because the placenta might be aging and could calcify or detach, possibly starving the fetus.

The second argument at least makes some sense (though some research suggests the postmature placenta isn't different from a term or pre-term placenta. I am aware that there are more complications with post-term infants, including more frequent stillbirths, more shoulder distocia, and more meconium staining. The thing is, she's been small during this whole pregnancy, so if distocia is going to be a problem it'll be because my pelvis just isn't built right, not because she's too big. According to this abstract, the chance of having a stillborn infant increases from 11.7/1000 (or, about 1/100) in a term pregnancy to 20.9/1000 (or, about 1/50) in a postmature pregnancy, and the largest two contributers to increased mortality are congenital defects and infections in the amniotic fluid. Of course, that's only one study and I really don't know if in my "research" I'm coming across good studies or bad, but still, I'm getting the impression that the medical community may not be relaying completely accurate information to us patients. That said, I do understand why they get a bit twitchy about letting pregnancies go past 42 weeks, given the approximate doubling in the chance of stillbirth.

The other excuse is the one that irritates me more, primarily because I accepted it. Seriously, would they not reschedule me? And what does it matter if my doctor is the one who sees me? I'm quite convinced that all the doctors in the practice are competent--I've heard nothing but good about any of them. If I'd had my baby last week spontaneously I would have had Dr. J. Random delivering her anyway. So, why did this argument work? It's not logical. Was it the lack of logic that made it so effective? If it's a nonsensical, but reasonable sounding argument, is it more effective? Why?

Really, the thing that most annoys me is my own reaction. Instead of just saying no, just saying what I wanted and insisting that I be listened to, I used Derrick's illness as an excuse, essentially manipulating my way out of what I felt I was being pushed into. That reaction speaks to the powerlessness I feel in this relationship between me and my health care providers. I feel like I lied (since I kind of did) to get the decision I wanted, when really I should have had a say in the decision in the first place. I hate being manipulative. I hate being in situations where I feel that's the only option available to me. Grr.

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