I am not the bad guy

I have a confession. I was not the perfect pregnant woman. Every few weeks I had a glass of wine. I snuck some raw cookie dough and licked the cake batter bowl. I ate too much sugar and not enough vegetables. Many of my babyloss counterparts say “I did everything right” and I often have chimed in, though I know I did a few things that others might have looked down on me for. But none of these things killed my baby. A faulty chromosome was really her downfall- something that is usually quite livable, but in her case leading to a cascading effect of fatal birth defects.

So when I hear people doing some counter culture things in pregnancy (crossfit? An occasional glass of wine? Medication with potential effects on the baby?), I have always been rather understanding, even now in my grief. But I draw the line.

Arguing with me about how marijuana should be allowable for pregnant women doesn’t change the fact that it’s still illegal here. My job requires that I protect your health and your baby’s health. If you are unhappy with the law, take it up with your state legislature, not with me.

I could go on about how people who smoke marijuana often use other drugs, about how unregulated marijuana could be laced with other harmful substances, how people who make poor decisions regarding drugs are more likely to participate in other risky behaviors.

I am not the bad guy.

Being pregnant is a privilege and an opportunity to better oneself. I was told my baby was likely going to die and I still recognized that. I asked advice of my providers and listened. I wish others would do the same.

Do you have any confessions? What do you get mad at seeing other pregnant woman doing?

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8 thoughts on “I am not the bad guy

  1. After the losses I’ve already been through, I’m pretty spazzy about things myself. Now, that doesn’t mean I’m going to condemn somebody else for eating cold lunchmeat, but it irks me when someone tries to tell me I’m worrying unneccesarily. I choose not to, say, eat brie because it is an unnacceptable risk to me. I don’t care if you ate it all through your pregnancy and were fine. I didn’t always wear a seatbelt when I was a kid, and I was fine. It doesnt mean I should have been in a car unseatbelted.

    Mostly, I am upset when people don’t do things, like their gestational diabetes test. There is a scary movement right now in the U.S. to eschew all modern medical treatments. Everything must be “natural,” and Obstetricians are evil people you must not listen to. I am of course aware that you are a midwife, and I’m not at all indicating that I have a problem with midwives. ^.~ I only have problems with people who are extreme in either direction. One of the scarier examples I’ve run across of this anti-medicine school of thought concerns Rhogam (which is something I have to have as I have blood type A-). Some women’s providers advise them to refuse Rhogam because mother-baby blood time interactions seldom occur anymore. The reason they don’t occur anymore is because of Rhogam! I even saw an article instructing women to follow a particular diet to change their blood type. REALLY?! You can’t change your blood type. I think the anti-Rhogam movement is part of the larger anti-vaccine movement, and don’t even get me started on that one. Ummmm… I’m done ranting now.

    • love your rant- it expresses so many thoughts I have too! You obviously know my strong feelings on the glucose test too! and dont even get me started on rhogam! luckily I havent had any issues with pts refusing (yet).

      I also love how you framed it in the first paragraph- its about acceptable risk. Absolutely- people can take the risks they find acceptable. the marijuana issue is tricky for me because in my state it is not legal. smoking has risks too, but it is legal. I some might argue smoking more risky than marijuana, and that might actually be true. however- I am bound as a provider to know the difference and I cant bend the rules just because the science and laws dont match up. I actually dont make the rules 🙂

  2. Like Autumn, it drives me crazy when people tell me I’m worrying unnecessarily and when people do not follow sound medical advice during their pregnancies. I did everything “right” during my pregnancy because I am a high anxiety person, and because I’m very competitive and obedient by nature and wanted to “excel” at pregnancy (hah, in retrospect. Though I’m still baffled sometimes but how dismally my pregnancy failed. Things like that had never happened to me before). However, I know that most people don’t follow all the pregnancy rules perfectly, and they and their babies are perfectly fine. In fact, next time, I think I’m actually going to cut myself a little slack (at least I think this now). At first I thought I’d be even MORE paranoid, because of what happened to Ander. But I know that wasn’t my fault, and wasn’t due to anything I did or did not do. So I think now that maybe I’ll be a bit more forgiving of myself. Now that I know that bad things can happen even if you do everything right, I’m more forgiving of others, too.

