Monday, August 17, 2009

The Hospital Experience, Part II

The things I didn't care for regarding the hospital can be divided into two categories: the systemic and the organizational. By systemic, I mean those things that are done because... that's how they are done;that, to get around them, one would have to sign an "against medical advice" waiver. By organizational, I just mean those times when it seemed like the left hand didn't know what the right hand was doing.

To be admitted to Labor and Delivery, one should be at least three centimeters dilated, or with water already broken. This makes sense in theory, since it keeps women from coming in too soon. My issue was that I had a scheduled doctors' appointment the morning I went into labor. My contractions started about 5:00am, and I was at the OB's office by 11. At first they freaked out a bit, because I happened to have a contraction right as the nurse was taking my blood pressure, so my BP readings, which had always been in the low-normal range, were way off. The doctor rushed in and started rapid-firing all of the Pre-Eclampsia questions: headache/ blurred vision/ vomiting/ etc?-- but I assured him I was fine, had merely had a contraction right at that moment. He re-checked it and it was back to my usual 110/68. I asked for a cervical check, to see if this was "real labor" (as I mentioned previously, I never did lose my mucus plug and my water never broke), and my doctor determined that I was three centimeters dilated, with the baby totally posterior. He asked about the timing of my contractions, which at that time were all over the place, and said that once they became regular, 3-4 minutes apart, I should call back in. Well, they became regular during the five-minute drive back home. I timed them: every three minutes. I hung out at home for maybe an hour, called Don home, called the doctors' office. They made me come back to the office for another "check" before sending me to the hospital. I pointed out that I'd been there not two hours ago, and had already been declared 3 cm, but apparently there was nothing in their protocol that allowed for such inconsistencies in the routine. So, even though I'd been checked at 11:00 by The Bad, I had to go back at 1:00 to be checked by The Good, since he was the one who'd be delivering me, and THEN drive from there to the hospital. (Which, OK, is basically across the street, but still. In the three minutes it took to find a parking space, I had two contractions in which the baby turned completely around*, and it hurt like hell.)

Robert's extra time in the Special Care nursery was pure CYA on the hospital's part. They held him until they were absolutely sure that he didn't have an infection of some sort, particularly Group B Strep. From what I understand, the antibiotics I was on during labor, while drastically reducing the odds that he would contract the strep, also made it very difficult to diagnose an infection should he get it anyway. The doctors never said this explicitly, since it would make the antibiotics look questionable, but its what I pieced together from their explanations. Since Robert was breathing very fast and had a somewhat elevated temperature, the doctors weren't taking any chances. I understand why they do that, but it was pretty obvious after his first day in the nursery that Robert was perfectly healthy-- his breathing had dropped to mostly normal, no fever or anything-- and his being there wreaked havoc on my post-partum emotional state and on our breastfeeding relationship.

The organizational problems were things like nobody being able to come up with a breast pump for me during the time that Robert was not able to eat (breathing so fast that it was an aspiration risk; IV only); a nurse forgetting to bring me my (desperately needed) Ibuprofen; my previously-described hospital-discharge fiasco; and the three-hour bath. A few hours after the birth, as I was rolling from the delivery room to maternity, my nurse offered to take Robert to the nursery for a bath. I agreed, mostly because his hair was still caked with dried blood. I didn't see him again for three hours. If I'd known that ahead of time, I would have kept his grotty little head with me, instead. Apparently, newborns have to be 'warmed up' under heat lamps to a certain temperature before the nurses can strip them down and bathe them, then re-warmed before being returned to their mothers. I ended up calling for him repeatedly on the little intercom: "Yes, this is Room ___, the nurses took my baby for a bath? But that was ninety minutes ago? Can you tell them to bring him back?" Had I been able, I would have simply marched down to the nursery and retrieved him, or hung out there while he was bathed and warmed, but I was still totally bed-bound at that point.**

So, there it is: the less-than-pleasant aspects of giving birth in the hospital. The whole experience is still tilted in their favor, all things considered.

*I could tell partly because up until then, all of the contraction pain had been in my back; these two were all over the place, and from then on the pain was much more "in front". Also, the next time I was checked at the hospital, the baby was no longer posterior.

**Three hours later, with Robert safely at my side, I got out of bed and went to the bathroom all by myself. This is something I never thought I'd have to be proud of, but it took heroic effort and planning.

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