Wednesday, November 21, 2007

Placement (Probably) Accomplished, Moving (Probably) Planned

So yeah, barring major weirdness I'll be starting at a very busy practice in the first week of December. A VERY BUSY practice. Yiiiiiikes!! But this MW was telling me about how I do get to tell her when I want to be on-call and not. YAY for MWs that have their own backup plans!

And I submitted the rental applications for a place in Kirkland. Three bedrooms, here we come. Again, barring any major weirdness.

How strange to have those two things fall into my life at the same time, relatively out of the blue! As needed and looked-for as both events are, neither came through my direct efforts or in quite the way I was expecting. The Universe works, yet again...or so I hope. We haven't signed papers yet. So I may be bestowing a royal jinx upon myself. I shall knock on several large pieces of wood in penance.

Next challenge? WHO THE HELL IS GOING TO WATCH MY KIDS WHEN I GET CALLED TO A BIRTH once I've moved?! Holy nerve-wracking! Oh all ye Kirkland/Bellevue homeschoolers/unschoolers/homeschool or unschool friendlies....I'll trade you babysitting hours. Seriously. You'd only have to cover my ass in the daytime, no middle of the night babysitter calls...Fran's got that.

Non-Insomniac Insights

I swear, I have all these great ideas just as I'm about to fall asleep. Of course they deserve full attention and full treatment, but I just can't muster that lately. As I lay in bed, prisoned by sleeping Toddler and my own strange desire to actually get a little sleep, these thoughts are quite lucid and eloquent. As I sit at the computer in the middle of the night after finishing loads of reading and a little bit of writing, my brain has been pounded to the consistency of spicy mustard and these thoughts really aren't so lucid and eloquent anymore.

Still, they're not getting out otherwise, so here are a few that I can remember at the moment:

I just gotta love this whole "cesarean by choice" issue. Oh, gotta love it. A woman has a right (a right, I tell you!) to get a cesarean on request despite the fact that it is riskier than vaginal birth in low risk (and in many "risky") pregnancies. But she doesn't have the right to chose a vaginal birth? I've used up my thoughtful writing allotment for the month (how I'm going to get through onsite, I don't know), so instead of giving these points full treatment, I'm going to go ahead and just run the list:
  • Doctors say they are after patient rights - what they're really after is their own right to make a living. If they were really after patient rights, they would be all over letting women chose VBAC after a risk/benefit discussion, just as they're all over letting women chose csection after a risk/benefit discussion. The fact that they're promoting the option that is more profitable, easier to schedule, less time consuming, more predictable, less likely to result in lawsuit, and *cannot be performed by alternative practitioners* is highly telling. When are women going to wake up and see this for what it is?
  • Csection carries similar risk to vaginal birth for the fetus (various studies have shown slighly elevated risk to the same risk for csections performed without 'firm' indicators). Csection carries elevated risk for the mother and more trauma than vaginal birth (almost regardless of how traumatic the vaginal birth was! Csection is major surgery, remember, and even a very generous episiotomy...well...doesn't expose the abdominal organs). This proves *getting to the point here* that we STILL VALUE THE FETUS OVER THE WOMAN. If a woman balks at the stats that say she's more likely to DIE, that she will certainly experience morbidity, that her recovery will be difficult...she is told that it doesn't matter. Her baby will be fine. WOMEN HAVE THE RIGHT TO CARE ABOUT THEMSELVES, about their own health, their own well-being, and their own recoveries. They have a right to care about these things, to ask about these things, to demand these things, without being treated like selfish know-nothing amoral pains in the ass.
  • We can cut into the abdominal wall, severing abdominal muscles. But heaven forbid that the vagina and pelvic floor get a little wonky for a couple of weeks. Shows where our priorities are, eh? Are women good for nothing else?
  • When is the last time you heard of a woman getting a legal order compelling a doctor/hospital to allow her a vaginal birth? Never, right? But there has been such a thing as legally compelled cesarean section. And there is, and continues to be, such a thing as doctor-coerced (institution-coerced, insurance-coerced) cesarean. Why does the opinion of a doctor, a hospital, or (worst of all) an insurance company trump that of the woman whose body (and perhaps very life) is on the line? Why can't a woman DEMAND vaginal birth from the very providers that allow her to demand cesarean? The answer, I am afraid, is that women simply don't mean very much. In the scuffle to achieve an ethical solution, we've placed the fetus above the woman. Her elevated risk doesn't matter. The fact that the fetus is likely to be as safe or safer (this is debatable but most doctors believe it) - that is what is important.

Reading into some of the issues surrounding legally compelled medical procedures (I'm so distractable, that wasn't what I was looking for in those journals...) I've come several times across the rather inflammatory notion - and one I happen to at least partly agree with - that it is our own damn fault that we're in this frigging mess. If women would disagree with their providers more frequently and more vehemently, maybe their providers wouldn't feel like they had this moral imperative to decide things for women. Maybe they wouldn't be so confused by dissent. Maybe they would realize we have brains after all.

The pregnancy websites and magazines are still littered with listen-to-your-doctor advice. As if most women needed any MORE prodding to be compliant! We've got this "thing," we women do - whether it is natured or nurtured into us is largely irrelevant for this specific discussion - we want people to be happy with us (to be happy at all, really), and we do a lot to make it so. It is difficult for women to stand up to their doctors and their nurses. Why? Intimidation, conditioning, desire to make things quicker and easier, sincere belief that the doctors and nurses are acting in their best interests.

I've officially run out of coherent thoughts for the night. 'Till next time...

Monday, November 19, 2007

Lake in the Fall

These don't require a whole lot of explanation: