Part Two: Three Midwives and a Sumo Wrestler
Now, in these parts, family doctors are nearly impossible to get and obstetricians are scarce. If you don't have a family doctor -- and mine went out of practice while I was away -- you have to go to walk-in clinics if you're ill. I understand that now there is a pool of obstetricians you can go see in the later months of your pregnancy if you don't have a family doc but at the time, this either didn't exist or I didn't know of it. Hiring a team of three midwives to see me through pregnancy and birth sounded like a great option. I had had two miscarriages when I was 21 and 23. And the toughest part about them was being afraid and waiting in the emergency room for hours to be seen. In fact I lost one of the pregnancies while I waited. The midwives carry a pager that you can call any time day or night if you have concerns. That was very important to me because I had begun to have nightmares about miscarrying again. As well, I had read so much about unnecessary interventions into birth that happen at hospitals and I wanted to have the most natural pregnancy possible.
At my first visit with the midwives, I was three months pregnant. They had me test my urine for about 10 different things including sugar. Wouldn't you know, I tested positive in trace amount, which I was told was normal. Next visit, I was four months pregnant and just got back from a lunch out with coworkers where I indulged in pasta, a sundae and a Coke. I don't remember the numbers on the scale but I tested positive for sugars on highest end of the scale. My midwife told me it was due to what I had eaten and that I should not eat that much sugar at once. No mention of gestational diabetes. I continued to test high for sugars at every visit until in January one of the midwives sent me for a random glucose test. I took it two hours after I ate no carbs (because by that point I was completely discouraged from them). It was 7.3 mmols. She sent me home with urine test strips to use throughout the day and report the results. I had sugar at every test including first thing in the morning. She said I was "borderline" and that if I ate right I would be fine. By my eighth month, I had lost 20 lbs. This I blamed on the vomiting that had continued throughout the entire pregnancy. I was put on two pills four times per day of Diclectin and was still vomiting every two or three days.
I think at around 35 weeks things took a turn for the worse. Suddenly I gained 12 lbs in a two-week span -- so much for a stretch-mark free belly -- and my blood pressure shot up to 140/90. This is the part where I really should've begun questioning my treatment but I had a hard time finding good information. I had a few pregnancy books like What to Expect and they all made vague, completely unhelpful references to these problems. 'It's common to have some sugar in urine during pregnancy.' 'For some women, morning sickness lasts the entire pregnancy.' There was a description of preeclempsia but it didn't say what an unhealthy blood pressure was, so regrettably I didn't question it. Unbelievably, I continued at my job until my 37th week of pregnancy. At my appointment that week my blood pressure had now raised to 160/110. The midwife sent me for three more random glucose tests to take two hours after eating. The results were 9.5, 4.8. 7.8 and 6.3. Not horrible, but at the time I was eating maybe 20 grams of carb per day. On March 15, 2007 the midwife told me I had preeclempsia and gestational diabetes. She told me to count the movements of the baby every day and call if I had a headache or felt dizzy. The next two nights I lay awake in my bed scared to fall asleep and wake to find my baby motionless. Fabe worked nights at the time, so he wasn't there to watch over me. I'd had enough and on March 17 I called the midwives and demanded a non-stress test at the hospital.
My midwives have hospital privileges and can make decisions for their patients. The obstetricians on duty can step in if they feel a patient is in danger. I had the non-stress test where a monitor is strapped to your belly so that the baby's movements and heart rates are recorded. Baby was fine but my blood pressure was still very high. The midwife and obstetrician made a deal: I would be able to leave the hospital if my blood pressure stayed below 150/110. We were in triage at the time with only curtains to divide patients. A woman beside me was in the throes of labour pleading for Allah to help her and saying she couldn't breathe. I looked at Fabe and I was like, "Grab your coat, we're leaving. I don't want a baby after all." My blood pressure didn't drop and the obstetrician looked me right in the eye and said, "You and your baby are in danger. In these situations, if something goes wrong, it will go wrong very quickly. You need to have this baby now."
I was induced and was begging for an epidural within two hours. I didn't tolerate the epidural well and within a few minutes I passed out and my blood pressure dropped to 67/35 or something like that. I just remember waking up and having an oxygen mask over my mouth. The details are blurry but I wasn't allowed the epidural so it was fully out of my system by 7:30 a.m. I gave birth via vacuum birth at 12:30 p.m. My son Darius was 8 lbs 7oz at 37 weeks and 6 days.
I had this vision of the birth of my son to be this special, magical experience where the doctor holds him up and exclaims, "It's a boy!" and everyone in the room wipes away tears of joy. In reality there were about 20 people in the room and my son, who looked limp and pale, was immediately taken to an area at the side of the room for examination. I yelled at my husband to go check to see if he was ok. He was and after about 15
minutes he was handed to me. I took one look at him and thought, "Who ordered the Sumo wrestler?" Darius was so fat that his eyes didn't even open all the way. He was a little more than two weeks early but the Swaddler diapers didn't fit. Nor did the outfits I had brought to the hospital to bring him home in. He was in the 98th percentile for his gestational age. Over the next few months Darius quickly dropped down on the growth curve and has consistently stayed in about the 20 percentile for weight over the last two and a half years. I believe he was never meant to be that big at birth.
My high blood pressure did not go away immediately. At about 3 a.m. the obstetrician prescribed pills to bring it down. But the next morning there was no improvement. The ob did not give her permission for my discharge,
but the midwives and Fabian thought I'd do better at home, so on their recommendation I left the hospital about 24 hours after Darius was born. My blood pressure returned to normal within a few weeks.
Now that my diabetes has finally come to light, I began looking back on that experience and questioning my treatment. Last spring I demanded to see the file the midwives kept of my pregnancy. There is a note from one of the midwives saying she diagnosed me as having gestational diabetes and preeclempsia on March 15, 2007.
The hospital admission records the midwives filled in on my behalf on March 17, 2007 say this:
Maternal Health Record:
Does mother have diabetes?
They checked "no."