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<p>i hope you don't mind me venting here.. my husband is very supportive but my family wouldn't understand because they just think differently.</p>
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<p>the whole pregnancy, i planned on giving birth in my hometown. i'm about an hour away from the city hospital that would be the other option. i had a HORRIFYING experience giving birth there in 2004. they ignored the signs of pre-e and sent me home, they pumped me so full of IV fluids saying i was dehydrated (i was saturated! but i wasn't producing urine, it looked like pepsi). the doctor literally yelled at me while pushing - her idea of encouragement was "push! get that baby out! GET ANGRY!" ...meanwhile i was using positive imagery, picturing my pelvis opening and my baby being welcomed lovingly by all present. lord forbid, i said "shh!" in the middle of a push. the bitch doctor actually LEFT THE ROOM, and then came back and told me off for being a "difficult patient".</p>
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<p>my after care wasn't great either. they still didn't shut off the damn IV. my weight at my last prenatal visit? 225lb. my weight 3 days after DD1 was born? 250. that's all water weight. the edema prevented me from breastfeeding for three whole weeks. during those 3 weeks, i peed *over 70 lbs* of excess fluid. i examined my chart, there were gross charting errors. there was a note from that doctor about me being a difficult patient, so i guess everyone else read that and used it as an excuse to dismiss everything i said.</p>
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<p>the edema was so bad, i couldn't walk from my bed to the bathroom without awful cramps and muscle spasms. my feet were purple-grey and the arch of my foot wasn't an arch at all. so then my 3 days of recovery were up and they decided to send me home - never mind the fact that self-care was impossible. i was a single mom, in a 2 storey apartment. i didn't have help. they *grudgingly* let me stay one extra day, because on the weekend my mom would be able to help me with wound care and getting up to the bedrooms, where i pretty much stayed for days. the bathroom was down the hall. the kitchen was downstairs - it was several days before i could get down there to prepare my own food. i literally lived on water and high-protein boost because it was not physically possible to access the kitchen unless mom was there.</p>
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<p>all because they dismissed everything i said. i begged for lasix to help with the water, they just decided i was obese, not edematous. i wanted to use positive energy to assist the birthing process, they said i was a bad patient (which i believe is DIRECTLY responsible for the "failure to progress" that resulted in a c/s - any time she would yell at me, i became very distressed and couldn't push).</p>
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<p>so that's the history, and this is my vent now.</p>
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<p>they say my BMI is too high to give birth in my hometown. apparently the anaesthesiologist can't work with someone whose BMI is over 40. my BMI right now is 39, and that's 36 weeks pregnant. that's NOT all excess fat. that's a good 20 lbs of baby, placenta, fluid. i see absolutely NO reason to kick me out of my hometown hospital unless there is an identified problem (pre-e, early labour, whatever).</p>
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<p>so now, after being dismissed by the OB doing the surgery (he said i was diabetic, i'm NOT. he said i had an 8 lb baby at 34w, totally ignoring the fetal assessment that said katie was at the 56th percentile), i now get to give birth in the hospital where i am NOT comfortable. which is an hour away from my family. which is where my daughter can't come visit easily, it'll be an ordeal that will likely result in her not getting to bed on time. where none of my family can be there, except my husband, and thank god for my doulas. where they deal with dozens of babies all the time, and the nurses are run ragged, and they simply cannot give the same level of care that my hometown hospital (average 2 births per week) can give. i'm familiar with the staff of my hospital. they're looking forward to meeting katie. i'd get a private room, and they don't push you out as soon as humanly possible. and my daughter could come visit with a moment's notice and not miss supper or bedtime.</p>
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<p>all because of a number on the scale that does NOT truly represent the level of fat i have in my body.</p>
 

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<p>How can they tell you what hospital you have to be at? Insurance coverage? What if you didn't have "time" to get to the other hospital and showed up at your hometown hospital? How can they refuse you?</p>
 

