Doctors and Their Tests... My doctor was wrong.

This is my story about an OBGYN getting incorrect results from a pregnancy test and the lack of follow-up afterwards. It's so important to realize doctors- and science- can be wrong sometimes. Get second opinions.

I am 14 weeks pregnant with Baby #2 and I wanted to share my experience with the OBGYN we saw at the beginning of this pregnancy with you because I think it's so important and a reminder that we should always question "science" and "authority" because regardless of how accurate science is and how many degrees your doctor has, humans can be wrong and make errors.

A "Brief" Birth Story from Baby G's Birth
I had an unplanned c-section after a planned natural unmedicated birth center birth with Baby G due to his position (sunny side up) and size (10 lbs 12 oz) so we're hoping to have a VBAC (vaginal birth after cesarean) with this baby. I labored until about 9 cm (until 8 cm unmedicated, only made it another 1 cm post Epidural/Pitocin) and he never dropped past -2. I had transferred from the birth center to the hospital near the birth center at 8 cm; the hospital unfortunately has a pretty high c-section rate and I ended up with one. Part of me knows it was necessary and part of me is highly suspicious that I ended up with a 7:05pm c-section on a Friday night. Gosh darnit! I've been anti c-section since my Child Development class in college when my Psychology professor was telling us that the #1 determining factor of whether a woman gets a c-section or not is her INSURANCE COVERAGE. Not baby position, fetal distress, or any of those many other factors. When I was reading up on child birth prior to Baby G's birth, the one stat that seems to pop up is that c-section rates rise on Friday evenings and around shift changes. Doh.

Three or four days after my c-section, as I'm getting information from the OBGYN who performed my c-section about follow up care for discharge, she tells me she recommends that I not attempt to VBAC, then quickly says she did stitch me up the "correct" way to VBAC, however. I ask why she doesn't recommend it. "Well you had a 10 lb 12 oz baby and the next is probably going to be bigger," then goes on to stress how Baby G's shoulders could have gotten stuck, etc. I had spent a couple emotional days post partum with a cranky baby... something I blame on the rather rude c-section birth and associate drugs (Epidural, spinal, Pitocin, pain killers...)... in severe pain and unable to even get up to change my crying child's diaper (Daddy B did it though, just to clarify!). I was emotional courtesy of the lovely hormones as well as the fact that my birth plan went down the stinky potty... etc. Bad timing lady... I turn to her with my super sweet voice and ask, "Oh no... was there something biologically WRONG with me that you're diagnosing me with?!" Her: "Uh... oh... no." Exactly.

A baby's size isn't a reason to c-section someone. Now Baby G's position AND size did make for what was probably a necessary c-section (based on three separate midwives' opinions).

Protein During Pregnancy

Also, I had a suspicion why I'd had a high birth weight baby. My birth instructor recommended drinking protein shakes during pregnancy because they said that you need 120 g of protein while pregnant and most people don't get that amount. Just to clarify... you do not. You need about 70 g. And you should get it by eating foods with protein. Just avoid the protein shakes. Since having Baby G, I've done a little research and while there's not a lot of info on it, it definitely seems like protein shake use can contribute to high birth weight babies. My birth instructor, the one who recommended and used protein shakes herself, had her baby a few months after Baby G was born and her daughter weighed in at over 11 lbs. Honestly, I think your body will do an excellent job of telling you when you need to increase your protein... usually your cravings will give you an indication. Want a big fat cheeseburger? Yeah, you probably are lacking protein. This pregnancy I've been craving bread and butter... I've been going through loaves of bread like no one's business; I think I needed to increase my carbs.

This Pregnancy

As such, this pregnancy I will not be going to the same hospital or midwives. I really loved my midwives, but the law in Maryland doesn't allow me to have a VBAC at their freestanding birth center and so I'd need to go back to the same hospital. I'd likely see the same OBGYN and the hospital has high C rates, low VBAC rates, and I felt like the OBGYN had way too much control during my labor with Baby G once I transfered. I don't like the idea of walking into a hospital where I know the OBGYN whose making final decisions has decided BEFORE I even left the hospital with the last baby that I can't VBAC.

Some people seem to be doing VBACs as a home birth (home birth after cesarean, HBAC), but I don't see licensed midwives doing that and I get the sense that these lay midwives aren't legally practicing in Maryland. I don't trust people who don't follow the law in terms of medical practice. Licensing boards are there for a reason and child birth is a time when you're pretty vulnerable. Not only that, but I think that if your midwife is practicing illegally, then I assume that they'll hesitate more before transferring you to the hospital for fear they would have legal repercussions  As a result, I'm going to a hospital, but I have a choice in which hospital I go to.

I contacted my local iCan (International Cesarean Awareness Network) chapter to find out which hospital and doctors are best to use. Mercy Hospital was recommended as their head OBGYN is very supportive of VBACs and gosh that hospital is beautiful! I checked out a couple of their recommended providers and chose one to see.

