Choice

Choice. Everybody talks about it like it's something we're entitled to, but the minute you try to actually choose something, everyone gets all up in your business and tells you that You can't do that! For instance, with all this bruhaha going on with the hospital goliath in our city, I am looking for a non-affiliated FP who can provide care for me for my pre-existing condition. I called a few places today (after having been sent to collections again, you could say that I am highly motivated). I spoke to one nurse who was supposed to take my medical history, and then give the info to the doctors in the practice, who would then decide if they can take on a new patient. So I gave her my information: my pre-existing condition, the fact that I'm currently pregnant (I made it very clear that I am not looking for prenatal care, or any pregnancy-related care), how I heard about their practice, when I'm due, and who my pregnancy care provider is. I told her that I was receiving care from a midwife and that we were planning a home birth.

I got a call later that afternoon telling me that because I have this condition and am choosing to home birth, they cannot provide any sort of medical care for me ("But best of luck with all of your future endeavors, etc., etc.,"). Seriously? Because they don't agree with my choice to home birth, they are not going to help me. Now, obviously, I know that choice goes both ways, and they're free to choose not to help me if they don't want to, but it's just a little aggravating that I'm never the one that gets to make any choices here. And it's not just with this. I mean, the whole reason we started home birthing in the first place was because I was given no choices my first pregnancy (there are standard-of-care protocols for people with my condition, and regardless of a person's individual situation, these protocols must never be deviated from, even if it puts the individual in danger, or causes poorer outcomes). I ended up with a c-section because the OB who insisted on inducing me at 37.5 weeks had the nurses turn the pitocin up so high that it sent my baby into fetal distress (more on that another time). Then, when I became pregnant with my second baby, none of the doctors in my area were willing to support my choice for a vbac. So I found a home birth midwife who would, and did it myself, thankyouverymuch. Which ended up being the awesomest thing ever.

During my third pregnancy, people pretty much left me alone, which was actually refreshing, and I was feeling pretty good about this whole choice thing.

Fast-forward to this pregnancy: the care provider that provided early prenatal care to me in my last pregnancy informed me that she was no longer able to provide prenatal care because I birth at home. "Take your business elsewhere, fool!" So then I called around to other care providers at the other goliath hospital system in town, and was told that I could only be seen by actual OBs; no NPs, no CNMs, no FPs. When I went into be seen for my first visit (which, ironically was with an NP, because everyone sees the NP first at this system), I was criticized for choosing home birth. Which, you know—I can handle criticism.

So, now, it's this. I can't choose my care provider. I can't choose home birth. I'm supposed to bow down and let everyone take care of me. Because, last I checked, people taking responsibility for their health is the best way to, you know, be healthy. But apparently, it's frowned upon in the medical community, and all doctors are spoiled brats who take their toys and go home unless you play their way.

At least, that's the way I choose to see it. Because, darn it, that's one choice they're making it easy for me to make.

Well, I Guess I Know Where I Stand, Now, Anyway

I got sent to collections. Again. For $10. A scant three weeks after I was sent to collections the last time. Like, somewhere in there I was supposed to make a third payment to them (during a one-month period)? Like, apparently they didn't like my nasty letter, and just sent me to collections without calling or notifying me in any way so we could discuss things further? Like, even though I technically fulfilled all the requirements that I was supposed to fulfill for their little pay-your-bill-in-smaller-increments thingy (they demanded all kinds of info from me, and told me to send a letter of explanation for any information I did not provide. Which, I most certainly did), and even though they technically are not supposed to send me to collections when I'm working out a payment plan with them (or so I'm told by the billing CSRs), apparently, we're both playing passive aggressive, and I'm the one getting screwed over by it.

It really is frustrating, actually. I mean, I feel totally powerless, because I'm sure that technically they have every legal right in this situation, and I have none (and, if I do have any legal rights here, it's not like I can afford a lawyer to find out that I do), so they're bullying me into doing something that I really can't do. Note to Sanford Health System: just because you have a legal leg to stand on, doesn't mean you ought to go around standing on it. Stop being a bloated, bureaucratic, feelingless automaton, and recognize that, you know, you're dealing with individuals here, with individual situations. We are not patient numbers.

