It’s not that easy to say “no” to medical interventions during pregnancy.

When I was pregnant, I read tons of birth stories on the internet. Even though most of the birth stories I read were about hospital births (not home births), I loved reading them. Except for one thing — so many of them involved interventions of some sort. The interventions were pretty much always unwanted by the mother but happened anyway (and nine times out of ten, the mom “ended up with a healthy baby” and didn’t continue to be upset or complain about what happened). I have to admit that, more than once, when reading one of these stories, I thought, “Why didn’t she just say no to that?” What I didn’t realize was that, aside from being a totally judgmental and bitchy response, it’s just not that easy to say “no” to interventions.

I learned this from a bad experience I had with what I refer to as my “crappy HMO.” Although I was working with a midwife and planning a home birth, I did some things through my crappy HMO. They did all my lab work and ultrasounds, and I went to them for CVS. I would’ve had to pay extra to have this stuff done anywhere else, so it was better to get it done at the crappy HMO, where lab work was free and I just had a deductible for everything else.

Most of the time, this worked well. When I needed labs, I contacted the nice PA I saw for my first prenatal appointment (before I switched to the midwife) and she put in a referral, so all I had to do was show up at the lab and have blood taken or whatever. I didn’t even have to see anyone for an appointment.

It wasn’t all good, though. I had a bad experience with the perinatologist who did one of my ultrasounds. They always asked me what my deal was because they saw from my record that I didn’t come to them for routine appointments. I’d explain that I was working with a midwife, and this guy asked if I was planning a home birth. I lied and said I wasn’t sure (because I didn’t want to argue with him about it). He said that he knew some people who did home births and “something” went wrong and — this is a direct quote — “they were never able to forgive themselves for being so selfish.” He wrote in my chart that he explained to me the things that can go wrong with a home birth, but that was a lie. All he said was that “something” could go wrong and it was selfish. Asshole.

The one thing that had me worried for a while was getting the Group B Strep test through the crappy HMO. This is kind of an, um, intimate experience and not something you can just have done at the lab. I told my midwife I’d have it done through crappy HMO, but I really didn’t want to — I just had a bad feeling about it. I didn’t want to go. I contacted Planned Parenthood about getting it done there, but they don’t do it.

So I made an appointment with the crappy HMO for a routine 36-week prenatal visit. I figured I’d just do the appointment because I didn’t think they’d “let” me come in for just the GBS test. (They’d been treating me like I was crazy, off-the-grid hill people for a while and always did weight, blood pressure, pee in a cup, etc. even when I came in for stuff like CVS, which they don’t normally do.) Further complicating matters was the fact that I’m claustrophobic and the ob/gyn department I used was on the 10th floor of a building with crap-ass elevators (the last time I tried to take one, I got in, pushed the button, the doors closed, and nothing happened — the elevator didn’t move and I had a panic attack) so I always took the stairs. I didn’t think I’d really feel like climbing that many stairs while 36 weeks pregnant. So I made the appointment at a different office. Further complicating matters even more, I ended up seeing the PA I saw a few years ago when I had a miscarriage and hated (she was weird, ordered me around, and didn’t explain anything she was doing and did stuff like swab me for whatever STDs and didn’t even tell me she was doing it, which really bothered me).

I had a really bad feeling about this appointment from the day I scheduled it. I got incredibly anxious and eventually felt like I was having a low-grade panic attack for days. I’m not even sure what I was expecting, but it freaked me out. I checked my blood pressure a few times that week (I check my blood pressure at home because I get white-coat hypertension) and it was on the high side. I thought (and hoped) that the elevated blood pressure was because of my anxiety.

The day of the crappy HMO appointment I was a wreck. I really wanted to blow it off, but I knew I needed the GBS test. I was super-anxious all day. By the time I got into the exam room and was faced with the woman who told me I was having a miscarriage and totally freaked me out about everything, I felt like my heart was going to jump out of my chest. I gave her my blood pressure readings from earlier that day (my midwife always used my readings and did not insist on taking my blood pressure herself). She took my blood pressure and, I shit you not, it was like 155/100 or some shit. It’s never been that high in my life. I told her I was having a panic attack. She took it a couple more times and said it was still high.

Nothing about this appointment was like it was with my midwife. This is a tangent, but I want to take it for a minute so you can see how different things are with a midwife. With her, when there was a test she wanted me to get or even something she didn’t think was necessary, she’d cover the topic like this: (1) introduce the subject (for example, the traditional antibiotic eye ointment and vitamin K injections given to babies right after birth); (2) provide information on the pros and cons and maybe give me additional written information; (3) give me time (usually until our next appointment) to do my research and make a decision; (4) ask me what I want to do. She always made me feel informed and empowered, and she always respected my decision, even if she didn’t agree. For example, she didn’t recommend the gestational diabetes screening, but it would’ve been fine if I did it (I didn’t).

