I walked into an intellectual fire-fight today. I went to my normal OB appointment at 30 weeks. My regular OB surprised me with an immediate referral to a highly trained High Risk Pregnancy Specialist. (I got to a major HMO in Washington DC, so there is tons of procedure to get a referral. I was told 10 weeks ago that there was no way I could see a specialist before 32 weeks because before then it was too early to track my specific placenta issues via ultrasound).
Jon had taken our kids to the local Mall to entertain them during my OB appointment. All the sudden, I'm alone in the ultrasound room of the super Guru who has the power to tell me that things look bad. Weirdly enough, I have my first ultrasound with an extra cheerful and chatty tech. It was such a change of pace. My ultrasound takes 50 minutes. She talks to me comfortably the whole time. Then she takes breaks every so often to tell me things look really good.
I'm coming from 2 months of massive restrictions on this pregnancy--so I don't really believe her optimism that things look good. I feel like she's just being nice to me. Still, I'm really enjoying not sitting in fearful silence for an hour wondering what the frowns and the squints and the multiple shots of the same image mean for me and my youngest child.
So then the Guru comes in. This is my third time meeting with him. I met him for the first time while I was pregnant with my fifth child, Abigail Clare. I met him a second time for a consult after Leo's Death last November. This is my first time seeing him with this current pregnancy with Matthew. So I know the Guru--but I don't know him well. He's not one of my regular OB doctors.
He sits down next to the cheerful tech. She does a live viewing with him for more than 10 minutes. He tells me things look excellent.
So it's sort of a shock to me. Twice, my regular trusted OB told me absolutely that this pregnancy was going to end in a miscarriage. Once we got over that hurdle, since the standard ultrasound at 18 weeks, it's been "The baby looks great, but the placenta looks terrible. You could have major problems." There has been wave after wave of restrictions and trouble-shooting advice that's come down during every OB appointment.
So now, the Guru is looking at live shots of my uterus and saying "There are absolutely no problems here. There are 3 major risk factors for bad placenta problems and you have zero of them." So I'm trying to digest his diagnosis that there is an 85% to 90% chance that I can walk out of a sixth c-section with zero complications. Zero!
He tells me he's cancelling all the precautionary orders for my c-section surgery in 9 weeks. He's not going to ask that there is a special back-up surgeon on call. He's not going to have blood products pre-thawed in my surgery room. I'm trying to resist the urge to argue with him. "Can't we even have extra blood on hand? Like I'm A Negative. I'd feel better if we had something ready in case I need some extra help during surgery." I tell myself, "Just enjoy this. This guy is the Guru. If he really thinks you're going to be safe in surgery, take that in rather than immediately start to doubt it."
Here comes the crazy part. In the middle of this incredibly positive High Risk Pregnancy Visit, the same doctor starts freaking out about a possible uterine rupture with a future pregnancy. He tells me "Get a Tubal Ligation!" during this c-section. I told him simply, "I'm Catholic. I can't do that." The Protestant Ultrasound Tech agrees, "She's Catholic. That's option isn't on the table."
Somehow having two women tell him that this is against the Catholic Faith sets the Guru off. He starts this 10 minute tirade at me. He says "I'm a Catholic! There is Catholic and then there is Catholic! You've got to make your own decisions when it's Life and Death."
This Guru is highly agitated. I'm laying down calmly on the table with an ultrasound wand still stuck on me. I start talking in a calm, smooth voice. I say "Look I'm 40. I'm 100% comfortable with not having another baby. I respect you opinion that a seventh c-section might be dangerous. I just can't sign up for a tubal ligation."
This conversation with the Guru goes no where. He's so upset. He says "What happens if there is just an 'accident' with your tubes during the c-section?" I ask myself, "Am I in the middle of a Grey's Anatomy Script?"
So then I change the subject back to this current sixth c-section surgery. We go over all the details again about how the surgery outcomes for this current pregnancy look so positive. The three of us chat for another 10 minutes.
Afterwards, I ask him about the follow-up procedure. "When do you need to see you again?"
The Guru tells me happily, "I'm signing off on all of your paperwork. You never need to see me again during this pregnancy!"
I say "Great!"
The Guru says "In fact, I'd really like to never see you again. I'm serious, no seventh pregnancy. I grew up in a Catholic family. My Mom is a Devout Catholic. In fact. she's a former midwife. We are on opposite sides of the spectrum. She has no idea what I do all day. I just tell her, "I had an interesting consult today." She knows nothing about what I do in my practice."
(At this point, the ultrasound tech starts laughing).
"There are Catholics and they have these rules. But they don't know reality. So I just don't tell them. You should take a page out of that playbook and just not tell them either."