So, anyway, I'm going to fight this the best way I can (and they darn well better take that $10 bill back from collections!), and I am going to take my business elsewhere, because I refuse to pay for crap service, and I absolutely, positively refuse to be bullied.

And now, I am angry.

Thanks for Nothing, Folks!

The third trimester exhaustion has hit me. Hard. My husband keeps subtly suggesting that maybe a little exercise would boost my energy levels a bit. I disagree. Plus, it's hard to muster up the energy to exercise, when I can barely muster up the energy to go pee. Again. Which is—serious—to say the least. Other than the exhaustion, though, I've not really had any third trimester symptoms; no swelling, no difficulty breathing (well, except for when I'm trying to chase the toddler up the stairs), no real discomfort. Well, maybe insomnia, but, since I'm exhausted, anyway, who really cares. Right?

Other than that, I'm embroiled in a battle with the billing department of the hospital from which I receive all my medical care for my pre-existing condition. As in, I have, like a $500 bill running with them right now, and they sent me to collections over $45. Which I was totally incensed about, because I'd been making monthly payments to them, like, every single month this year, and a couple of months I actually made two payments to them. So I called them to square all of that up, and I was told that the remainder of my bill would be sent to collections if I didn't set up a payment plan. But when I tried to set that up, they wanted waaaaaay more money per month than I can afford. I mean, we keep it cheap at our house. As in, we don't do cable or Netflix, my husband's cell is paid for by his employer, and I have a cheap no-contract phone so that I have a way of keeping in touch with civilization in case I'm stranded out in the middle of nowhere with three kids while making the 30-60 mile drive that I have to make whenever I need things like groceries, gas, and medication. As in, if I wanted to make these obnoxious monthly payments, I'd have to take them out of my grocery budget. Which, I ain't doing.

Now, let me explain: I've been receiving services from this hospital for the past seven years. In seven years, I've never, ever, ever not paid my bill. Ever. But, apparently, they've totally redone their billing system, and the new one has no long-term memory. Or something. So the CSR said that if I wanted to negotiate lower payments, I would have to fill out an application. Fill out an application, folks. Like, regardless of whether I fill out an application, I can't pay more than what I've offered to pay. But I said, fine, so she mailed it out to me.

Yeah. I got the "application" in the mail a few days later, and, let me tell you: my mortgage application didn't even require as much information as this "application" required. Plus, they wanted the last two pay stubs of every adult member of the household, and permission to check our credit. Um—let me think—NO. So I was totally insulted, because the little letter that they sent with the application was totally demanding and demeaning ("We don't trust you or believe you, so prove that you're too poor to pay the monthly amount of money that we think you should pay."), and the application was ridiculous. As I said, I've been making payments on my bills for the past seven years, and I've always paid them off. Dude, I'm not "applying" for financial aid or bill reduction. I'm simply telling them that I can't pay the monthly amount that they're demanding; here's what I will pay.

So, instead of enabling this pettiness, I sent them their empty application back, along with a nasty letter (they said that if I didn't send the requisite information, it had better be accompanied by a letter of explanation—well, they asked for it!) explaining just what I thought of their system and their demands and their overall suckiness. Or something. This is what I said:

To whom it may concern:

Last week, I received a very unexpected letter from [collection agency name], informing me that [hospital name] had turned my account over to them for collections because of a $45.77 outstanding balance. I immediately called [hospital name]'s billing department regarding the letter because not only had I been making monthly payments on my [hospital name] bills for the entire year (I have enclosed bank records that indicate this), but I had received no phone calls or any indication that [hospital name] was somehow not satisfied with my payments. When I spoke to the CSR in billing, I was informed that [hospital name] has been implementing a new billing/patient records system, and that my account had not had any payments made on it for several months and was past due. The CSR also informed me that the new system automatically sends all past-due accounts to collections. Apparently, because I had been paying off a bill (that I had received prior to the bill sent to collections) from the old system, the monthly payments that I had been making were completely irrelevant. I paid the balance that had been sent to collections over the phone, but I was absolutely insulted that my bill was sent to collections at all, despite my best efforts to make payments, and I was beyond frustrated that your system, apparently, has no actual person reviewing whether an account really needs to be sent to collections.

