Eager Baby.

Quick background on my attitudes toward the healthcare system in terms of pregnancy and levels of intervention: My mom had C-sections with all four of her kids, I assumed I was set for the same fate. Then I went to college and read an article in an anthropology class about the high rates of C-sections when they were not completely necessary, and that got me thinking. Checked out "Misconceptions" by Naomi Wolf, read it cover to cover, and sought out the closest birthing center with my first pregnancy. Developed pre-eclampsia, was put on bed rest for the remainder of the pregnancy and had to be induced and delivered at the hospital. Second pregnancy, did a home birth and rocked the pants off it. This third pregnancy, I'm planning a home birth, and working with a new midwife (was a midwife at the birthing center I went to for my first pregnancy) who is more medically inclined than the midwife I worked with in my last pregnancy.

Follow all of that?

Anyway.

Friday morning, I woke up and started getting ready for work. I noticed some pretty intense, painful contractions, but I hopped in the shower anyway, figuring they were just Braxton Hicks and I was being a pansy. However, I noticed that I kept cranking the hot water over until it couldn't get any hotter to try to get some relief when one of these "pansy" contractions happened, and then I vomited. Uhhh... no bueno. As I'm fumbling around, trying to find clothes to wear to work (curse having a meeting scheduled so I couldn't go with my comfy maternity jeans that were allowed on Fridays!), the darling husband took the liberty of timing the contractions.

"They're three minutes apart. Don't go to work."

I explained that I HAD to go to work. The meeting, 30 minutes out of town, was important, and they were providing LUNCH. THAT was enough to go. I gasped out that reasoning, however, as I was rocking on my hands and knees trying desperately to get through the painful contraction.

At 35 weeks, this was not a good place to be in. The babe needs a little more time to cook.

I headed to work anyway, and barely made it up to my office (did you know it takes more than three minutes for me to get from my car up to my office? I do, now, because I had a contraction getting out of the car, and then again before I collapsed into my chair). As I sat, just minutes from having to get up and leave to go to the meeting, I started shaking uncontrollably from how uncomfortable I was. I called my supervisor and explained what was going on, and that perhaps I shouldn't go to the meeting ("It would be awkward if my water broke in your nice car"), and she told me to go home. So I did. And spent all day on the couch, on the ball, in the bathtub, anywhere and everywhere trying to get relief from the contractions. Sent a text to the midwife when they didn't die down by the early afternoon, and as she was out of state on vacation with her family, she decided to try to get me an appointment with the doctor she works through. When that wasn't going through, she wanted me to go to the ER to get checked.

I looked at Bobby. "Nope." I'd had enough false starts with my second babe that I was not about to go in and go through the hassle of all that to be told that this was nothing. In a few hours, it would die down, and I'd be fine.

Fast forward to the next morning, where I was still having contractions every three minutes and didn't sleep the night before, I finally conceded. Something was going on, and I was willing to go in even if it meant just finding out I had a UTI and had to go on an antibiotic or something. Anything to make the contractions stop was better than just dealing with them (oh, and the possibility that the baby was going to come too early. However, that didn't seem like such a threat, because of all the false starts with the last pregnancy).

The husband dropped the kids off at with friends, and came back to retrieve me. We went to the hospital, got checked in, and the nurse (who was super nice) got me hooked up to monitors and asked all the medical history stuff. No big deal.

Was monitored. Contracted. Did my thing, only did it without the guilt of being a terrible mother because I knew my kids were hanging out with their buddies playing outside instead of trying to climb on their grumpy mom who didn't want anyone to touch her.

After a while, the nurse came in with a cup and an order from the doctor. The cup was to pee in to test for a UTI. The order from the doctor was to give me a shot of Terbutaline. Having never heard of that before, the conversation went a lot like this:

Me: What is that?
Nurse: It's a smooth muscle relaxant. It should relax your muscles and stop the contractions.
Me: Are there any side effects? Will it do anything to him (the baby)?
Nurse: Well, it will probably make your heart race, so in turn, it will make his heart race.
Me: So it won't have any negative effects on him?
Nurse: Nope! And we usually give three doses, but the doctor just wants to try one injection and see how that works for you.
Me: I'd like to talk to my husband about it first and see if that's something we're comfortable with.

She left the cup, and as I went to do what preggos do best and attempt to aim a cup around a gigantic belly close enough to get urine in it, the husband pulled out his laptop and looked up the medication. Immediately, he came across this:

The U.S. Food and Drug Administration (FDA) is warning the public that injectable terbutaline should not be used in pregnant women for prevention or prolonged treatment (beyond 48-72 hours) of preterm labor in either the hospital or outpatient setting because of the potential for serious maternal heart problems and death.