At the crappy HMO, I got the GBS test. Then I was told that we were going to do an ultrasound to see if the baby was head down. (I already knew he was head down because my midwife told me; she also told me he was finally facing my back, something I’d worked hard to make happen and is very important during labor and traditional ob/gyns never seem to address this, which I think is completely irresponsible and shows a lack of respect for women and the birth process, but perhaps that’s a rant for another day.) Even though I knew he was head down, I didn’t refuse the ultrasound. Who but crazy hill people refuse a chance to see the baby? So I had a totally unnecessary ultrasound.

After that, she said that, because of my blood pressure, they were going to put me on the monitor and do some other shit. Also, I had to pee in a cup so they could check my urine (something my midwife never did because she said it doesn’t provide any useful information). I didn’t refuse any of this. I should have. At the time, I was still in panic mode. I felt tiny and alone (Ben didn’t come with me because I didn’t ask him to) and terrified and awful. And I didn’t think that I really had high blood pressure, but what if I did? What if there was something wrong with the baby? Didn’t I want to know? It’s really amazing how fast you can get freaked out about this stuff.

They took my blood pressure again before I had the next round of tests. It was still high. Um, duh? They were scaring the everliving fuck out of me. How could it not be high?

I ended up getting another ultrasound — it was some test where they measure the amniotic fluid (I don’t remember what it was called). The results were fine. Then I got hooked up to a monitor for a nonstress test. I’d read about people having this done in the late weeks of pregnancy. It was often followed by interventions. It terrified me. For the test, they put me in a recliner and wanted me to be reclined all the way. I refused that part — reclining is a position that makes it very easy for the baby to flip so he’s facing forward, and I’d worked so hard to get him to flip the other way I wasn’t willing to risk having him flip back. So they had me sitting up in this awful chair with crap stuck to my belly and told me to push a button every time I felt the baby move while some machine spit out numbers and printed out spiky lines.

I don’t remember how long this all took, but it was a long time. At some point Ben started calling/texting me because he was worried. I told him I was on the monitors and it was awful.

According to the NST, everything was fine.

The awful PA came in and sat down and told me that I have hypertension. I did not have signs of pre-eclampsia (my biggest pregnancy fear). She gave me a prescription for blood pressure medication and told me I had to be seen by an OB on Monday (this was a Friday). She told me to get “pre-eclampsia bloodwork” done at the lab and take it easy all weekend.

I figured I should fill the prescription just in case, so I went to the in-building pharmacy, which was packed. I had to wait forever. I spent most of this time outside, on the phone with Ben, explaining what happened. I was upset. He was upset. I cried. This is stupid, but I really felt violated by everything that happened. I was still in a state of panic, even though I hoped that this was the last time I’d have to deal with the crappy HMO during my pregnancy.

I got the medication and left without getting blood drawn. Nobody explained the purpose of the blood work, and I just couldn’t handle being in that place any more. The PA called me that evening and left a message, encouraging me to get the blood work and to see an OB on Monday. I needed to be monitored, she said.

The next morning, I still felt anxious but a little less so. I don’t even know why I did it, but I logged on to the crappy HMO’s website to check the notes from yesterday’s appointment. What I saw sent me right back into full-on panic mode. Provided for me on the website were post-appointment instructions for pre-eclampsia. What? I have pre-eclampsia? Holy fuck. This was my biggest fear. She told me I didn’t have it. What the hell is going on?

Then the phone calls started. I got a message from someone stating that I had to call them to find out important lab results. What lab results? I didn’t know they were doing any more lab work (they checked my urine while I was at the appointment and I got yelled at because there was sugar in my urine and I didn’t do the GD test). Honestly? I’m a big wuss and I was afraid to call them back. I logged into my account later and found a new lab test result. It said there was protein in my urine. There had always been a “trace” of protein in my urine when I had it checked, but I guess this was different? I’m not sure. But protein in your urine and high blood pressure are sure signs of pre-eclampsia, which I’d been told the day before I didn’t have.

This was when I realized that things could get very, very bad for me. What if I did have pre-eclampsia? You know what happens then? You get put on bedrest and probably are induced early. If I had to be induced, it meant I couldn’t have a home birth with my awesome midwife. I’d have to go to the hospital and work with someone I’d probably never met from the crappy HMO. I wanted no part of that. In fact, it terrified me. It was the last thing I’d ever wanted.