I called your billing department again, later that day, and spoke to a different CSR about setting up a payment plan so that the remainder of my bill would not be sent to collections, but the CSR informed me that I would have to make the first payment immediately, and, furthermore, the minimum payment that your system would have allowed me to make was much, much more than I can afford. I told the CSR that I could pay a lower amount, and she said that I would have to fill out a form, provide copies of my last two pay stubs, and would probably want to provide information regarding my monthly expenses. I agreed to do this, so she mailed the form to me.

I received the form in the mail on Friday, 12/21, and as I looked over it, I was again completely insulted. The letter accompanying the form was extremely demeaning and petty, and the information that your form is demanding I supply is completely irrelevant to the situation. My mortgage company didn't even require all of the information that your form requires, when my husband and I were applying for a home loan. I can possibly understand asking for every minute detail of my financial situation if I were applying for financial aid or a bill reduction, but that's not the case. I am simply trying to pay my bill—in its entirety—in increments that are affordable to my family's budget. You do not need to know who the lien-holders are on my mortgage and car loans; you don't need to make inquiries into my credit. None of this information will get my bill paid any faster than I am able to pay it, and it is a gross invasion of my privacy.

If you review my payment records, you will see that in the seven years that I have been receiving healthcare services from [hospital name], I have never once failed to pay my bills. And let me be very clear: I will be paying this bill—all of it. I will pay it as quickly as I can, in increments that are amenable to my family's budget. You can take my word for that, you can let my seven-year bill-payment record speak for itself, or you can take this letter as a written contract. But I will not be providing the very personal financial details that your insulting form is demanding. I have enclosed my family's monthly budget for 2012, and while I object strongly to providing this information to you, I have also enclosed copies of my husband's last two pay stubs. If your billing system can't work with this, then perhaps it's time to reintroduce a little human reason, understanding, and compassion to your new system.

If you would like to discuss my account further, you are welcome to contact me.

I may have just totally ruined my really, really good credit. But, dude, it felt so good to mail that letter.

Nursing in Public, Sunday-Style

My sister and I visited a church this weekend; it wasn't a church that either of us would ever, ever attend. Ever. But we both went to the school associated with this church, years and decades and lifetimes ago, and we still know and love a lot of people there.

So we sat up in the balcony with our two and three kids respectively, while the pastor stood up at the pulpit and made it very clear that noisy/crying/distracting children should be immediately removed from the service, as we would not want to hamper the work of the Holy Spirit. Who is, apparently, a lot less powerful than I always gave Him credit for. So five minutes into the song service, my eighteen-month-old started talking. Loudly. So I took him to the designated "cry room," which had been pointed out to me the moment I stated that my kids would be sitting in the service with me. Yes, even the baby.

The cry room was--weird. There were no less than thirteen people in there, several of them men. The chairs were arranged in rows, facing the front of the room, but no one was at the front of the room. The sermon was being piped in, and everyone was sitting in the rows of chairs, facing the empty front of the room, listening to the sermon. I was one of two people with a child. I sat in the back, next to a lady that I had known when I went to the school, and started to discreetly nurse my baby.

"Do you have a blanket or something to cover up with? That doesn't bother me, but there are men here."

"No, and my baby won't nurse under a blanket."

"Here, I'll get you a blanket from the nursery." She laid her coat over my baby's head and stepped out.

My baby immediately threw her coat on the floor.

We stopped nursing, and tried our luck walking around in the lobby. We ran into her as we were leaving--I told her my baby was done, and she handed me the blanket anyway. "The nursery has little curtained rooms in it if you need to nurse again."

Honestly, I was annoyed. Probably incensed. I was nursing my baby in the only place I knew to nurse him (and really? I'm supposed to shut myself up in a little curtained room every time my baby wants to nurse?). I was covered, but apparently, because that covering was a tank top, my shirt, and my baby, instead of a giant flannel blanket, I was being dirty. Immodest. Disgusting. Probably causing men to have lustful thoughts.

In the five-and-a-half years that I have been nursing, I have never encountered negativity while nursing in public until now. And of course, it had to be in a church, because obviously, God hates breasts. Especially those used for nourishing a baby.

A mom nursing her infant as discreetly as I was nursing.

