Smoking while pregnant!

WARNING!!!! RANT AHEAD! (But it is against the NHS, no one personally. )
Also - WAY too much information - - -

I personally hope that the U.K. doesn't change its attitude about pregnancy being a normal course of events, and not a sickness. I think overall, the U.K.'s system is better than the U.S.'s just based on this alone.

Have you read Naomi Wolf's Misconceptions? It is ALL about the US system being over medical about the whole process - basically exactly what you're saying. I read it and was thankful that I was giving birth in England. Really - it is a fantastic book and I'd recommend it to every pregnant woman - but only when they aren't feeling too emotional!

So yeah - I was excited about giving birth in England, but then I gave birth in England, and wished I had been in the US. Both systems have their benefits. Yes it was nice to have a hands-free experience most of the time - but sometimes some intervention would have been nice. I had sever morning sickness for 22 weeks. Had I been in the US I would have received medication (that is safe for the baby) to help me. But as it was, I was so sick that I could not eat anything but white bread and potatoes - which wasn't exactly the healthiest option. I'd have been better served with some intervention. I also was border-line pre-eclamptic for the 5 weeks before my delivery. While I was "monitored" to be safe, they only insisted on seeing me once a week. By the time I went into labor my blood pressure skyrocketed so high and my platelets were so low that I was minutes away from an emergency c-section - fortunately Philip decided to be fast. As for my "after care" - well, this is where the NHS' system of "hands-free" and I really, REALLY fall out. I tore naturally (as I wanted) and got a lot of stitches in the hospital. I also caught an infection. The stitches they used dissolved in 3 days, but because of the infection I was nowhere near being healed. They waited 5 days before putting me on anti-biotics, saying that they'd prefer me to heal naturally. 5 days later (and a lot of calls to the midwife) I was finally put on meds because I couldn't sit. THey didn't give me enough. After my course my infection was Still there. Weeks pass and my wounds are still open, but they refuse point blankly to re-do the stitches so I can heal properly, saying they want them to heal naturally. They also said "Why would we bother fixing you if you are just going to have kids again? Wait until you're done having babies and then we'll sew you back up properly". They could not have been ruder or more instnsitive to me. I even had a doctor - the big fancy specialist no less - say that they wouldn't perform the surgery because they couldn't justify the cost. So here I am, 5 months later, still sore, still unable to have sex, still really suffering because they are refusing to treat me. Why? Because I'll just have more babies, so why would they bother?  :\\\'( Nevermind that in order to have another baby at this point I'd have to adopt...

*phew* How about *that* for a rant!

I guess my point is this: both systems have their advantages. I loved the midwife care here, the home visits, the lack of paranoia. I do think US women get so much scare-mongering in their direction that it causes more stress than is helpful. I like the UK for that. But, in the US you'll get monitored like a hawk. Sure it is because they don't want to get sued... but I wouldn't have minded. In both countries it is ALL about the money. The UK doesn't want to spend it, and that is why they go the natural way. I had faith in the UK system that I'd get hands-off care until I needed intervention - but when I needed intervention they didn't give a damn, and made me feel like I was being vain. I am now in the position of having to wait until I get to the US and am facing reconstructive surgery because I have been refused care here COUNTLESS times. Despite the fact that my GP agrees with me! As did my midwife! But in order to get a 2nd opinion I'd have to travel way way far away, and have to fight my corener again and try to justify to them why I deserve care... and I don't have it in me. I'll wait 2 months until I'm in the US and get it there.

I don't intend to start a fight here, and I don't know why I went off like that - I guess it was just a rant waiting to happen towards the lovely NHS system that I adore so much.  :\\\'( I suppose I haven't said anything because I don't want to scare anyone. I *know* that I could have received really good care here. I *know* that it depends on the people you see, and that other people in my exact same situation would have received the intervention they needed. I *know* mine was a bad experience, but it doesn't mean the entire system is wrong, nor does it mean my case is the norm. But - - - it's my body, I feel like it has been mistreated, and I *personally* hated the experience so I won't be repeating it.


I'm SO sorry for going so massively off-topic here - - - - but I do get riled at the whole "natural" approach sometimes. Yes it is awesome, yes it has its place - but YES sometimes it isn't the way to go.

I agree with Rebekah that viewing pregnancy as an illness requiring all manner of invasive and unecessary interventions is a bad part of US medical care. Doctors do seem to make it all quite stressful and fraught with danger, when in reality it's a perfectly natural and rather unremarkable function of the female body. I think the UK system has a good take on it all. (Before any mommies become outraged at the word 'unremarkable', I mean it only in the sense that it's something the body is perfectly capable of doing on its own...like sneezing. Gad, you only have to watch Trisha for a week to see how unremarkable it is!) 

