People who have dealt with frightening or sad reproduction-related matters should know that the following post is about pregnancy. It has a happy ending and a Rick Santorum-directed tirade, but there’s stressful stuff in the middle. Follow me behind the jump if you want to read more.
Two weeks ago, I went to the doctor for a prenatal checkup. If you have never experienced one of these, they are, generally speaking, straightforward, short, and non-invasive - one gets weighed, pees in a cup, gets her blood pressure taken, has an external exam, hears the fetus’ heartbeat, gets asked if she or her partner have any questions, and that’s it. The wait tends to take longer than the appointment.
The external exam is belly-focused - the doctor palpates a bit and then takes out a tape measure to check the distance, in centimeters, between the woman’s pubic bone and the top of her uterus. This measurement is called the fundal height (fundus = top of the uterus). In a “dang, Nature, you’re cool” coincidence, the fundal height should match the number of weeks a woman is pregnant - 8 cm at 8 weeks, 12 at 12, and so on.
At my 27 week checkup, I was measuring 24 or 25 centimeters. Dr. Google* tells me that medical professionals generally consider a 3 cm deviation in either direction to be the threshold for a potential problem. Measuring too large can indicate things like gestational diabetes or, hey, surprise - there’s another fetus in there! Measuring too small can suggest problems with the fetus’ kidneys, a dangerous lack of amniotic fluid, a malfunctioning placenta, or some seriously frightening business known as intrauterine growth restriction, which can lead to a host of complications for the pregnant woman and her fetus. Most of these complications can be addressed with monitoring and, in some cases, early delivery, but some have serious, long-term implications.
My doctor told Dave and me to do our best not to worry, but that I should have an ultrasound to rule out any problems. We had to wait an unpleasant week and a half before I could get in at the assessment center at the hospital.** Long story short - everything is okay. There is no clear reason why I’m measuring small. Baby’s kidneys are fine. Fluid’s fine. Placenta’s fine. Baby is in the 57th percentile for size - 2 lbs, 15 oz as of Wednesday morning. Baby is practice breathing and his/her heart is beating away, all systems go. The nurse who performed the ultrasound suggested that perhaps my yoga practice has given me abs that are throwing off the doctor’s tape measure or that baby had positioned him/herself in a way that made me measure small. Also, those of you who have met me may have noticed that I’m not exactly an amazon, another possible cause.
This morning, Rick Santorum went on Face the Nation and repeated his belief that certain types of free prenatal screening should not be offered by the government because they “[end] up in more abortions.” He specifically referred to amniocentesis, but other types of screening, including the ultrasound I had this week, can lead to diagnoses of serious birth defects that, to use the delicate phrase employed in the medical profession, “are not compatible with life.” From these procedures, women and their partners may learn information that may lead them to choose to end a pregnancy. But if they are barred from having these procedures because they lack the means to pay for them and a social safety net to offer them, they will not know. They may welcome a baby who will not survive more than a few days. They may have a child who spends more time in hospitals than out of them, draining the family financially and emotionally. They may have a baby who is perfectly healthy and thriving, but will have to wait countless stressful and uncertain weeks to discover that.
My husband and I spent nine days dealing with the outside chance that there might be something wrong with the Bloomling. We lost sleep; I cried; he did the hard work of being the calm one. A 30 minute procedure, paid for by our health insurance, let us know that we don’t have to worry. It has let us rest, exercise, eat properly, and happily gather things for a baby who will join us in about 11 weeks.
If we were dependent on government services in Rick Santorum’s world, we still would not know. I would have measured small - if I had been measured at all, as that is another type of prenatal screening that can indicate birth defects - and been left with the choice to either wait 13 more weeks to find out why or pay out of my own pocket to get some peace of mind. If could not afford the latter, I would have no choice at all. The mere thought of being left to contend with such uncertainty is terrifying.
If Dave and I were poor and living in Rick Santorum’s world, we would have no idea what we should be preparing for, to stop us from making a decision that Santorum finds objectionable, a decision that, really, no one wants to make in the first place. I would still be losing sleep and counting kicks, waiting for either the worst or the best. How is this the best option? How does this support families, mothers, and children, as Santorum likes to loudly assert that we should?
* - I know, I know, but I’m a librarian. I know what I’m doing.
** - Living with Pregnant Ladies Protip, “Wisdom Gained by Experience” Division: Telling a pregnant woman that she looks small/appears not to have gained much weight is not a compliment under any circumstances. In the nine days between my doctor’s appointment and the hospital, I had two people praise my smallness. I know that they meant well, but it brought my heart up into my throat both times. Alternatively, if you are foolishly driven to make some remark, be prepared for her to either start avoiding your or freak out and lay out some heavy medical information. But you don’t want that, right? No one wants that. Talk about the weather instead.