    • It’s funny because I was relatively lax in my pregnancy with Mabel. I took a lot of acceptable risks (as autumn stated) and maybe even more so after learning about her DS and later her kidneys/fluid. I knew that a glass of wine wouldnt influence her chromosomes or her fluid (for a while I had a theory that if I had a glass of wine one week, her ultrasound showed a little more fluid- making me oligohydramnios rather than anhydramnios!). but the next time, I dunno, I might strangely be more cautious? i just dont know.

  3. I attempted to do everything right (though my dr was always unhappy with me because I still managed to gain weight when I wasn’t supposed to), and ate way better than most of my pregnant comrades did. It’s not like I never had ice cream or a burger, but I certainly did not pig out daily like so many other women I knew. Drugs, though? That’s a pretty big deal. You’re taking in something that affects your big, grown-up nervous system, so why the heck would it not affect the tiny, developing system in your womb? Cigarettes are legal and I’ve never heard nicotine use supported during pregnancy. A little wine here or there? Sure, I see no real harm in that (as long as you’re not ingesting enough to “feel” it). It just seems strange that patients will complain a drug is illegal–if it were legal, you should still not use it during pregnancy…

    • yes! I told her I hadnt come across my first pt who had been prescribed it for medical reason and also was pregnant, and I didnt know what I would do when the time came. sure enough a week later , just that instance. but the pt herself said “of course I stopped it as soon as I became pregnant.” and there you have it!

  4. I had a lot of fears during pregnancy, some rational and some irrational, and it “hits home” for me when people do things that would’ve made me nervous. Like working with flu pts who may be contagious (rational), or doing intense exercise (irrational, but I was so afraid of a cord accident that I tiptoed around – even though I know that doesn’t actually prevent cord accidents). For medications, though, I do support looking at risk/benefit and that can mean keeping someone on a drug with potential risks. I do wish marijuana was treated like other drugs with product regulation and studies comparing risk and efficacy – for example, comparing it to other meds prescribed for nausea and sleep. I’m sure that’s coming in the future. You’re absolutely right about the danger of street drugs being laced – in the Midwest there was PCP in so much of the street marijuana that it was common to find both on drug tests for people who had never even heard of PCP. Bad news!!

    • right! so the research (minimal in pregnancy) doesnt seem to think there is any risk in pregnancy (more studies need to be done) and I’m a fan of research- like there’s lots of good studies about limited alcohol use in pregnancy have no effect (even possibly a little benefit). and what I tell my patients is “my party line is that I can not tell you how much alcohol is safe to drink in pregnancy, so i have to say I cant recommend you drink any” but will also mention research in which case they can make their decisions themselves based on the research. But here’s the major difference with that and marijuana- we know whats in alcohol, it’s regulated and legal. marijuana here isnt (street marijuana at least. it just became medicalized). and there within lies the problem- I cant endorse illegal activity/drug use in pregnancy. And for her, I do wonder about other decisions she is making. I’ve had others admit to marijuana use in pregnancy, especially first trimester and for the most part they all understand why I had to do the testing I did and encourage them to stop (be mj free by 3rd trimester). they didnt argue with me. when/if marijuana is legalized, my stance might change (perhaps akin to alcohol) but for now I’m bound.

      interesting side story- there was a practioner in a related field at my hospital that was arrested. her husband was growing marijuana in their house. she herself was arrested for child endangerment because they had a two year old in the house (i’m pretty sure she happened to be pregnant also). it was in the paper- so public knowledge. but that reflects the legal environment in my state. A person knowing of a drug in the house, that a child could have access too could be considered dangerous. I alluded to this to the pt and got the response “its not like i’m goinna blow smoke it my childs face. i’m not like that.” trying to reason with the unreasonable.

      also I lve how you talk about being afraid of cord accidents- that’s our world of knowing too much, huh? I sopped running because I couldnt understand how my baby’s cord was cushioned from accident with no fluid. and the few times I ran after getting her oligohydramnios diagnosis, I would freak out about not feeling movement afterwards. but then when I was hospitalized and did continuous monitoring it was amazing watching how my baby’s HR really had no changes while I exercised at bedside (granted I wasnt running- hard to do in a hospital room tethered to a machine, but I got as much vigor as I could). I think my case should be written up- the case for exercise- baby’s heartrate shows no distress during exercise despite lack of fluid!

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