    <heres another NHS rant sorry ahead of time...>   
You know its funny because I have now seen both the US Health system at work and now the UK one as I had one child in the US and the second one most recently here in the UK and to be perfectly honest if we decide to ever have any other children I would want it to be done in the US.

   I felt like I was actually better taken care of like while I was in labor and was asked what kind of method I wanted for pain and the midwife kept suggesting I was doing fine naturally and when the pains started getting really nasty <ladies you know what Im talking about  > and told the midwife I wanted an epidural like I did with my first child and she said I wasnt far enough along for one, she kept telling me I was only dialiated to 4 and I KNEW that had to be wrong because I remembered what it felt like when I had my son because I was 4 when I drove myself home from the doctors office to pack my bag for the hospital  And so after an hour I started getting adament that I wanted that epidural and another midwife came in and looked at my chart while the one who told me I wasnt far enough along for one was doing something else in the room and the other read on my chart out loud that I was dialiated to 8 an hour ago when the other said I was only 4!  Needless to say I wasnt too happy with her, this is supposed to be someone you can trust after all and she deliberatly lied, I dont get it and I let it be known I wasnt happy when they sent off and  the man finally came in to give me the epidural and it hurt like &*$£!!!!  The man asked me if it hurt and I said yes, no point in trying to be nice about it when it did and he didnt make me feel any better when he said he hardly gave epidurals often and unlike in the US this epidural didnt take immediate effect and I was still having major pains and was wondering what was going on.

   They called for him to come back in and it was then I was informed that they only give partial doeses at first and if you need more they administer that which he did but was basically too late.

   The midwide even had the balls to say to me afterwards ''I guess you dont like me too much now huh? Even though you got a great result from it.''  And I just looked at her smiled and agreed. 

    And I too had to have stitches and havent healed properly but its only been nearly four weeks for me and I just feel like it's not going to heal like it should unlike when I was in the US and had stitches as well and had no problems at all. 

   And right at the end of my pregnancy I left a bit alone because while in the US they were seeing more all the time and checking to see if I had dialiated any and whereas all I got here was how are you feeling, any pains yet? And how is our system compared to the US? <I got that question alot> Needless to say I usually avoided answering it.  And the thing is my first child was delivered by a midwife in the US, and I had loved it because it felt more personal and easier to talk to her about how I felt and everything, but here well lets just say it's a totally different change.

   And Im sure there are people out there with some nice experiences with the NHS, and Im not putting it down per say just telling you my story and how I felt that's all.

   <And to Marlespo, I had the same problem with morning sickness and no one helped me there either, so I just took what my doctor had told me with my first child and took motion sickness tablets.>

  <Rant Over and sorry I followed Marlespo in going off topic>   

Marles and Little,

I have repeatedly heard bad stories about the NHS and having kids here. If I ever have them, I'll go with the States. For some reason, the NHS seems overly paranoid about painkillers--I know that from having a joint disease.

Given where you're both hurting (and without getting too detailed), I don't know if this would help, but vitamin E capsules (not cream, the actual capsules) are supposed to help with healing. I've used vitamin E capsules on cuts that normally would have scarred, and it's hastened the healing process. If you can find them here, maybe they could help. Puncture the capsule, squeeze the gel out, and apply (I'm thinking of a second career writing instructions on drugstore products). Worth a try?

Suzanne

you owe it to that child to give it the best possible physical start he or she could have. You can't (or shouldn't, anyway) continue to smoke/drink/carry on the same lifestyle as before, given that any drug that goes into your system (nicotine, alcohol, etc.) goes into the fetus's pretty directly, via shared blood.

Well said, Suzanne.  Regardless of whether you're pregnant under US or UK medical care, the bottom line is, when you're pregnant, you shouldn't be doing anything to risk your baby's health, period.

I agree with Rebekah that viewing pregnancy as an illness requiring all manner of invasive and unecessary interventions is a bad part of US medical care. Doctors do seem to make it all quite stressful and fraught with danger, when in reality it's a perfectly natural and rather unremarkable function of the female body.

My doctors in the US never made my pregnancies or births seem stressful or fraught with danger at all. I don't feel I was treated as if I had an illness either. I was quite happy with the care I received. Maybe it's just a matter of what doctors you go to. Mine were both great.

Maybe it's just a matter of what doctors you go to. Mine were both great.

There's a thought! 

I had to practically beg my doctor to intervene in anything!

See my long post on this, I started a new thread.

