This is going to be long. Perhaps get a cuppa before you start this one. Here’s the story from start to finish.
A few things you need to know first.
- I was on antibiotics for a UTI (symptomless yet again)
- Antibiotics gave me thrush (TMI?)
- I FELT fine
- I’d had an Ultrasound on Tuesday in the Pregnancy Care Clinic by an OB named Tom, which showed everything was fine. Normal fluid
- The whole time I was in hospital, my obs and CTG’s were perfect and I had no fluid loss (they asked me this every day two or three times)
- I made the mistake of trusting the public system. Not saying it would have been different elsewhere, I don’t know that for sure, but it did let me down.
- I’d had an ultrasound from a dumb woman at BMI on 18/3 which showed low fluid (AFI 5), subsequent ultrasounds on the following two Tuesday’s at the clinic showed AFI of 11 and 13 (normal).
Friday – I went to the hospital (Barwon Medical Imaging – BMI) for a routine growth ultrasound. The same technician that I thought did a bad job last time, also did this scan. She said to me again that I have low fluid around the baby but didn’t give me a number. Following the scan, she had the radiologist look at it and he rang up to the MDAU (Maternity Day Assessment Unit) and told them that I needed to go up there for further assessment for low amniotic fluid around the baby (the measurement for fluid is AFI – amniotic fluid index and it should be between 5 and 25). The midwife in the MDAU admitted to me that he spoke poor English and she had struggled to understand what he was saying. At the MDAU they put me on CTG to monitor the baby’s heart rate, my contractions and baby’s movement. They look for accelerations, decelerations and a baseline on the fetal heart rate. Bean was co-operative and gave us these results in about 20 minutes – an indication of a very happy, healthy baby. An OB by the name of Emily looked at the results from the CTG and decided to do another ultrasound herself in MDAU – she came up with an AFI of around 10 – so normal. She also thought it would be a good idea to do an amnisure test – this is a pelvic swab (really unpleasant painful one I’ve talked about before) to check for the presence of amniotic fluid outside the cervix indicating a ruptured membrane. I had been previously told that these test CAN give false positives for a variety of reasons. The test came back positive. Emily admitted me immediately and said that they would induce me Tuesday when I said Mike would be back. I asked about the possibility of a false positive and whether they would redo the ultrasound or the amnisure before induction to which I received a resounding NO. I was admitted to the post natal ward and put on four hourly obs overnight (temperature, BP, pulse, fetal heart rate) due to the high risk of infection from ruptured membranes. Sleep = zero. I was told I could go on day leave from the hospital the following day after I’d had CTG and been seen by an OB and had to be back at 8pm.
Saturday – CTG was fine. Waited from 8.30am when I was told I would be seen to 2.30pm before being told that the OB Emily had RANG and said I could go home for the day without seeing her. I had the midwife ask her AGAIN about the possibility of redoing the ultrasound or the amnisure and again Emily gave a resounding NO, that was unnecessary. I would be induced now on Wednesday morning.
Sunday – CTG was fine. Another OB, Lauren, turned up nice and early to see me. I had expressed my concern to my midwife overnight and she agreed that someone needed to speak with me reasonably urgently (mainly for my emotional well being as I was starting to fall apart). She listened to what I had to say and my concern about a false positive and agreed to send me to the MDAU at 8.30am Monday morning for another AFI check via ultrasound. I was happy with this – I really needed to know I was doing the right thing by letting them induce me. Mike got home about 5.30pm. Sue had been taking wonderful care of me since Friday but it was nice to have Mike home and have his arms around me.
Monday – CTG was a bit more difficult because Bean was on the excited side, so took longer, but Bean’s activity was a good sign, it just meant that it took a lot longer to get a baseline heart rate because I’d had about 30 movements in 30 minutes! So the monitoring took over an hour. Emily came to see me again. She immediately cancelled the ultrasound Lauren had ordered for me saying it was a waste of time. I AGAIN questioned the possibility of a false positive and was AGAIN told no, it was impossible, this test was infallible and as the BMI ultrasound showed NO fluid around Bean, the baby was coming out whether I liked it or not. So by this point, I was starting to accept that I was being induced. She told me that they’d moved the induction to Tuesday night, 6pm. The no fluid issue was a surprise to me, since I’d seen fluid on the scan myself and so had Emily but then I thought maybe I’d misheard her. During the day I had expressed my feelings to Mike that if they ended up changing their minds, I may emotionally find that more difficult than being induced early. I needed the Dr’s to be right. I went home on day leave.