Now, call me old fashioned, but I would think his mother potentially dying would probably have a negative affect on the babe. That could just be me thinking too highly of myself, though.

Terbutaline is approved to prevent and treat bronchospasm (narrowing of airways) associated with asthma, bronchitis, and emphysema. The drug is sometimes used off-label (an unapproved use) for acute obstetric uses, including treating preterm labor and treating uterine hyperstimulation. Terbutaline has also been used off-label over longer periods of time in an attempt to prevent recurrent preterm labor.

Again, this may be nit-picky, but I feel like there should be some kind of obligation by medical professionals to say something along the lines of, "Oh, bee tee dubs, this medicine we want to give you to treat this? Not even really supposed to, according to the FDA. No big deal, though, we do it all the time." I hear all these awful stories about how insurance won't cover treatment for people because it's too experimental, but they're hunky dorey with covering an intervention that the FDA doesn't even approve of? How is that consistent? (slash ethical?)

So when the nurse returned to retrieve the pee cup (hit my target, thank you very much), she asked what we had decided with the shot. I told her it was something I wasn't comfortable with.

Fast forward an hour or so, and she returned to check to see if I was progressing (I wasn't), and said that the urine test indicated it could be a UTI. So did I want to go ahead and get the antibiotic called into the pharmacy, or would I rather wait until they ran the 24 hour culture? As a person who isn't huge on taking antibiotics just for kicks and giggles, I told her I'd wait.

As she went through the discharge instructions, she discussed all the things I needed to look for to come back in again. One thing she stressed was that if I developed a fever, I needed to get in immediately, as babe #3's heart rate was measuring at the high end of normal, and a fever would increase his heart rate-- making him tachycardic, which would be dangerous. (This is the part where you remember back to when, just a couple hours prior, they were trying to inject me with a medication that they were pretty certain would increase my son's heart rate). She then told me that the doctor would call me the next day to let me know the results of the urine culture, and off we went. It was 2:00 p.m. Saturday, which I noted so I could anticipate about when to expect the phone call the next day.

Sunday evening rolls around, and while I was still contracting, they seemed to be easing off a bit in intensity. I was trying to hydrate like it was my job, and entertain myself on the couch, when I got a text message from the midwife letting me know she was back in town, and wanted to know how I was doing. I gave her an update, and told her I was still waiting to hear about the culture. She texted back to say they may not have it done yet, and she'd call the lab to see. She calls back a minute or two later and lets me know that my culture was totally normal, and I didn't need any antibiotics. She then told me something that reinforced why I absolutely adore my decision to use a midwife:

"You know, you could have gotten a virus. Or a bad night's sleep. Or you were dehydrated, and vomiting made you more dehydrated, and that kicked up the contractions. Or your body just likes to practice before you go into labor, as you saw with your last one. I don't know. I can't pretend to know, because the human body has surprised me so many times that I stopped making guesses when I just don't know."

I just don't know.

Instead of assigning diagnoses or reasons for why something is happening when there is no idea, wouldn't it be great if people in medical professions could just say "I don't know"? The doctor didn't know why I was contracting, and rather than go with that until there was a known reason, I was having medications thrown at me that could have negative effects on myself and my child. And for what reason? So I would be more confident in her practice? So she could feel like she was doing something in a situation she didn't feel she had control over? When I told my midwife about the terbutaline, she told me, "Oh, that stuff makes you feel crazy. I can't imagine how getting that would have made you feel any better than you were feeling in that moment." Awesome.

I am completely for hospital interventions to save people's lives. I am grateful for the experience I had in my first pregnancy, and while there are some things I would change about what happened (I had no idea internal monitoring meant they'd put a BARB in my son's HEAD, because nobody told me!), it was still a really great experience and I felt like we were well taken care of. I was sick and needed to be there to make sure both my son and I were healthy and safe. However, there comes a point where virtue turns to vice, and when we stop questioning the things that happen because we dare not approach the pedestal we've placed medical professionals upon, I think things get sloppy as a result of the lack of accountability.

In a the age of google, it's a privilege to be able to say, "Let me explore that first." With tablets and smartphones and tiny laptops, that information is so easy to get to anywhere we are. Let's take advantage. Let the accountability come back.

And in case you were wondering, the fact that this kiddo still can do a roundhouse ninja sequence in the midst of an intense contraction means he's pretty hardcore. I'm not too worried about him.