Dr. Stempel Surprises Me

 . . . in a very good way. 

Last Monday (two weeks ago now) was a day that started out to be stressful but ended surprisingly well.  I had two appointments at Emanuel that day--the first was to have a glucose tolerance test to check for gestational diabetes and the second was to have my regular prenatal visit with Dr. Stempel.

Both visits were stressing me out, for different reasons.  I was unsure about taking the glucose test mostly because I don't generally consume a lot of sugar at one time (although I had been in the habit of having two Udi's oatmeal raisin gluten-free cookies just about every day as a snack and a treat.  It helped all the spinach salads go down easier. ;)  But I was worried how our little guy would react to 50g of sugar being dumped on him at one time.  I was also pretty sure I wouldn't feel very physically well from it.  Besides that, I'd read in Ina May Gaskin's Guide to Natural Childbirth that the midwives at the Farm just do glucometer testing and then refer those patients who show elevated blood sugar levels for the actual glucose tolerance testing.  I struggled with what to do and tried calling Dana (Andaluz midwife I was set to see the next day for my fiirst appointment), but couldn't reach her.  So I ended up calling Jennifer right before I would need to drink the glucose.  I was supposed to drink it, then have my blood drawn exactly an hour later.  Jennifer said that the glucose would probably have more effect on me than the baby, since my body converts the food I eat into glucose and that is what nourishes the baby anyway.  I decided if that was the case that I could just go ahead and do it.  He was my main concern.

I chugged the lemon-lime drink (had to drink it all within 5 minutes) and it actually didn't taste as awfully sweet as I was expecting.  It reminded me of the Otter Pops I used to eat back in the day.  Mmmm.  Love those.

I felt okay until I got to Emanuel.  Then I noticed a bit of a headache while I was waiting to get my blood drawn, and it also felt like my heart was racing somewhat--nothing terrible, just uncomfortable.

After the blood draw I had my regular appointment with Dr. Stempel.  Renee checked my weight (still 144, but she wasn't concerned that I hadn't gained any weight in about a month.  She said most women gain the greater part of their pregnancy weight in the last trimester.) and blood pressure (fine).

When the doctor came in, he had a female student with him, but didn't ask me if that was okay.  At OHSU, we were always asked before a student(s) entered the room.  Maybe Stempel figures if you mind, you'll say something.  Anyway, I was fine with it.

He measured my womb and said he thought the baby was head down, his bum on the right side of my abdomen and his legs and feet on the left--which would explain the kicking I almost always feel on that side  He also checked the baby's heartbeat which was 130 beats per minute.  I asked if that wasn't lower than normal and he said no, that anything from I think about 120-160 was normal at this point.  Their litle hearts beat faster earlier on in a pregnancy, which is why I remembe it being 145 and 150 before.

After the quick exam, he asked me if I'd made an appointment yet to see the Emanuel nurse-midwives.  I said that I had made an appointment, but with the midwives at Andaluz and that I knew that wasn't what his choice for me would have been.  Here's where he surprised me: I explained that I felt comfortable there and that as long as everything kept going smoothly with the pregnancy and everything looked good going into my final weeks, I really wanted to shoot for a waterbirth there.  He seemed to agree that that would be fine as long as things continue to look normal.  He even made a comment about how in most cases, things go pretty straightforwardly.  I took that to mean that they go so straightforwaardly that a hospital birth isn't necessary.  I told him that I understood if he wouldn't feel comfortable taking over my car in the event that I need extra help.  He got thoughtful (as he has done in visits past) and I jst sat quietly and waited to see what he would say. The student looked a bit uncomfortale, staring looking anywhere but at me or the doctor.

Finally Dr. Stempel said that neither he nor his partners htave ever co-managed prenatal care with the Andaluz midwives, but that he would not be averse to it   That way if it ends up that I do need to be in a hospital (or I decide that is where I am most comfortable), he will be in the loop, having continued to see me for regular prenatal visits.

I was so stunned and happy that he would basically offer to do that for me.  We decided that I would come back in two weeks (I'm far enough along in my pregnancy that the visits now drop to once every two weeks instead of once a month !) )and he even asked me if I had copies of my records to take to Andaluz.  When I admitted sheepishly that I hadn't thought that far ahead, he offered to get them for me so I could take them with me when I left.  And then he even ended up making the copies!  I think that last part was what really impressed me.

I forgot to mention that when we were discussing the option of a co-managed pregnancy between his office and Andaluz, I said that I really preferred an integrated approach anyway.  And he said that he does too.  Wow.  Could have knocked me over with a feather--but in a very good way.

So that is where we are now . . . and I feel good about having people on my side in both camps: the medical model of care and the midwifery model of care.  It really does seem to me that great benefit can come from both sides just working together (as with so many other things in this world).  I believe that in general, doctors and midwives both want the same thing: safe births and healthy mothers and babies.  And there is at least one doctor in the Portland area who seems to believe that too.