Sackloth and Ashes

In the circles in which I grew up, the name Jack Hyles was big. Really big. Really, really big. If we had been catholic, he would have been the Pope. If we had been Mormons, he would have been Brigham Young. We were not, of course, associated with any of those sinful cults, so he was simply called "The Founder of Fundamentalism." Or something. His church, First Baptist Church of Hammond, was the bastion of fundamentalism. Books and sermon tapes poured out of our Mecca at an alarming rate, telling us how to live, how to raise our children, how to dress, how to be good, upstanding Christian men, and meek, submissive Christian women. I remember a great many hard-bound books on my mom's bookshelves bearing the names of Jack Hyles and his family members as authors. When I was in middle school, my school (it was a Christian school, of course) took a part-day field trip to a local church to hear The Man himself speak. He was well past his prime by then, and I don't really remember much about him or his sermon, other than the fact that for some reason, I thought he looked a lot like my grandma on my mom's side. On the bus ride there and back, I heard stories of stage antics in which he threw microphones, jumped off pews and pulpits, yelled, screeched, hollered, slammed books down, and did all manner of strange and wondrous things. He didn't do any of that this day, and I must admit, I was mildly disappointed, but he was an old man by then, so I understood. Anyway, he was a really, really, really big deal.

I remember, as a teenager, hearing whispers here and there about The Man, and some supposed sexual forays. My mom viciously discounted these rumors and forbad me to speak of them, saying they were stories made up by jealous men who were trying to destroy the Cause of Christ®, and the great name of Jack Hyles. I accepted this, mostly because I was young and dumb, and honestly, I didn't know enough about sex to really understand the significance of this accusation, other than that it was a Bad Thing. Later on, in college, when I was old enough to think for myself, and understand the import of such stories, I read Robert Sumner's expose of Jack Hyles, "The Saddest Story I've Ever Told," in The Biblical Evangelist. I delved further into Jack Hyles' teachings, writings, life, and family, and his church, First Baptist Church of Hammond (FBCH). I admit it was mostly morbid curiosity, since by this time, Jack Hyles had been dead for some years, but it was also somewhat of a Truth-Finding mission, since I was going through a crisis of faith, of sorts, and wanted to know if all that I had been taught as a child was based on actual Bible, or on some sexual deviant that got his kicks out of making up crazy rules that people had to follow in order to be "godly."

The truth, as I discerned it eventually, fell somewhere in between these choices, although closer to the crazy side than to the biblical side. I've had to reconsider a lot of what I believed about God and His demands, but honestly, I'm totally okay with that. God makes a lot more sense, now that I know Him better. Mom never has come around to the Truth about The Man, or about God (as I see it), so we just don't talk about that stuff. Maybe someday.

Anyway, I say all of that to say that I've happily been out of that world for quite some time now, and all of a sudden it all came crashing back into my reality this past week, when The Man's predecessor and son-in-law, the newest Archbishop of Fundamentalism, Jack Schaap, was ousted from FBCH for some kind of sexual mishap with a teenage girl. And this is what I want to talk about. Because obviously, the Schaap-haters are out en masse vilifying him, posting YouTube links to every crazy sermon and sound-bite he ever made, saying, "Dude! You're surprised about this?" (a la "The Polished Shaft"). And I have to admit, as a Schaap-hater myself, I sort of agree with them. I mean, there is definitely something wrong with the guy. Has been for a while. But of course, when the Schaap-haters come out, the Schaap-lovers come out, and defend him. Tirelessly. Sometimes crazily. They flood message boards and Facebook pages and blog posts with messages of support and love and grammatical malfeasance. And you kind of feel badly for them, because you know they're yelling so loudly because their world is crumbling around them and they're trying desperately to grab at something firm and truthful. At least, that's what I hope is their reasoning. Otherwise, they pretty much just need to be committed and medicated. 

I head him speak a time or two, as a teenager. He was a big deal, like his father-in-law. The only sermon of his that I really remember was something about sackcloth and ashes, and I think he came out on stage wearing sackcloth and ashes to illustrate whatever point he was making. I don't really remember what the point was, but I know he played clips of an Amy Grant music video that showed her dancing around and taking a scarf off her shoulders, and he told us that's why we shouldn't listen to the world's music, because it's all about sex. As a fourteen-year-old teenage girl, I didn't really get it, and I kinda liked the song, but it certainly wasn't a new message (my parents told me the same thing all the time), so I figured he was right, and whatever. Sackcloth and ashes, right? 