Tuesday – CTG was fine. Tom came to see me early, listened to everything but reassured me that everything was OK and Bean would be fine delivered early – better out than in given the risk of infection. I finally accepted that this was going to happen. Something I said must have hit home with Tom though, he’d read the REPORT from BMI which said that there was NO fluid around the baby and he agreed with me that their report and his from Tuesday seemed very different on a number of levels. BMI said Bean was in the 95th percentile for size (nearly 8 pounds – so heading to be a 10 pound baby at term). Tom had measured Bean at the 51st percentile – around 6 pound 5. BMI said No fluid, Tom had an AFI of 13. He agreed that if I had lost that amount of fluid, there was little chance I could have mistaken it for anything other than breaking my waters. I’d asked him whether the thrush could have given a false positive on the amnisure, he wasn’t sure, but didn’t think so. Either way, Bean was being induced at 6pm. At 2pm, I received a phone call from the hospital saying that Tom had reviewed the BMI ultrasound, not just the report, and that it showed at an AFI of at least 13 and that rather than being induced, they would redo the amnisure, because thrush can cause a false positive. WTF?????? I HAD ASKED FOR THIS SINCE FRIDAY AND WAS REASSURED OVER AND OVER AND OVER AGAIN, THAT THIS WAS UNNECESSARY and thrush did not cause false positives. My legs literally gave way from underneath me. At this point, I was certain I needed a second opinion. I rang Geelong Ultrasound for Women and asked if I could get an appointment. She said that the next available appointment was April 27 – so I told her what was happening and she said she’d see what she could do and rang me back to say that she had convinced a radiologist who was finishing early to stay on and I could come in at 3.20pm. that left me 1 hour to get a slip from somewhere to actually get the ultrasound done. I rang the hospital and THEY REFUSED! REFUSED ON THE BASIS THAT THEY THOUGHT IT UNNECESSARY. I asked for Tom but he was in an emergency c-section, so I had to take whoever was available and was told that Sue – an Indian OB that I struggle to understand, would ring me back. Figuring I now had less than an hour before the appointment I rang my GP office – of course my GP was on leave and everyone else was booked. I then explained to the receptionist what was happening and she said she’d speak to a doc and ring me back. She rang back in less than 5 minutes and asked me to come straight in. A GP, Annette, who I used to see was happy to see me and write the slip for Geelong Ultrasound. At the appointment, I explained what had happened and Annette was in tears! I went in for the ultrasound and the radiologist assured me that he was looking at a healthy, happy baby with an AFI of 13. He saw NO indications of needing to induce the baby. He agreed that Bean would measure around 6 pound 5 (not that this was particularly important, it just told me that BMI had really fucked up).
So armed with a written report from Geelong ultrasound, I went back to the hospital around 4 – I was due back at 5pm, but I was so tense and upset, I needed to get there ASAP. Mike dropped me off, but since there still existed the possibility that they would induce me, he had to nick home and a do a couple of things. I rang Sue the OB, as soon as I sat back down on my bed and I think from my tone, she realised just how pissed I was. She came up within 20 minutes. I don’t think the poor woman will ever recover and I’m not entirely sure she’s ever had an expectant mother so willing to defend her right for a second opinion nor for control over her own body and the treatment of her baby. It seemed to me to be a pointless exercise to redo the amnisure at this point because they had left the thrush untreated because of the risk of the treatment causing infection due to the “ruptured” membranes. I was only going to get another false positive. Mike made it back for half of this conversation and I think he was kind of surprised at just how willing I was to stand up for us. So I convinced the OBs, by this point, I had also had them include the head of OB/GYN at the hospital (aim high I say) in this discussion, that I was going home and would return Friday for a repeat amnisure after treating the thrush. One of the really nice midwives was there supporting me as well and the OB said that I could go after another set of obs and then she left. I asked the midwife if she thought I was doing the right thing and she agreed whole heartedly. She did my obs, and of course my blood pressure was through the roof 170/95 and she was nice enough to write in down as 140/90 – otherwise I had to stay another 4 hours.
So lesson learnt the hard way yet again. Your body, your decision, defend it. I KNEW on Friday that I was right, that Bean was OK, that I was OK.
Emily in particular can shove her tight little mini skirt up her uptight little ass and I hope in the long run, she chokes on it. It was largely her unwillingness to listen to me that put us in this situation.