Fight For the Maternity Care You Want

stamp series for the social welfare, midwife a...

stamp series for the social welfare, midwife and child :*Ausgabepreis: 7+3 Pfennig :*First Day of Issue / Erstausgabetag: 1. Oktober 1956 :*Michel-Katalog-Nr: 243 (Photo credit: Wikipedia)

This is a Maternity Monday post by guest blogger Jess Levey.  This series will appear every Monday on Beccarama. 

Soon after the excitement about my pregnancy began to set in, the practicality of medical care became a reality.  Would my meager insurance plan cover the midwife that I wanted?  In the beginning I mostly spoke on the phone with my gynocologist who I have been seeing since I was 16 years old.  She no longer delivers babies, nor does she take insurance, but she was happy to chat with me about my options, ease my anxiety about miscarrying, recommend some midwives, and call in a prescription for my first sonogram.  I felt in control.

Then, I started calling around to different midwives. I knew all along that I wanted to deliver at the local hospital where I was born, where my dad has worked as a doctor for over 30 years, and which happens to be a 10 minute walk from my house. It’s not the most popular hospital in Brooklyn, and most women seeking a birthing center experience travel into Manhattan to Roosevelt Hospital.   That’s a 45 minute car ride, or more if there is traffic.  But after speaking to one of the local midwives, she assured me that being at my local hospital feels just like a birthing center, and it’s even better since it is much quieter than Roosevelt.  Plus, they have Jacuzzis in the room, (which sounds oh-so glamorous even though I have yet to meet anyone who has actually used the tubs during labor.)

So, I knew what I wanted, that was a very important first step, now the real work would begin. I spoke to a few midwives and decided on a woman named Chris. Not only does she have the same name as one of my all time best friends, but she also was a midwife at Roosevelt for many years before deciding to move to Brooklyn, so I was confident that she had loads of experience. Plus, I just liked how she sounded on the phone, she was kind, down to earth, smart, and seemed to get my humorous neurosis. Now, the main issue here is that not one of the midwives at this hospital take insurance. I called my insurance company, and after being told that it is VERY rare to get what they call an “in network exception,”  I could try, and see what happened.

So, that’s what I did. The first time I tried for the exception was by phone, explaining why I wanted Chris as my midwife and why I wanted and needed to deliver at my local hospital.  I am due in January, and for all they know NYC may close their roads due to a snow storm, and then how on earth would I get to a different hospital?  A few days later I was told that I was denied.  But!  I could appeal! This would mean writing a letter to the powers-that-shouldn’t-be and explaining my case once again, this time on paper.  A week or so later, I got a call that once again I was denied. But!  I could appeal AGAIN! So, that’s what I did.  At this point, I was pissed. That feeling of control was dissipating, and my anger towards nasty American Corporations was stirring once again.  I don’t take NO very lightly, never have. At some point I started spotting, and felt so frustrated that I couldn’t just go and see someone to make sure the baby was OK.  I had to wait for THEIR approval to get the care that I needed.

At some point during my frustration I called my insurance company to tell them that they really needed to speed this along since at this point they were threatening the health of the pregnancy.  I happened to speak to a woman who has children, who actually listened to me, and who responded with compassion. She told me there was really nothing she could do since I am not allowed to speak with anyone in the appeals department, but she could at least write a note to speed things along.  The next day I received a voice mail message from her telling me that she was thinking about my situation all night and was going to try her hardest to do what ever it was she could do to get this approved. Wouldn’t you know, around a week later, they approved my midwife, Chris! I wanted to send this woman flowers and chocolates, but of course when I called back no one could tell me who she was.  It’s confidential I guess, which makes sense considering all the hate mail they must receive.

I remember calling my dad during all of this stress and being a typical MD, he said “you know, it’s not the worst thing if you just have a doctor.”   But I feel like birthing is different for a midwife.  Each patient is special. Every appointment is at least an hour, and when I was having some pains the other day, I could text my midwife and ask if I could come in and hear the heartbeat, and she replied right away with “sure, anytime.” About 4 million American women may give birth every year, but it’s still pretty miraculous, and I want someone helping me through this process who understands how unique this is for me and my husband, and who doesn’t see it as just another routine procedure.  I don’t believe that everyone who chooses a doctor to deliver their baby is going to have a bad experience, but I for one did not want a doctor who I never met before come into my room during the most intimate and trying experience of my life and tell me what to do, as can happen when you’re at a mulit-doctor ob/gyn practice.