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Discussion Starter · #3 ·
<p>insurance is a complete non-issue. health care is funded by the province, and it would be covered regardless of where i birthed, anywhere in canada. i could hop a plane to toronto tonight, and give birth at whatever hospital i show up at, and everything would be covered.</p>
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<p>the little bit of evil in me wants to try to induce labour on my own, so that they'd be forced to deal with me locally. i'm not at all cool with doing everything on someone else's terms. it's bad enough they're scheduling me for 39w1d when i thought 38w was a perfectly acceptable compromise given my medical history (i've been having strong BH for 11 weeks already, i'm starting to dilate a little, and DD1 had to come out at 37w exactly, nobody who knows me thinks i'm going to make it to 39w!) and the doctor was a total jackass.</p>
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<p>the worst part is i know my family is not supportive. i mean they're supportive of ME, but they are super excited i have this jackass OB because he's "the best in the province". ok, so he's the expert. fine. but it's MY birth experience and i deserve some respect. my family doesn't believe in birth plans. literally, my sister said "i think the plan is get the baby out safely. full stop. end of discussion." i think birth plans are about telling the staff who you are, what's important to you, and what your goals are. sure, get the baby out safely. that's a no-brainer. but also support breastfeeding. i have mental health issues that mean that too much stimulation (especially noise) overwhelms me. you want me to be a good patient? then treat me like one.</p>
 

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<p>That SUCKS! And no, they can't know your BMI when you're pregnant. That's ridiculous. You can't truly know BMI anyway unless you weigh yourself in a special water tank. It's just BS.</p>
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<p>I'm sorry.</p>
 

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<p>So you're scheduled for a c-section then? I can't see a way to get around that. That is such a bummer. It sucks to have your birth hijacked like that - not just that you have to have another c/s, because it's so difficult to get a VBAC, but that they would dictate which care center you are required to do it at!</p>
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<p>Ugh, and your sister's comments are not helpful at all either. People just do not understand what a birth plan is. It's not about your sunshine and rainbows dreams for your perfect birth, or about unreasonable demands, it's about asserting our right to refuse non-medically necessary interventions and procedures, and to instead follow practices that will aid with bonding and breastfeeding.</p>
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<p>Well, maybe we should focus on what you can do to advocate for yourself in the situation you've been forced into. If there's nothing you can do to get out of going there for your birth, you should still have some say in the protocol they follow to make sure you have the best chance of bonding well with your baby. I'm sorry you've been labeled a "difficult" patient just for wanting a gentle birth. ARGH!</p>
 

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Discussion Starter · #6 ·
<p>i agreed to the scheduled c/s specifically because they don't do VBACs in hometown. if i thought for ONE SECOND that i wouldn't be able to birth in the local hospital, i'd have never scheduled a c/s at all, i'd try for a vbac and only go to c/s if it was an emergency or if i had pre-e again. which might happen, actually. my systolic pressure just jumped 20 points because of the stress this is giving me and i already had protein in my urine for days now.</p>
 

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<p>Well, (assuming you don't have to be induced for pre-eclampsia), it's not too late to call off the scheduled c-section and go for a VBAC.  I mean, if you are going to be in the larger hospital anyway, why not?  Just call and cancel.</p>
 

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<p>Is there a way to request to not have that same doc? I haven't ever had to do that but you always hear around my area that if there is a doc or a nurse you don't jive with that you can just request that they not be on your service. </p>
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<p>Where I deliver also has a BMI rule but it is 50. 40 seems so low to risk you out. My midwife said the BMI rule was made by the anesthesiologists at my birthing center. They think there is more risk the higher you get I guess. :(</p>
 