I'm completely silent. I'm sort of stunned that all this personal stuff comes roaring out of him in the middle of a medical appointment. The whole "My Mother doesn't approve of my work, so I don't tell her the truth" felt like such a non-sequitur. Then I reminded myself that this is what happens when I show up places with a giant pregnant belly. People just volunteer their inner most details.
Then I'm trying to figure out the take-away advice from his speech. Does the Guru want me to just lie to my priest and get a tubal ligation anyway? Because it's not like my local parish priest is forcing me to risk death in order to have another baby. I'm the one trying to figure out an ethical decision, for myself!
I stayed completely silent and walked out of there.
Then I went downstairs to the Lab to start my 1 hour glucose test. I tried to call Jon, but there was no answer on his cellphone. I took my number from the Receptionist Table and waited to be called back to the Lab Tech. While I waited, I could feel myself starting to shake with a pre-panic attack. Ugh! I hate panic attacks. I hate panic attacks, especially when they are in public places in front of total strangers.
I'm trying to calm myself down by saying "Things are fine. The baby is fine. You are fine. You are totally fine for the next 9 weeks. You are even cleared to have sex now, so there are no immediate worries."
Even as I was reminding myself to stay in the moment, I felt this strong fear. I didn't know what I was supposed to do after the baby was born. I'm looking at years until I hit menopause. If it was seriously life-threatening to get pregnant, I knew that sterilization and a back-up abortion weren't an option. I knew that 10 years of abstinence wasn't going to happen. I've also had enough real-life experiences with NFP to know that I wasn't feeling a 100% confident I could completely avoid pregnancy for multiple years if my life really depended upon it.
I felt trapped. Trapped means that I get emotional asthma and stop being able to breath comfortably.
Somehow, I survived another 3 hours and got home without an actual panic attack. My scientific husband started looking up actual Medical Journals online and soothed himself by reading the real data behind uterine rupture risks.
I started looking up the church teachings. I found this document
from the Vatican written by Pope Benedict and approved by Saint John Paul II. Somehow, just knowing that my Catholic Church has already studied the issue and written an official guideline calmed my soul. I'm not just hanging out here having to guess "What would Jesus do?"
As I suspected, my Catholic doctor is wrong. The church makes a line between procedures necessary to immediately save my life during a c-section, and medical procedures that "might" help save my life in the future. I have no guilt about losing my uterus to complications from surgery. But I can't sign up for sterilization in order to safeguard against losing my uterus from complications in a future pregnancy.
This is my second time running into bad advice from a Catholic doctor. My first OB, who actually did a fantastic job during my pregnancy, encouraged me to use birth control at my 6 week post-natal check up even though it was against my Faith. She used the almost same line "Well, there are Catholics and then there are Catholics. You've got to decide, what kind of Catholic are you?"
I've got to say, that I've had more respect for my religious views as a Catholic from my Protestant and Jewish OBs, then I've had now with two self-professed Catholic OBs. When someone is not Catholic, they seem to get it. When an OB is a Catholic, but one who isn't entirely consistent with the Church's Teachings, I feel like there is all this extra pressure to bend the rules. "Don't be one of those nut jobs who obey everything the Vatican puts out. Live in the real world with me."
I am a Catholic who appreciates Modern Medicine. I'm not a Christian Scientist. I'm not a Jehovah's Witness. I'm not on some crazy death wish to die as a martyr in child birth. I'm quite happy to live my little life and stay-around a long time to watch my three youngest kids, ages 4, 2 and 0, graduate from college.
We live in a crazy culture. The hardest part for me, is that it's a struggle to get solid, medical facts. There are a lot of opinions. There is a lot of hysteria. There is little data, facts, and options. Honestly, I feel like I have to homeschool myself in Medical School just to be able to make informed decisions about my own medical care.
As a pain-in-then neck that it is to be Catholic somedays, I'm really grateful for my church. My church is wise and caring. I'm glad that I don't have to homeschool myself in spirituality and ethics too. The real issue behind sterilization is abortion. I know of so many regular people in my life who had sterilization procedures that didn't work. I don't think that a Catholic couple, like myself and my husband, who have worked this hard for twelve years to get six healthy children into the world should face having an abortion as a back-up birth control plan.
So I'm not consenting to a sterilization in October. I'm not consenting to a back-up abortion. I'm going to look around for help. I'm going to get a second medical opinion. I'm encouraging my husband to feed his inner Science Geek and read even more esoteric medical journal studies. I'm going to talk to a few trusted people to find the balance between prudence and obedience in my Faith. Also, I'm keeping my assigned HMO High Risk Pregnancy Doctor in the loop about my decision-making process, because that's what responsible patients do.
It's not always comfortable to be a Catholic receiving medical care inside the USA. Sometimes, I wish I could just move to Italy during my pregnancies. (Gelato and Catholic Medical Care, heaven right?) Yet the body and the soul go together. St. John Paul the Second, reassures me that Faith and Reason fit together too!