Later, I started hearing all the crazy, crazy stuff he wrote and preached about, but by then, I was waaaay out of the movement, so I just kind of chuckled at him and took a moment to be grateful that I was in a much happier, saner place now, and--end thinking about it. So when crap hit the fan at the end of July, and rumors started seeping out of Mecca about the Archbishop stepping down indefinitely for "medical reasons," and the Word About Town was that he was indeed sick, but not of the physical variety, I can't say that I was either surprised or sad. Yes, to my shame, I was just a little bit glad that maybe crazy was finally going to have it's microphone shut off. Hate me if you must, Schaap-lovers. 

So as the story came out (for yea, verily, it always shall), his ailment was one of a much darker variety than stress or Crohn's disease or irritable bowel syndrome. Mostly, it was sex. With teenage girls, apparently, among (I suspect) other things. So this is what I'm getting to with all this. There has been some discussion amongst, well, just about everyone, as to whether or not Schaap's fall should be labelled "Adultery" or "Abuse." Cue angry opinions on both sides, and toss around words and phrases like consensual, molestation, legally of age, old enough to choose abortion so she's old enough to choose sex. Really, I'm not interested in any of these words and phrases, because they have absolutely no bearing on Schaap and his actions. 

Here's the truth, folks: Schaap is a 54-year-old man (I'm using the term man loosely, of course) who was supposed to be counseling a 16/17 year-old girl for sexual abuse (a "bus girl," from what I understand, although the details are hazy on this point). Stop right there and think about that for a minute. A teenage girl has been sexually abused by someone, probably someone close to her, since statistically, that's who it is, and she goes to her pastor for counseling, because obviously, she's troubled about it. She's vulnerable and emotionally fragile and she probably doesn't have a really great support structure at home, if I may be allowed to use stereotypes for a moment, because most bus kids don't. (No, really--what good parent in his right mind would send his kids off on a rickety church bus, staffed by teenagers and over-exuberant college kids, and one old guy (the driver), to spend all day at some church somewhere that he has never seen and knows nothing about?) Her pastor, a man she has been taught to look up to, admire, and trust, a man old enough to be her grandfather, starts to shower her with "attention" and "love." He tells her she is special, and means a lot to him, and she's been dying all her life to hear this. I mean from someone--credible. He hugs her. Maybe kisses her. Suddenly, he's having his secretary transport her across state lines so he can "counsel" her when he's out of town. Did she tell him "No!"? Did she gladly lay down in the bed with him? Does it really matter? Really? No. No, it doesn't. Regardless of what she did, or what she said, every shred of responsibility falls smack at Jack Schaap's feet. He is at fault. He took advantage of her, yea, preyed upon her. He failed to have another woman counsel her (or, at the very least, attend the counseling sessions with her). He is the adult. Regardless of the "age of consent" in Indiana, she could not consent, truly, because she was not in a position to do so. Regardless of whether she is old enough to operate a motor vehicle, or have an abortion, or buy alcohol (oh. wait.), she was not in a proper frame of mind and understanding and emotional stability to truly consent to his advances. She was not some brazen hussy who wooed him with her wily, teenage-girl charms. She was not a temptress or a slut. She was a broken, bruised, and wounded young girl who came to him for help, and found--the furthest possible thing from that. He sexually abused her. Which, whether it is recognized as such by the legal system in Indiana, is, of course, called rape. Ugly word, huh? It takes an ugly man to rape a teenage girl. And Jack Schaap is an ugly, ugly man.

So why do I care? Why am I even talking about this? Because it bothers me. It bothers me that anyone can possibly be placing any kind of culpability on this teen girl, thereby lessening--softening--the ugliness of Schaap's evil deeds. She is a victim, twice over (or many, many times over, possibly). She is a victim. He is evil. He has destroyed her. He has destroyed his family. He has grossly misused the trust that was placed upon him as a pastor, an adult man, and a counselor. He has, I have no doubt, injured his marriage beyond reclamation. Whether his wife stands by him or not, he has damaged that relationship irreparably. He has dirtied his name--the name that his children must now ignominiously bear forever. He has shamed and broken his wife. He has raped this young girl, sexually abused her, taken advantage of her trust. He is evil. He is wicked. He bears all the responsibility. Don't you dare say otherwise, because you know you're wrong.