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<br><br><div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>soccerchic21</strong> <a href="/community/forum/thread/1287141/i-am-really-upset-right-now-warning-extremely-long#post_16137278"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a><br><br><p>Where I deliver also has a BMI rule but it is 50. 40 seems so low to risk you out. My midwife said the BMI rule was made by the anesthesiologists at my birthing center. They think there is more risk the higher you get I guess. :(</p>
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<p>This doesn't make a whole lot of sense to me.  I mean, what if there is a non-pregnant person with BMI over 40 or 50 or whatever, who requires surgery?  Would they just not perform it?</p>
 

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Discussion Starter · #10 ·
<p>i can see why a high BMI increases risk. that's certainly true of weight loss surgery, for example - the bigger the person, the more risky the procedure. my issue is mostly that the stupid BMI charts are simply not accurate for some professional athletes, bodybuilders, or pregnant women - because they don't have the same lean/fat ratio as an average person might, and the BMI charts are designed with the average person in mind. when you consider that 20+ lbs of my current weight is baby-related, not fat, i have the same body composition of someone who is smaller than i was before i got pregnant. at 36w i now weigh exactly the same as i did at about 10w pregnant, because i lost weight. my BMI was 37 before pregnancy, so that should put me well within the acceptable-risk zone in terms of how my body fat might affect anaesthesia.</p>
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<p>i don't think i can request another doctor at the city hospital. when i was there for my first birth, the doc who handled it was whatever doc was available at that moment. i had never met DD1's delivery doctor before. when push comes to shove, i don't actually care who gets the kid out safely as long as they do get her out safely.. i do care whether or not decisions are based on real data, rather than somebody's assumptions. when numerous GTTs say i'm not diabetic, it means i'm not diabetic. when 3 different fetal assessments say my kid is normal, then my kid is not dangerously large. and what i care most about is whether or not i, the person who is gestating this little miracle, am being treated with respect. maybe i'm not a "good patient". i'm certainly not an ignorant or passive patient. i do trust in people's competence but that doesn't mean i'm going to roll over and take whatever they throw at me. if i had been very loud, and very adamant, perhaps my first birth could have been managed better. and as a result, perhaps my brain would not have been buggered up for life.</p>
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<p>i haven't written up my birth plan at all now.. i was going to write an introduction to who we are, and what's important to us (for example, we're using positive imagery to relieve stress, and under NO circumstances can my baby be given cow formula, whatsoever, period - strong family history of allergy). i don't even know what to say anymore because i'm feeling so negative, it'll sound completely wrong when i type it out.</p>
 