Thanks for the suggestion Suzanne, my midwife suggested the same thing as well - that and lavendar. I lived in lavendar baths for the first 8 weeks (well, when I could!) - - unfortunately none of it really helped... the problem is the way I healed. It is as if you slit your forearm deeply with a knife that needed stitces, got an infection, and just let nature take its course rather than sewing it back up. The result: very tender, very messed up, nothing anything but surgery will fix.  :\\\'( And Little_evo - THANK YOU for posting your story as well, it is so nice to know someone else is in your boat.

Marlespo,

That is awful what you've had to endure with your tear.  (Btw, I also endured severe "morning sickness, until my 24th week, without the help of meds.  That was a singularly sucky experience like none I've ever known, lol.)  I wish yours was a rare experience, but my sister, who just delivered her first 8 weeks ago, also sustained a second degree tear.  She wanted to get it fixed, but was told by her doctor the same thing as you were.  "Wait till your done having kids, it'll just tear again."  She's in Texas, and I'm in Pennsylania.  We've both had lots of individual experiences with the OB system here in the U.S.  Basically, after all my research, and after reading literally thousands of individual accounts, and reading up on the topic, and now a nursing student working towards an R.N.--it's not just the opinion of a few fanataics that the U.S.'s system is too medicalized--there are countless women and many organizations out there testifying to harrowing experiences due to this very tendency of doctors to push unwanted procedures onto their patients. 

Someone said doctors don't push epidurals on women.  Know what, go and spend months of reading up on endless accounts of women who have been threatened, bullied, and even forced into epidurals and c-sections.  Haven't you heard of the well-publicized case of the young 26-year old woman, who was diagnosed with cancer while 24 weeks pregnant, and court-ordered to do a c-section?  It was the OB doctors and the hospital which took it to court, even though her doctors (the ones treating her for the cancer) testified that she most likely wouldn't survive the surgery.  Well, she didn't, and neither did her baby.  You can go to www.Ican.org and read up on other accounts of women who've literally been tied down and forced to go under the knife.  You'll think I'm insane, but that's really the case!

I don't doubt the U.K. has its flaws, and can err and does err on the side of too little too late.  However, please be aware that the U.S.'s philosophy of too much too soon is as dangerous, and perhaps even more so, since the body of evidence suggests that labor and delivery more often then not turn out fine in the absence of intervention.  Yet, every time intervention is introduced, whether it be I.V. fluids, A.R.O.M. (artificial rupture of membranes), narcotics, epidural, forced pushing in the lithotomy position, induction or augmentation of pitocin--all of these carry very serious risks, which are largely ignored because the medical community is under the delusion that whatver problem they cause by initially interferring, can ultimately be fixed by the most radical of interventions--c-section. 

Case-in-point: a young woman I know, Dina.  Induced at 39 weeks, due to PIH (Pregnancy induced hypertension).  Her doctor first gave her Cytotec, a drug which is not approved for such use by its manufacturer, and even includes a label warning against its use for inductions.  But, because it is roughly half the cost of Cervidil, another cervical ripening agent, it's become very popular.  The dangers of this drug are that it can cause tetanic contractions (where they are super long, very intense, with little or no break in between, thereby stressing the baby and reducing oxygenation).  Once administered, it cannot be removed--only counteracted by other drugs, which may or may not work.  My friend first endured intense contractions from the Cytotec for a day; then, on day two, Pitocin was introduced.  The dosage was adjusted throughout the day trying to get optimal results.  Next, her membranes were ruptured, and the baby lost it's buoyancy in utero, causing her to come to rest in an awkward position, leading to back labor for Dina.  Third day--continuation of Pitocin, and it had been 72 hours since she'd been "allowed" to eat or drink (remember, in most U.S. hospitals, no eating or drinking is permitted).  At the end of day 3, she was finally permitted to receive the epidural.  Day four of the induction--yes FOUR--after she'd finally finished dilating and pushed for 1 hour, her doctor decided she was not going to be able to deliver vaginally and sectioned her. 

She was fortunate that she did not suffer massive hemmorhage due to an extremely tired uterus not being able to contract down well enough after labor and major surgery.  Did she get a healthy baby?  Yes, but she also got a shitty labor experience.  I'm so tired of hearing that thrown at people like my friend.  "Well, you got a healthy baby, right?"

