I still haven’t shared the full story of losing Isaac and his subsequent birth, but I wanted to talk about the missed signs that something had gone wrong in my pregnancy. Of course, I have no way of knowing whether Isaac could have been saved – he did, after all, have a knot in his cord. I also do know that it is normal to want to blame someone when you lose a baby or anyone for that matter. However, in our case, there were concrete signs that all was not well with my pregnancy. Perhaps the other doctors I have spoken to are just humoring the grieving mother, but it does not seem I am entirely alone in thinking that my doctor failed us in this case.
I should start at the beginning. I was a high-risk pregnancy from the start. I am the lucky owner of two defective blood clotting genes that can be triggered by the massively increased estrogen associated with pregnancy. To prevent a dangerous clot from harming either me or Isaac, I began daily injections of blood thinners as soon as I was confirmed pregnant. I was also sent to a perinatologist after my first OB appointment. This is the first point that something was off. I didn’t realize it until I was in the hospital after losing Isaac, but I should have been seeing the perinatologist regularly throughout my pregnancy. I saw one of the doctors at my first visit for a discussion, and he simply made recommendations to my OB (of which I constantly had to remind him). Another one of the perinatologists came in to tell us everything was normal at our 28-week growth scan and told us he thought the other doctor was being overly cautious with my care. He and my OB had told us that it was fine to wait until 33 weeks (rather than 32) for the first weekly non-stress test. That’s a test that could have shown Isaac was distressed, that could have shown us something was wrong. I learned at the hospital that I should have been regularly overseen by a high-risk specialist.
At 29.5 weeks, I saw my OB. My OB isn’t just a random doctor I found online. He is the doctor that delivered me and my younger sister. He is a very capable doctor. I had seen a different doctor at the practice 3 weeks prior to this appointment and had found myself questioning my choice of doctor briefly when I realized the other doctor seemed to pay a bit more attention to my situation. At this visit, however, it felt like something was off. The first warning was that after gaining weight at a healthy rate throughout my pregnancy, I had gained 9 pounds in 3 weeks. I hadn’t changed anything. I was just quite swollen. My cheeks had taken on a chipmunk appearance, and my boney ankles had been replaced with cankles. When the nurse came in, she took my blood pressure. She even asked me if I had a history of elevated blood pressure. I had not. In fact, I’d never had elevated blood pressure. The nurse suggested that I was nervous and that must have triggered it. I did tell her that I was not at all nervous, but she didn’t suggest that they try to take my blood pressure again.
The doctor came in and told me that I had passed my gestational diabetes test and that I was the least anemic patient in the practice (at least I had that going for me?). He listened to Isaac’s heartbeat (I wish I had known that was the last time I would hear it). Everything was fine. He asked how often he was seeing me at the moment, and, upon noticing the previous doctor had picked 3 weeks, he suggested I return in 3 weeks. I explained that I was planning to be out of town and that he had previously and repeatedly given us the all clear for that week. I suggested I would be home in 2 weeks (for a high-risk pregnancy, in particular, that would have been normal) and in 4 weeks, unless that was a problem. He said, “See you in 4 weeks!” As he sat me up, I told him I had some questions. I asked him if I should be concerned about my “elevated blood pressure” (I didn’t know what it was until I was in the hospital). I also told him that I had been seeing spots and noticed significant increases in my swelling. I asked if that was normal. “Totally normal,” he said as he patted me on the back and ushered me out the door. I went on to ignore these symptoms for too long, having been told by a medical professional that they were normal.
I learned later that my blood pressure was such that they should have retested me in 4 hours to see if it remained elevated. If it had remained where it was, even in the absence of protein in my urine, I would have met the criteria for diagnosis preeclampsia. I also learned that my out of character weight gain should have been a red flag. It was so clear that I was retaining too much fluid. Further, the swelling and seeing spots were two standard symptoms on the checklist for preeclampsia diagnosis.
To the perinatologist, who suggested that his colleague was overly cautious with my care: you were wrong. To the OB, who told me my symptoms were normal: you were wrong. The problem seems to be that these doctors see TONS of patients around here. I became just another statistic to them. It’s not just their fault, I should have stood up for myself. My doctors were making me feel like a crazy pregnant woman for asking questions when really I was just a concerned mother-to-be.
There is a clear lesson to be learned here. If you have doubts about your doctor, change doctors. Insist that your questions be answered. We, as human beings, are not just statistics. If you don’t stand up for yourself, you could end up like me, full of “what ifs” and other regrets.