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<br><br><div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>Pirogi</strong> <a href="/community/forum/thread/1287141/i-am-really-upset-right-now-warning-extremely-long#post_16137582"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a><br><br><br><br><div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>soccerchic21</strong> <a href="/community/forum/thread/1287141/i-am-really-upset-right-now-warning-extremely-long#post_16137278"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a><br><br><p>Where I deliver also has a BMI rule but it is 50. 40 seems so low to risk you out. My midwife said the BMI rule was made by the anesthesiologists at my birthing center. They think there is more risk the higher you get I guess. :(</p>
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<p>This doesn't make a whole lot of sense to me.  I mean, what if there is a non-pregnant person with BMI over 40 or 50 or whatever, who requires surgery?  Would they just not perform it?</p>
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<p>Preaching to the choir here. I don't get it. She said the reasoning where I am giving birth is that it is just a small birthing center and if there were serious complications there isn't a trauma unit or trauma area? Either way how bad can it get and to me an OR is an OR.<br>
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Discussion Starter · #12 ·
<p>UPDATE!</p>
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<p>well, i talked to my regular pregnancy doctor about dr.jackass (she giggled when i said that.. it just slipped out). she shook her head when i mentioned the diabetes thing, the 8 lb baby thing.. she said "no, you're not diabetic. and your fetal assessment here says your baby is normal, fluid is normal. you're just measuring really big." THANK YOU.</p>
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<p>apparently, the reason why they reject people with a BMI of 40+ is that if something goes wrong, it's very difficult to intubate a person whose neck is fat beyond a certain level. the throat collapses too easily. such would be the case with my husband for sure. but it's not true of me - i have LESS neck fat than i did when they easily intubated me for my gallbladder! but the policy does not distinguish between pregnant and non-pregnant patients, it is absolute. so it sucks, but at least i have an explanation. they can better handle high-risk patients (including morbidly obese patients) at a hospital with a trauma centre. end of story. if my husband showed up at our local hospital and needed surgery, they'd send him by ambulance to the city hospital after stabilizing him as best they possibly could.</p>
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<p>i told dr.nicelady that i did not want to spend one MINUTE in the city hospital longer than medically necessary. i told her i had a horrific birth there with DD1 and that my entire family is in Smallville. she completely agreed that it was probably in my best interest to be transferred back to Smallville for recovery as soon as a) we're both medically stable and b) there's a bed available. given that Smallville has 2 births a week on average, and 6 beds available (i think) i should be just fine! she'll happily transfer care from City and says that on average, c/s patients are pushed out of City in 2 days whereas in Smallville they stay an average of 4 days unless the patient is doing really well and wants earlier discharge. the care is also close to 1:1 as far as patient:nurse ratio is concerned, it's quieter, and with my mental health issues (severe anxiety when there's too much going on, especially noise) i am just flat out better off in Smallville.</p>
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<p>so, hooray! unless there is a clear medical reason for me to stay in City, i'll most likely birth on Thursday morning and come back to Smallville by friday morning! which means my daughter can come see me straight away after school on friday, and visit as much as she wants on saturday/sunday. my oma can come whenever she wants. ditto my parents. and with the exception of thursday, DD1's dinner and bedtime routine need not be disrupted.</p>
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<p>i can't tell you how relieved i am!</p>
 

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<p>So glad that things are working out for you!  And I agree, the policy re obesity as measured by BMI during pregnancy is ridiculous.  Then again, I feel that way about a lot of policies surrounding obstetric care.  :)</p>
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<p>And I think it's really great that you have such a strong family support for you.  I think a lot of women miss out on that these days.</p>
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<p>Good luck with your birth!</p>
 

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Discussion Starter · #14 ·
<p>yeah, i'm pretty lucky. i'm very much a "it takes a village" person, and i've got a good village. the best, in fact. for the birth itself i'm getting two doulas - one that was at my first birth, and one who's in training but i knew her in university. my husband has been unwavering in his support! my parents are wonderful, when DD1 was born i was a single parent. she came whenever she could to help with post-C/S wound care and baby cuddling. my dad took DD1's laundry almost daily for several months. i was wayyy below the poverty line, and DD1 never ever wanted for anything. she had me, mama milk, an extended family who loved her. and DH has been amazing throughout this (rather challenging) pregnancy. i want them ALL nearby. if they choose to visit sporadically, that's fine, but i don't want it to be because i'm too far away. i want them to have the option of popping by whenever they want. i know they will.</p>
 

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Discussion Starter · #15 ·
<p>oy.. as supportive as they are in many ways.. they sure aren't like me in many ways! i told my mom that we'd be birthing at City hospital and getting transferred to Smallville when we're stable. so, probably in the city thursday, back friday, home sunday or monday. she was shocked, and couldn't understand why it made any difference. she figured the city hospital isn't so far away.. and in some ways that's true but it's a HUGE difference in terms of how it will affect our stress level. i'd rather be in a peaceful place close to my family. my parents might bring DD1 once a day to visit, or less, who knows.. but if daddy comes, it's an all day excursion whereas if i'm in town, he can pop in, go home and take a nap, come back later, run to get me something i forgot, etc..</p>
 

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<p>I agree (from experience!) that being closer to home is much, much better than being an hour away if it is at all possible.  I was an hour away with Micah and while it isn't impossible, it would have been much easier for my husband if I had been in the local hospital 5 minutes away.</p>
 
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