Here's what I think about that:
http://www.birthlove.com/free/meghan.html

I made a choice to have my baby in a birth center with midwives, because of out of literally more than 30 women I've known who've had babies in the last several years, only a handful have been able to avoid uncomfortable, painful, and unwanted procedures in the hospital environment.  Anyone who thinks that many, or even most, doctors here do not try to manipulate or coerce their patients into complying with things such as I.V.'s and continuous monitoring, despite a lack of medical indication,simply doesn't know the situation for what it truly is.  It is not contained in just one region of the U.S., or confined to small pockets throughout.  It's the mainstream.  Put simply, women are psychologically taught on many levels that their bodies are fragile, broken, and not trustworthy. 

I know I'll get lots of stories about individual experiences with nice doctors and protests about how great our technology is.  But folks, I'm speaking as a nursing student, and someone who has been studying this situation for years.  The truth is, if you are one of those women who does not desire the medicalized, interventive approach, due to concerns over the accompanying risks, you are going to find it very, very difficult to find a doctor who is truly supportive, as well as a hospital with staff who won't interfere with your wishes.  Because, plain and simple, even if you do have a great doctor, he or she doesn't even show up until it's time to push.  The rest of labor is handled by nurses and hospital staff, and you are constrained to follow whatever rules they put upon you.

If you want all the interventions, great.  Good luck to you and your perineum.  Hope your baby doesn't get induced because a doctor wants Labor Day weekend off and that's the baby's due date, so you get a premature kid.  That crap is constantly happening here, every day.  Why is the U.S.'s rate of infant mortality 26th amoung industrialized, western nations??  Because its OB mentality is out of touch with reality, and that reality is the more they interfere, the more complications, infections, prematurity, unnecessary injuries, and deaths occur. 

IF doctors practiced evidence-based medicine, rather than litigous-savvy manuevering, then we would see a decline in many iatrogenic injuries and deaths.  But, that's a pretty big if, and I don't see the trend changing anytime soon in the U.S.

Rebekah

P.S.  Saf, Naomi Wolf is a pampered, whiny, intellectually lazy yahoo.  She bashed the medical system on one hand, but expected the same system to give her, personally, what she wanted.  Which is I don't know what, since she also bashed the natural childbirth movement at the same time.  And after such a poor outcome the first go 'round, she climbs right back about the Obstetric Express to make the same idiotic choices all over again.  Appears to me, she isn't very bright and doesn't learn well from her mistakes.  And like you, I think her representation of herself as just another "normal" mother is outlandish.   Proof positive she's lost touch with the real world. 

That was a really well put post, Rebekah... and just further proof that both systems really need a reality check. The things you mention about the US system are the things I fear: and hopefully my knowledge will help me towards a healthier delivery. But on the same hand, the too little too late mentality of the UK scares me as well. Sometimes I wonder if it's better to do it like a kitten, and have babies in a box in the corner...

Thanks, Marlespo!  And thanks too, for the heads-up on the downside of the NHS.  You are coming back here, but we are moving over there, and since I'll most likely be working in the NHS, I want to know as much as possible, the positives and negatives of the system.  There are some things I'm looking forward to there, and definitely, some things I'm not.  It helps to hear your own experience, so thanks for sharing it, I appreciate it.

If you don't mind me asking, are you going to be able to get the "reconstructive" surgery done to repair the tear while in the U.K. or here in the U.S.?  If they won't do it there, you should be able to find someone here to do it, and I *think* it would be covered by most insurances.  My sister hasn't decided if she is going to pursue the matter with a different doctor or not--but I think if it were me, like you, I'd be rather put-off by the "Just wait till your done with children," logic.  After all, how do they know it wasn't your family's plan to stop with one child?  It's rather presumptuous to me.  Anyway,  if you do opt to have it done here, definitely get an O.B., possibly with a urologist consult on the side, to do the procedure.  OB's usually will have had more extensive experience and training in such things---possibly because they get so much practice with their cutting skills!  O.K., that's the cynic talking again, lol--but for that reason, many midwives here whose clients suffer the rare third-, or fourth-degree tear will usually send them on to an OB to ensure the best results. 

I really hope you can get this cared for and repaired as soon as possible.  It saddens me that women have to endure things like this.  You can bet if it were men giving birth, and sexual or urinary dysfuction resulted, it'd be the first order of things to ensure all their bits and parts were restored to as close to "normal" as possible.  So, good luck, and I wish you a much better experience next time, if you have another, here in the U.S.!

Rebekah

You can bet if it were men giving birth, and sexual or urinary dysfuction resulted, it'd be the first order of things to ensure all their bits and parts were restored to as close to "normal" as possible.

Ain't that the truth!