That OB didn't work out. I really liked the provider at the visit, but I had major communication issues with the OBGYN. I've noticed this seems to be a trend with OBGYNs in Maryland which is why I'd seen midwives to begin with (along with wanting the birth center experience), but I'd hoped this place would be different. It wasn't and that's sad. I don't know if they're just over booking or what the issue is... I do realize they must be very busy. I keep getting told OBGYNs are a "better" option than midwives, but I find it hard to believe I'll get better care from a provider that can't return a phone call about lab results than I would from one who spends longer with me during appointments, returns calls promptly, listens attentively, and calls immediately with test results.

Here's the story of my experience with this OBGYN because I think it's interesting and an important lesson for people when dealing with doctors- you know yourself better than anyone... don't ignore your intuition just because the "professional" tells you you're wrong. Get a second opinion, if necessary. It's allowed.
________________________________________________

Time Line

February 26, 2013: First appointment.  A transvaginal ultrasound was completed and what appeared to be a gestational sac was pointed out, even though it was too early in pregnancy to see a baby. I was scheduled to come back in a week for another ultrasound if the HCG levels were okay. Blood and urine HCG tests were done.

March 4, 2013: I received a voicemail from the OBGYN stating that both my pregnancy tests (urine and blood test) were negative and my HCG was less than 1. It was also stated that what was observed in the ultrasound was "probably a blood clot." The OBGYN, in the message, stated that we "needed to talk" and that she would call back. I attempted to call back the office, but the person who answered related the OBGYN was out for the day and having surgery this week. They did relate that she would still be returning calls so they took a message. I canceled my appointment for the week seeing that there reportedly wasn't a baby. I wasn't sure what was going on, but assumed that I was not pregnant and if there had been a baby, it wasn't viable. I had a few glasses of wine, grieved, and waited for my period.

March 6, 2013: By Wednesday morning, I still hadn't gotten a call back or had any spotting or bleeding. I didn't know what was wrong. I took another pregnancy test. It was positive. I bought a different brand of pregnancy test. It was positive.

March 7, 2013: I called back to the office on Thursday to see if another doctor might be able to give me advice. A nurse called back to inquire if perhaps I'd waited too long to read the test and it was just an evaporation line. No, I followed all of the instructions. I was told I'd get a call back that day. I did not.

March 8, 2013: I called back early Friday afternoon after I did not receive a call back in the morning. I was told the doctor had a lot of messages on her desk and she'd get to me when she was able to. I received a voicemail while I was at work on Friday night at 4:52pm stating that I might be getting false positives if something was medically wrong, but that they could order me another blood test if I desired or I could go to Patient First. Seeing it was Friday night, past when the office closed, I was forced to go to Patient First if I wanted test results. I was really nervous because I was concerned that something was medically wrong if I wasn't pregnant by this point, seeing everyone seemed so convinced that the blood HCG couldn't be wrong. It was also very odd for me not to have my cycle on time. I didn't want to wait to test until Monday at the earlier, then have to wait another week for test results (based on how long it took to get results before).
  • I also contacted my PCP at this point to see what their recommendation was; they also assumed OBGYN's test results were correct and suggested I just retest if I don't get my period in the next 2 weeks. They also appeared to be assuming I didn't know how to use a pregnancy test. 
March 9, 2013: Saturday I went to Patient First, paid a $50 copay, and waited three hours there to get test results. The staff was awesome. My blood test came back positive and they sent it to a lab for the HCG quantities. The front desk lady gave me a high five when I left, haha.

March 11, 2013: Patient First called me with my blood HCG test results, stating again that I was pregnant and giving me the estimated numbed of weeks pregnant. Note that it took the OBGYN SIX DAYS to get back to me with the original test results, it took Patient First 30 minutes and then less than 48 hours (during the weekend too). I called up one of the other providers recommended for a VBAC- midwives this time- and asked to setup an appointment. They called me back and let me know they had a cancellation for the next day!

March 12, 2013: Saw the new midwives on Tuesday, received a referral for an ultrasound, and a lab slip for lab tests.

March 13, 2013: Finally got a follow up call from the OBYN's office from their late Friday evening phone call, to make sure I'd received their voicemail. I didn't bother returning the call. I try not to talk to people when I'm too angry to turn my filter on.

March 14, 2013: Went for my ultrasound and our baby was just fine with a heart beat of 153 BPM! Got my blood tests which were rock star as well.

March 18, 2013: The original OBGYN left another voicemail for me, following up on the other doctor's messages. In the message, she stated "the blood test doesn't lie" and that my progesterone was "very very low," but offered me a repeat blood test and ultrasound if I wanted.

________________________________________________

The "best" part is during that week, my dog had about 48 hours of continuous seizures so I was super stressed out. 