I am curious how you chose your doctor or midwife, and what was important to you in making your decision?

It’s Not Just Another Walk – A Very Personal Perspective on Why Breast Cancer Walks Matter

Today I’m doing something I’ve never done before – I’m posting a guest post.  As part of the Yahoo! Motherboard‘s recognition of Breast Cancer Awareness Month I wanted to write something that would resonate, be authentic and affect people.  The only way I could even fathom doing this was to have my friend Shari write about her incredibly strong, dynamic and loving mom.  I met Shari 6 years ago when our daughters started preschool and I don’t think I ever knew her mom as a non-breast cancer patient.  I am one of those people who believes that good people – truly honest, sincere, rock solid people don’t just happen – they are formed in the best way by their parents.  Shari is one of those people and there is no doubt that her mom helped make her so.  (Her dad’s pretty great too but that’s a whole other side of Shari I won’t get into here…)  I hope you will read Shari’s guest post and be moved in some way to donate or participate in the fight to find a cure.   At the very least, take 5 minutes to reflect on the women in your life and the way they’ve influenced the person you’ve become.

Throughout the years, my mom was always within arms reach. Whether it was setting up my new dorm room, fielding a helpless phone call after a lackluster term paper, or providing that last supportive hug as I whisked off for my honeymoon, no matter what was happening in her own personal life, she never once dodged any of the emotions, needs or complaints I so often (selfishly) hurled in her direction – even while she was battling terminal metastatic breast cancer.

Five years is a very long time to live with metastatic breast cancer.  There are only so many brain radiation and chemo treatments one can handle before they start taking their toll.  Unfortunately, I remember Mom’s very last hospital stay as if it were yesterday.  Outside, the day was crystal clear.   We were all in her hospital room  (the 3rd one in two weeks) and the grandchildren were on the floor obliviously making “Get Well” pictures to hang on her wall.   Mom asked me to comb her hair and to gently apply lipstick and blush so that the kids “Wouldn’t be able to tell” that she was sick.   After I finished, she let out a sigh and stared out longingly at her grandchildren and watched them play.  It would be the last time she would ever see them play.

Mom was my beacon:  a role model for me throughout grade school, college, marriage and motherhood, a friend with whom to share triumphs and fears, a confidante to my innermost feelings.  Home-cooked meals graced the dinner table every single school night.  Her sideline cheers and support buoyed me through every field hockey game and tennis match.   When I swallowed a bottle of pills at age four and was hospitalized for a week, I’m told mom kept vigil by the bedside.   When I transferred schools in sixth grade and feigned illness for a trip to the nurse’s office (and potentially a ticket home) Mom drove in every time and convinced me to stay.

It’s amazing how much about my mom’s life I learned through her death. I always knew Mom was a very private person.  Yet, her funeral boasted myriad outsiders who were somehow touched by Mom; it was my window into her true depth of compassion for others, even during her personal cancer struggle.  The receiving line represented grieving people from all walks of her life:  the Russian manicurist who looked forward to seeing my mom every week for the last eight years (even during her marathon chemo infusion days), the dry cleaning lady who loved receiving my mom’s crafty hand-written recipes each week, teachers from my grade school (over 35 years ago) who worked with her as class mom and were still kept up to date on my milestones, my high school friends from near and far–one of whom finally told me at the funeral that my mom had taken her to get an abortion her senior year in high school – mom never told me she did any of this.

Mom’s quiet strength prevented most people from even knowing she was deeply suffering from a terminal illness.  She always drove herself alone to her multi-hour chemo treatments at the hospital.  Devoid of emotion, she’d “Plug into” her chest port and start reading her favorite book or finish a crossword puzzle. When her hair fell out, she always had new wigs lined up ready to be styled.  When her eyebrows fell out, without hesitation new ones were tattooed on.  With the fifty -pound weight loss came new, vibrant zany outfits.  She didn’t outwardly pity herself.  She wasn’t willing to allow herself to give in.  She was always a pillar of strength to her friends, to her family and to cancer.  After her funeral, I vowed that I would do anything I could to not only preserve her memory but, to also raise money to help fund breast cancer research, awareness and screenings.  So, for the past two years, I’ve amassed a team of courageous women to walk beside me and a thousand other strangers in the Susan G. Komen 3-Day 60-mile walk.

