On the other side of the exam table

Well, the cat is out of the bag with our friends and family that I’m pregnant!

Half the reason the blog has been so quiet lately is that this pregnancy has been affecting every waking moment of my life, and if I were to write, I couldn’t not write about it. Even in this short time it has affected how I think about my profession and changed the way I practice and discuss things with the folks I care for.

From the day I found out we were pregnant, I began my long (and on-going road of) constant, daily nausea. I’m talking every-single-minute-of-every-single-day-and-even-when-I-wake-up-at-night kind of nausea. I write about this not to complain, or garner sympathy, but to underscore exactly how difficult pregnancy can be physically and emotionally. To be completely honest, I have been humbled at the feet of this great unknown in the past 11 weeks or so.

When I think about the way I used to think about or recommend remedies to the women I cared for, I think, “I would have slapped me If I had been my midwife. Just stay hydrated? Oh, have you tried ginger, and saltines before you get out of bed in the morning? Try eating small frequent meals. Try all of that first before we jump to the bigger guns of prescription medications.” Yeah.

None of these things has worked for me. None of these things tend to work for pregnant people who have severe, unrelenting nausea. Even zofran, which is a prescription medication that is given to chemotherapy patients, has not been helpful. I have had to step out of exam rooms, delivery rooms and operating rooms to try and control my nausea before re-entering.

I discuss these unpleasantries with such frankness because I know that what I am experiencing is normal and common. Close to 80% of pregnant people experience nausea and vomiting. What this knowledge has left me with is an unrelenting awe at the power and strength of pregnant and birthing people.

In some ways, I already felt this reverence and awe, but truly knowing the physical and emotional toll such illness can have has further increased that feeling. For the first time in my life, I can empathize with the people I am taking care of, not just sympathize.

Most people’s early pregnancy symptoms dissipate by 12-14 weeks of pregnancy, coincidentally when it is conventional for couples to share their good news. So what does this mean? That we, as a society, by convention, leave pregnant people to keep their suffering to themselves. Many pregnancy apps and blogs have “helpful pointers” on how to hide the fact that you’re not drinking or how to keep your needed trips to the bathroom at work concealed from the suspicion of co-workers and bosses.

Not only does that mean that we are leaving women to suffer in silence and without support, but it also means that we are leaving people to miscarry in silence and alone. Most miscarriages occur prior to 12 weeks of pregnancy, and this woman’s devastating tale of grief  and her thoughts of feminism following her miscarriage was deeply moving to me. She writes:

For us (in American culture), miscarriage is a solo and secretive happening. Women miscarry alone, isolated by the 12-week rule: Don’t announce your pregnancy until the second trimester. The thinking here is sensible. One in four pregnancies ends in miscarriage; most in the first three months. A woman who does not announce her early pregnancy will not have to announce its loss. She can move on in privacy, as if it never happened…

The more I considered it, the more I became convinced that the silence around miscarriage was connected to feminism’s work around abortion. How could I grieve a thing that didn’t exist? If a fetus is not meaningfully alive, if it is just a collection of cells – the cornerstone claim of the pro-choice movement – what does it mean to miscarry one? Admitting my grief meant seeing myself as a bereft mother, and my fetus as a dead child – which meant adopting exactly the language that the anti-choice movement uses to claim abortion is murder.

While the feminist circles that I run in definitely don’t take such a hard line that would leave people to believe that the grief people feel after miscarriages is unjustified because a “fetus is not a person,” I do believe that this author is scratching the surface of battles that are not often fought by the feminist movement.

This rough first trimester has made me an even more staunch advocate for reproductive justice and free abortion access than I ever was before. It has also made me deeply ponder the purgatory that couples who are facing fertility issues, or for whom a wanted pregnancy does not come quickly or easily experience. I know so many kind, wonderful people who have desired parenthood for a long time, and have had to try so hard, that it almost makes me feel guilty that this thing came so easily to us.

The beginning of this journey has also changed how I talk with people about their fears or lack of knowledge surrounding their own bodies or their pregnancies. I have always tried to convey empathy for those who are scared or who have seemingly infinite questions, but even through my best intentions I sometimes think to myself, “Can’t they google this?”

Being on the other side of this journey, being the one going through it has given me fresh eyes with with I view all the pregnant people I care for. I had one day of light spotting a few weeks ago and my heart raced and panic set in before I could remind myself that this was absolutely normal. I have found myself re-googling which fish are safe to eat and in what quantities, and I still worry when I forget a day or two of prenatal vitamins. I am awash constantly with these feelings, and I am the so-called expert on these things! In a world where so few people know the ins and outs of their own bodies, let alone what is normal or not normal for a pregnancy, I have tried to reset my mind. Hear my own, panicked voice on the other end of the phone.

So now I speak slower. I listen deeper. I make sure to ask how my patient is feeling and offer condolences, understanding, before the advice. Because sometimes everyone’s had enough of advice. Eat this. Don’t eat that. Have you tried this? What about that?

What about just listening? Just connecting with another human being who will take in your frustrations, all your fears and your feelings and has known them herself?

Midwife means “with woman,” which I have always loved, always held so dear to my practice. As I enter my third year of midwifing, I’m excited to experience the childbearing year along with the families I take care of and bring new meaning to being “with woman.”

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One Response to On the other side of the exam table

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