The thing was, I had absolutely no symptoms of pre-eclampsia. I may have had a tiny headache here and there, but nothing major. And I had no swelling at any point of my pregnancy (and believe me, I spent that weekend constantly, obsessively checking my hands, feet, and face for any sign of swelling). I obsessively checked my blood pressure, which was still a little high but not as high as it was at the appointment.

I got at least three or four calls a day from people with the crappy HMO for the next few days. (I know that, as far as they knew, I had a serious condition and they were just doing their jobs. See also covering your ass.) After the first couple, I didn’t even listen to the messages. It freaked me out too much. I wanted to do all I could to get out of panic mode so I could see if my blood pressure went back to normal.

That weekend was by far the worst time of my entire pregnancy. I really felt like the world was going to end. I remember being at our monthly dog party that Saturday, wondering if I was going to swell up like a balloon at any second and whether I was going to have to be induced.

Eventually, I started to be mad in addition to terrified. Why didn’t the PA believe me or listen to me when I said I was having a panic attack at the appointment? Why weren’t my blood pressure readings good enough? They were good enough for my midwife. Why didn’t they explain things or treat me like an adult?

I pretty much obsessively checked my blood pressure for days. Just the thought of checking it freaked me out and probably made it higher than it would’ve been otherwise. I tried to relax, but I realized that if my blood pressure stayed high, if I really did have high blood pressure, I’d have to tell my midwife and there was a very good chance she wouldn’t be able to work with me on a home birth. I’d have to go to the hospital. This scared me more than just about anything, ever. I didn’t want any part of that. (Of course, if I had pre-eclampsia or otherwise needed to go to the hospital to deliver, I would have. I wasn’t so stubborn about home birth that I would’ve put myself or the baby at risk if it got to that point.)

The good news is that, after a few days, I stopped getting freaked out every time the crappy HMO called me. Eventually, they stopped calling. Eventually, my blood pressure went back to normal. (I never took the medication.) I didn’t have pre-eclampsia or high blood pressure. I just had crappy HMO hypertension. I was totally and completely fine.

I got the GBS test result the day before I went into labor the next week. It was negative. I did not develop high blood pressure or any other complications during labor.

I learned some good stuff from this experience. It’s very easy to get into full-on panic mode when medical professionals tell you something is wrong and/or that they “have to” do something to “make sure the baby is okay.” I was lucky — I just had a bad appointment and a bad few days after. I can’t imagine how I would’ve felt if something similar happened while I was in labor — what it would be like to have someone tell me that we “have to use Pitocin” or “have to do a c-section” “for the baby.” I’m not sure I’d have been able to say no to these things, even if I thought saying no was for the best for me and for the baby. I hope I never have to find out.

Anyway, for other women out there, make sure you’re informed about your options during pregnancy and labor and that you’re working with the professional who is right for you. If you don’t mind interventions, cool. If you do, cool. It’s really important to know what you want and to work with the person who is most likely to make it happen. For me, obviously, that person was a midwife, and working with her was an awesome experience (I’ll tell you more about it soon, I swear).

4 thoughts on “It’s not that easy to say “no” to medical interventions during pregnancy.

  1. Ugh, I am so sorry you had to go through that.

    This can also apply to the general public (here as I fret over whether to have a repeat CT scan to see what is/isn’t there), but I think fear over an unborn child allows mothers to accept whatever’s handed to them, you know?

    • YES. Definitely. And for whatever reason, it seems like many (not all, I’m sure) OBs WANT women to be afraid so they just accept what they’re told. I hate that shit.

      I knew from the beginning of my pregnancy that working with an OB would probably freak me out and I’d end up having interventions and/or other shit I didn’t want (especially because I was “advanced maternal age” and shit).

  2. Just want to say your article is striking. The clarity in your post is simply striking and i can take for granted you are an expert on this subject. Well with your permission allow me to grab your rss feed to keep up to date with forthcoming post. Thanks a million and please keep up the ac complished work. Excuse my poor English. English is not my mother tongue.

  3. i agree 100% it is almost impossible to avoid interventions. by trying to avoid unnecessary tests i wound up with a bogus label of gestational diabetes. i should have denied the first glucose test but t thought what was the harm. well all the tests i took i was borderline normal but it still resulted in a domino effect of unnecessary “care”.(inulin, blood monitoring 5 times a day, unneeded ultrasounds non-stress tests twice a week) and now the want to do things like inducement and iv insulin and blood tests twice an hour glucose. this is not a natural process any more. if i had to do it all over i would have done my doc. research more carefully. contact with an OBGYN is the leading cause of birth interventions. they are toxic

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>