Thanks so much Rebekan - I've really enjoyed reading your posts on this topic, as an insider. There were several things about the UK system that I was unhappy with that I didn't mention, and I'll detail them briefly below. As for my surgery, they have refused point blank to do anything here. After the care I've received, I'd rather get it done in the US anyway. I'll consult with an OB ASAP in the states, and if it isn't covered in my insurance I don't care, I'll pay oput of pocket - but surprisingly they OB here wasn't even willing to let us pay out of pocket. We consulted the OB who does private surgeries for the hospital and he couldn't roll his eyes hard enough at me, thinking I was making a big deal out of nothing...  :\\\'(... so yeah, I'll be doing it in the US. :/

As for the things I didn't like about my experience:

1. My platelet levels dropped consistently with every blood test I ever had taken. Towards the end they were low enough that my midwife said I should be getting blood taken every few days - but she couldn't do it, I had to go to the GP. Fair enough, but they wouldn't schedule me for taking blood, saying it wasn't urgent enough. The midwife had to fight my corner, but by the time they got it sorted (2 weeks) I was in labor, with really low counts.

2. I am having to fight for my medical records. They got properly scared during my labor about my blood pressure and platelets, enough that they wouldn't give me any drugs and were going to do an emergency c-section. But they wouldn't tell me what my actual counts were, or what my blood pressure got to. In requesting my records they keep telling me I have to go to the hospital for an interview - which is hard since the hospital is 40 minutes away and my husband works 7 days a week. They have been very unhelpeful. Now that our move is imminent I'm calling them on Monday, and kicking ass on the phone. I know that legally they have to give me access (although only recently!!!) - and I'll just have to fight some more. I NEED to know, so that when I get to the US I can give my OB a fair view of what happened. I wish wish wish wish WISH I had made a photocopy of my records when I still had them, and had insisted they give me the info from my delivery right away. But officially, on the paperwork I received, it had no mention of my blood pressure or anything. So I have to request the midwive's hand-written notes. 

3. David wasn't allowed to stay with me after the birth. I gave birth at 4:34 am, and when they wheeled me to the ward he had to go home since no visitors are allowed. Husbands are visitors. Since everyone is in a ward and there is no privacy (curtains are privacy? LAUGH!) only mothers and baby are allowed. But since I didn't get wheeled in there until 8am, everyone else in the ward was waking up and babies were crying so I actually got NO SLEEP after giving birth. Got so fed up that David came (only with visiting hours though!) - and took me home 12 hours after giving birth just so I could sleep.

4. That whole "no private room" thing was awful. We have BUPA as well, but BUPA doesn't have any maternity benefits. When I was going in for constant appointments about my tear I was never in a private room, and they were perfectly happy to talk VERY LOUDLY about how silly I was being, with oh - 30 people in the room? NO matter what news was being given - throughout the entire pregnancy - there was never an attempt even to go around a corner. 

Gotta go - baby needs to go down for a nap.

3. David wasn't allowed to stay with me after the birth. I gave birth at 4:34 am, and when they wheeled me to the ward he had to go home since no visitors are allowed. Husbands are visitors. Since everyone is in a ward and there is no privacy (curtains are privacy? LAUGH!) only mothers and baby are allowed. But since I didn't get wheeled in there until 8am, everyone else in the ward was waking up and babies were crying so I actually got NO SLEEP after giving birth. Got so fed up that David came (only with visiting hours though!) - and took me home 12 hours after giving birth just so I could sleep.

Sounds very familiar.  I delivered at 3:30 am.  I didn't go to the ward until 6:00 am, with no sleep and by then babies and mums were awake.  So I was working on over 30 hours without sleep.

I had had an epidural which meant that I had lost the total use of my legs.  Instead of putting me in an electric bed, they put me in one of those deck-chair beds (there was a free electric bed too!), flopped baby in bed with me and promptly buggered off.  I couldn't sit myself up, I couldn't move without help and was so scared I would go to sleep and baby would fall out of bed because there was no hand rails to secure either of us.

When my legs came back, I wanted a shower.  I asked how I should go about this.  They said, "Just wheel baby into the shower room with you."  I was gobsmacked.   

By 1pm, I had enough.  The pediatrician had been to release Niall, but the OB hadn't been to check me.  I asked when the OB would be around, and they said that it was a shift change and not to expect him/her for another two hours.  Being very tired, very grumpy and more than a little pissed off, I told them they had a half an hour or I was checking myself out.  He was there within 20 minutes and I was out of the hospital by 2:00pm.

It's little wonder that some women feel so ill-prepared when they go home.  They've had no rest or time to recover.  I really feel for those first-time mothers who are exhausted to the core and just learning to handle a baby.  I think it's the worse possible start and could see how starting motherhood exhausted might lead to PND.