Sackcloth and ashes, dude. Sackcloth and ashes.

The Whole Saga

I was talking to a friend of mine on Facebook the other day--we've been talking about pregnancy and birth, and I've been complaining about all the frustrating experiences I've had this pregnancy. As I was composing my lengthy epistle in response to one of her notes, it struck me, that one of the reasons that I hate doctors (specifically obstetricians) so much is that they do not treat me, as their patient, with respect. And yet they demand respect (and obedience) from me.

For these last three of my four pregnancies thus far, I have planned to birth at home, but because I have some pre-existing conditions, I cannot use the services of a licensed midwife, and I have slightly increased risks for complications during the pregnancy and birth. I have found a lovely unlicensed midwife who assisted with my last birth, and will be assisting me again with this birth, but I like to get concurrent care with a doctor (my preference is a hospital-based CNM or a family-practice doctor, but none of those are ever allowed to provide any kind of care for me because of my pre-existing condition. Sucks.) through the middle of the second trimester. I like to have the "big" ultrasound around 24 weeks, and then, assuming all is well with baby (which is the point of the ultrasound), I switch to just seeing my home birth midwife.

But that first trimester and half, when I'm switching back and forth, is horrible! It is truly culture shock for me, to go from the woman-based care that my midwife provides, in which we spend time together, actually discuss my hopes and plans on an equal level, get to know each other, and build a relationship, to the provider-based care that the doctors provide, in which they expect me to get nekkid on the first visit, and lay on the little table with my nether regions exposed till they breeze into the room, shove their hands up my hoohaw, tell me I'm fat, ask me if I plan on having my tubes tied after this pregnancy, ask me (horrified) if I plan on birthing at home (because they absolutely cannot support such a dangerous practice!), and tell me that they would never have "let me" birth my last two babies vaginally, since they were so large. And then they whisk out of the room, confident that I have been properly subdued.

I have a passive-aggressive strategy that I use to avoid the nekkid thing, that, so far, has worked better than even I could have hoped. I leave my husband at home with the older two kids, and bring the fifteen-month-old by myself to the office. When the nurse tells me strip, I look at her, point to the baby, and say, I may have to put that off till my husband can come with me. At this point, the baby is usually yanking the paper off the little exam table, pulling cotton swabs out of the jars, opening the sterile instrument drawers, and causing no end of mischief, and my point is made quite nicely for me (although, I did have one nurse tell me that I'd have to talk to the doctor, to see if he'd "let" me put it off). I regret that I do not yet have the courage to just come out and say, "no," when they tell me to do something against my wishes.

This pregnancy has truly been a horror so far, regarding my run-ins with the local hospitals. It started last month, when I went to see the CNM who had provided my early prenatal care during my last pregnancy (I was grandfathered into her practice due to some truly providential circumstances). I was having symptoms of low progesterone, and was having trouble regulating it myself. Having a period every twenty days was a real wretch. So I go into her office, and she sits down and says, "Since you have your pre-existing condition, I am no longer permitted to provide any kind of medical care for you at all, per hospital policy. So we'll call this visit a consultation, and I'll send you out to the appointment desk to set something up with one of the obstetricians. Also, so you know, hospital policy also now forbids any care providers in our system to provide any prenatal care to home birthers. So don't bother coming back when you get pregnant." And that, along with a few side-swipes regarding my weight and how well (or not well) she thought I was managing my pre-existing condition, was pretty much the visit. I made the appointment with the obstetrician (although my better judgment was telling me to just forget it), and left. Fuming.

I got a call from this same CNM the next day saying that she'd talked to the obstetrician that I'd scheduled with, and she was just going to tell me to wait it out, lose weight, and try to get my pre-existing condition under control (even though I kept assuring them that I have it very well in hand), and maybe just go to the other hospital in town for help when I'm ready for it, since they have all my medical records pertaining to my pre-existing condition. In other words, "We don't want you. Go away and never come back." So I canceled the appointment with the obstetrician. And then I got an $81 bill from the hospital for the appointment in which I was told that they could provide no medical care for me. I'm fighting them about that right now. No way I'm paying for something that they could have just told me over the phone. /endvent

So I did my best to manage the progesterone issue myself, and somehow I ended up getting pregnant. Not sure how that happened. I mean, I know how it happened, but I don't know how I actually was able to get pregnant, with the progesterone deficiency. But I did. So I called about four different doctors the day I got my positive test to tell them that I had a progesterone deficiency with my last pregnancy, and could they please check my progesterone levels so I could get on a supplement if I needed it. No one called me back. For three days.