Participating in the 3-day walk is a vicious physical challenge. The medic tents at every stop are always overflowing with people suffering from exhaustion, dehydration, severe “road rash” and blisters—yet, the physical challenge pales in comparison to a cancer patients’ struggles.  The inspirational journey that takes place is beyond overwhelming.   I meet the most interesting people, from motherless children to 3-time survivors.  I hear their intimate struggles with the disease and how it has affected them or someone close.  Complete strangers become instant friends; we bond through something we despise – cancer.  Along the road I laugh with them, cry with them.  We support each other.  We never forget each other and the constant pain this disease has caused.

I walk the grueling 60-miles with Mom by my side, in my head, and in my heart.  I walk attempting to feel just a small part of her pain and her struggle.  I feel her life force as the wind carries me along the winding route. I walk because I am so angry that Mom is missing years of my life and my children’s life.  There will be no more handwritten notes, no more phone calls on my birthdays, no more fresh banana chocolate chip cake awaiting my Thanksgiving arrival.  Her comforting smell is now only preserved in a sterile perfume bottle I took when cleaning out her medicine cabinet.  I walk with a searing pain through my heart remembering my 5-year old son declare he “couldn’t really remember my mom, “Meema. “

I believe that Mom truly benefited from the anonymous effort of strangers who participate in these fundraising events.  Thanks to advancements in drug research (due in part to funding), Mom definitely lived longer than anyone had anticipated -with a decent quality of life.  How can I not be a part of something that can possibly, even remotely, help others live long, fulfilling lives?

The way I try to live my life is the greatest testament to Mom.  She will be an inspiration to me always – in life and in death.

I walk because everyone deserves a lifetime.

I walk because I can.

The Doctor Will Not See You Now

bad doctor md

I am 37 years old.  I have been going to the gynecologist for about 20 years.  During that time I graduated from high school and college, started a career, got married, gave birth to twins, tried many different forms of birth control and brands of birth control pills, and changed doctors 4 times.  One thing has remained the same in all these years of my “women’s” health care – I always saw a doctor, a Board Certified, Medical School Degree, diploma hanging on the wall doctor.  This year I went through the usual ridiculous measures that you need to take in order to see an OB/GYN in a busy Manhattan practice.  I called 3 months in advance of my desired date and, after much conferring with the receptionist,  got an appointment for my annual check up 4 months later.   All set right?   Well, no…

Last week I came home to a message from the receptionist telling me that my appointment time will have to be changed to 5:30 pm.  In other words I will have to get a babysitter so that I can go to the doctor.  When I called back to figure out a new time during the school day I was told the next available time would be 2 months later.  Or, the receptionist informed me, I could see the PA next week.   The what?  The Physician’s Assistant, like this was the most normal option in the world.  Turns out the Physician’s Assistant could do an exam, a Pap smear even prescribe drugs.  Just like a doctor, the receptionist cheerily told me, except she didn’t go to Medical School.

Now, maybe I’m crazy.  Or maybe as the daughter of a doctor this just smacks of the further denigration of respect for what doctors do, but isn’t that part about going to Medical School kind of important?  I’m sure a PA has been well trained and can help a doctor “see” more patients than she would normally be able to, but when I go to my doctor for a check up – a very personal check up I should add – I don’t think its too much to ask to actually see my doctor.  My vetted, carefully chosen, highly recommended doctor.  Isn’t that relationship important?  I feel like checking in with my doctor once a year is not just about the actual exam and subsequent lab tests, but about the yearly catch up.  How am I doing?  Am I thinking about having another baby?  Am I happy with the birth control we decided on last year?  How’s my marriage?  Any personal issues that I would only discuss with my OB/GYN like sex or post pregnancy blues, or other things that are so easy to talk about when you’re in that office with a doctor dedicated to women’s health suddenly become shunted to the side.

I’ve come to realize that now that I am not going to have any more children and fall into the GYN side not the OB side I warrant less attention in my doctor’s practice.  But, I want to know why a woman is less worthy of a Medical Doctor’s time because her appointment is “routine” instead of prenatal.  So I told the receptionist that I would not like to see the PA.  I will get a babysitter or have my husband come home early so that I can have an actual in person appointment with my doctor.  And I have to say this has made me rethink my doctor herself.  I will probably start looking for a new doctor, maybe one without the hyphen -OB, and one who thinks that a check up is an opportunity to check in.

This post originally appeared at nycmomsblog

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