I did end up writing the OBGYN's office a letter detailing my experience and disappointments with the practice, and requesting a transfer of records. I did get an apology phone call where the OBGYN said it was probably a mistake by the lab and that I shouldn't worry about all that wine I drank because a little is fine, but she seemed to remember her original message a lot differently than I did, considering she remembers telling me we should do another lab test to confirm in that message. I actually have the voicemail saved still and it most definitely does not state that or even imply that there was any hope that there was a baby in there. And I had a lot of trouble even getting a referral for another lab test, given the poor follow-up. 

Lessons from this experience
  1. I think a well phrased apology is a skill that is best taught and learned early in life specifically for situations like these where you realize you really effed it up. Everyone's allowed to eff it up sometimes and in this case, there's likely no real physical harm. But it helps to admit you really eff'ed up and not make excuses. Defensive tactics, like blaming the other person, are no good if you're hoping for forgiveness.  This is a great article on the 10 Steps to an Effective Apology. Sure, this is really a lesson the OBGYN should learn, but I think it's important to think about times where we could be in a similar position and try to learn the lesson from others' mistakes. 
  2. Intuition intuition intuition... if it doesn't make sense, keep exploring. Don't blindly accept something just because the verdict is given to you by someone who is in a position of power. All humans make mistakes, even if they refuse to believe it. Find someone who will accept the possibility that a mistake was made. You do eventually need to realize and accept when the provider is correct, but it should make sense scientifically or they should be able to explain it to you so that it makes sense.
  3. Don't make major decisions until you've gotten a second opinion. While I'm not strictly against drinking during pregnancy (in terms of one glass of wine here or there in the 2nd or 3rd trimester), I don't like drinking in the 1st trimester, especially not the quantity I consumed. Dumb decision. I'm sure it will be fine because I wasn't exactly throwing back shots of tequila, but it upsets me anyways. Those couple of days lost me progress on my diet too. Arg.
  4. Stay CALM and BE ASSERTIVE. I didn't write that letter when I was violently angry, nor did I cuss anyone out. In fact, I wrote a VERY nice letter (considering)... and I explained- assertively- how disappointed I was in the follow up from the office and that I was unable to continue with them for my pregnancy. All true. 
  5. Do NOT blindly trust doctors... they can be wrong. Why? They don't always listen, they're frequently in a rush and overbooked, and they're human. Add in the fact that SCIENCE isn't perfect or always correct... we've got a lot of room for growth, even though we've come so far. That leaves a lot of room for error.

    Here's two more examples:
    • I got told by two different doctors a few weeks ago that Baby G wouldn't catch Strep throat from Daddy B and me because kids under 2 rarely get it. Kept an eye out for him having a sore throat, but he can't talk so I had to rely on decreased eating, etc. and he was eating like a horse as usual. At our 18 month checkup a week later, I mentioned his continued cough and stuffy nose and mentioned that we had Strep the week prior. She did a Strep test, even though she thought it'd be negative. Oh the precious looks on their faces when that test popped up positive. Sigh. Wish I'd listened to mommy intuition the week prior because I anticipate it might have been an icky week for him. Poor kiddo. 
    • In college, I had some lab tests run and one came back positive. I was put on medicine. A year later, I found out that the lab tests had been messed up in some way (something to do with the manufacturing of the lab test) so the results weren't necessarily accurate. Oops.
  6. Get and keep doctors that you love and trust. I generally love my PCP, even though I wasn't pleased with the input over the pregnancy test. I love her not because I share this wonderful connection with her, but because she spends just enough time and listens to what you have to say so that she can make an accurate diagnosis. She's the only doctor I've ever had who has accurately diagnosed me with stuff without running a million different tests. When I first moved here and went to her because I wasn't feeling well, I had a pretty short list of symptoms. She ran four tests. I tested positive on three of the four tests.  I had a strain of Lyme Disease... other doctors wouldn't have asked me about my hobbies. She did. So she knew I liked to take long trail rides in the woods. While I really liked this OBGYN and while I anticipate that some of the issue was that the office was overburdened while she was out for a few days for surgery, I lost trust in her (and the office) due to that experience. I want to trust the person who is delivering my child. At some point during labor (and other times), I'll need to put my faith in them 100% that they're making the right recommendations.  I really love the midwives I transferred too and they're an excellent fit for me. 

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DIY Danielle: Doctors and Their Tests... My doctor was wrong.
Doctors and Their Tests... My doctor was wrong.
This is my story about an OBGYN getting incorrect results from a pregnancy test and the lack of follow-up afterwards. It's so important to realize doctors- and science- can be wrong sometimes. Get second opinions.
DIY Danielle
http://www.diydanielle.com/2013/05/doctors-and-their-tests-my-doctor-was.html
http://www.diydanielle.com/
http://www.diydanielle.com/
http://www.diydanielle.com/2013/05/doctors-and-their-tests-my-doctor-was.html
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