The day after my positive test, I started bleeding. I was pretty sure I was going to lose the baby at that point, because it wasn't the kind of bleeding that any pregnant woman wants to see, so I increased the amount of progesterone cream I was taking, started taking some herbs to help quell the flow, and I got myself to the walk-in clinic to try to get my progesterone levels checked. I pretty much cried on the phone with the hospital Ask-A-Nurse (I called to make sure I could visit the walk-in clinic for pregnancy stuff), and told her that I had called a bunch of doctors, and none of them called me back and I was bleeding, and I needed to get on progesterone, and *sob*. So the poor lady told me to stay on the line, and she called a bunch of doctors and found one who could see me, and who would start me on a progesterone supplement that very day. Bless that sweet angel, whoever she is.

So I took myself and my three kids to the walk-in clinic, and we waited for just about four hours to get my hcg levels tested (they don't test progesterone levels at the walk-in clinic, apparently). The doctor called me back and told me that I was either very early in my pregnancy (umm, yeah, like, nine days!) or I was miscarrying, and I needed to come back on Sunday to have my hcg levels drawn again.

So I picked up my progesterone, shoved one in at a gas station before I made the 60-mile trek home, and suffered through the weekend, not knowing if I was losing my little bean or not. When I got home, I looked at my progesterone package, and noticed that the doctor had prescribed 50mg of progesterone a day for me. With my last pregnancy (you know, the one in which they actually tested my levels?) they started me at 100mg, and raised it to 200mg after a second progesterone check. So I went ahead and took 100mg through the weekend, and figured I would call the doctor's office on Monday and explain my last protocol to them and ask them to check my levels and increase my prescription.

So Sunday, I head over to the walk-in clinic during morning church service, and have my hcg levels drawn again, and wait around for the results. My husband and the older kids met up with me and the baby after service was over, just in time for the results. They were rising, but they weren't doubling like they technically were supposed to be doing. The doctor was very optimistic (and very kindly complimented us on our kids!) and said that any rise was good news, but I left not knowing exactly whether to be relieved or to worry further. So, of course, I chose to worry. Because I am woman. Hear me roar.

Monday, I called the doctor and asked him to check my progesterone levels and raise my prescription (I was fairly sure that the bleeding was linked to my low progesterone, since it had been waning somewhat since I'd started on the vaginal suppositories (there, I said vaginal and suppositories on the internet. Again.), but it hadn't diminished completely yet, so I was mildly concerned about an ectopic pregnancy. Anyway, the nurse spoke to me and told me that they do not test progesterone (?!), only the fertility clinic does that, and 50mg is their protocol, so that is all they would give me. I tried to explain to her that they had actually, you know, tested my levels during my last pregnancy, and they were low enough that I was on a much, much higher protocol than 50mg, and I didn't want to miscarry. "Well," she said, "That's because you went through fertility last time [wha....??], but we don't do that at our clinic." So pretty much, it was tough beans for me. "Sucks if you miscarry, but we won't help you."

I was frustrated to the point of tears. I was not about to lessen the amount of progesterone I was taking, but I didn't know what other options I had. There are only two hospitals in our town, and one had thrown me out because I'm a homebirther, and the other one refused to provide the help that I needed to make this pregnancy work. I went to the internet, determined that I would go as far away as I needed to get what I needed. I found a small hospital an hour away in the next state over that was not only able to get me in with a doctor within two weeks, but faxed a prescription for 100mg daily of progesterone at that very moment, and said that the doctor would most likely check my levels if I asked him to. I didn't really give a heck if the doctor was a complete egomaniac--I had my progesterone taken care of for the time being, so I was temporarily appeased.

Meanwhile, the stingy-with-the-progesterone doc wanted me to come back in to have my hcg levels drawn again in two weeks to see if they were rising as they should. Not wanting to put all of my eggs in the same basket, I went ahead and kept all appointments with both doctors till I got a feel for how things were going to go. Somewhere in here, after nine days, the bleeding finally stopped.

My visit with the out-of-state doc went, well, pretty much as I expected. He was an egomaniac who told me that he would never have "let" me birth my last two children vaginally, given how large they were (ha! and you think I would have "let" you check their sizes at the end of my pregnancy? or that I would have "let" you cut me? Sucker!). He also told me that with my obviously uncontrolled pre-existing condition which caused my babies to be large, I should be in a larger hospital. Of course, I took exception to that, since my condition is very well controlled. I just happen to have big babies. Like my grandma. But no one really cares about my grandma. So we had a slight tense moment in which he didn't believe me and I didn't let him get away with that, but that passed, and he told me that he and I just weren't a good fit. "You are obviously a woman with very strong ideas about how things are and should be, and that's not a bad thing, necessarily, but I think you need to find another provider for prenatal care." Is that, like, a doctor's version of a compliment? Personally, I think the fact that I have three kids, had two home births, told him that I was considering a home birth this time around, and was wearing a skirt, made him think I was some kind of a religious nut that births at home on religious principle, instead of being a quasi-feminist who takes exception to doctors just having their way with me for their own convenience. And cutting my uterus open to remove my babies, because it's easier than waiting around for my babies to make their exit through the God-given hatch. So, yeah, we weren't a good fit. But he was very nice in agreeing to do an ultrasound to check on baby so we could rule out an ectopic pregnancy, and a follow-up ultrasound in a week, as well as prescribing the progesterone to me through twelve weeks. So all-in-all, I wasn't completely dismayed by the visit. Although, he did decline to check my progesterone level, since he wasn't going to be providing prenatal care.

My appointment for the hcg lab with the progesterone-stingy doc was the Monday following that appointment. I received a call the next day saying that my levels were over 11,000, which meant that they had been doubling well every two days since my last draw. A good sign, for sure. They wanted to schedule an ultrasound on Thursday of that week, so I went ahead and had that done, and cancelled the follow-up ultrasound with the out-of-state doctor. Baby was there, in my uterus, with a good strong heartbeat, so I was finally was able to breathe.

I am 7 weeks 3 days pregnant today, and as of yet, I still haven't had my progesterone tested. I am hoping that I didn't commit a fatal error by telling the out-of-state doc that I'd found a new care provider (I don't want to lose that progesterone prescription!). The nausea has been fairly frequent (although no throwing up, yet), and the exhaustion has been kicking my butt in a big way, so these are all very good signs. We will see what happens. If anyone ever again asks my why I home birth, though, I will send them to this post, and tell them it's because my midwife is the only care provider who has listened to me and respected me. Who else would I want to have assisting me during birth? Certainly not the asshats (sorry, Mom. It's the nicest word I have for them right now!) who have been giving me grief instead of prenatal care!

After This, I Promise I'll Move On

So I've been talking about Little Bean, mostly, these days, since, you know--that's mostly what I've been thinking about. I promise I'll try to find some other things to talk about, but I did want to mention that I got to see the heartbeat yesterday, pumping along strongly at 120 bpm. I was measuring one day short, but I don't think that's a problem. My dilemma now is whether or not to spend the extra $100 a month to get an additional 50mg of progesterone a day. I say this because one doctor prescribed 100mg daily, and one doctor prescribed 50mg daily, and I've been taking the 100mg, and ignoring the 50mg, but with my last baby, they had me on 200mg by this time, so I don't know if I should up my dose or not, since, you know, No One Will Actually Check My Levels! It's a dilemma. Especially since we're kind of cash-strapped right now as it is, with the new minivan purchase, and my insurance doesn't cover "formulary drugs."

On a slightly different note, I was extremely annoyed when I registered for my ultrasound appointment yesterday, and the registrar lady said, "Can we take a photo for your medical records?" As I was saying, "No, thank you!" (because it's not really any business of theirs what I look like. And I'm paranoid), she had her camera out and was snapping the picture. "It's something new they're requiring," she said, and that was that.

So why the heckity-heck did you ask my permission if I don't have an option to say "no?"

So now, somewhere linked with my medical file at that hospital, is a photo of me, scowling, with dark storm clouds gathering over my head, because some moron was taking a picture of me that I didn't consent to. Serves them right!