This was going to be a long entry in which I went through my mental list of “things we need for the babies” but when I got about halfway through writing that, something happened that made me change course.
I have a deadline coming up for my job; not for another week and a half, but it’s coming up. On Tuesday, my boss came in to talk to me about what needed to happen for the deadline. The meeting had me tensing up, at least partly because my to-do list got longer than I’d anticipated it being. When the meeting ended, I got to work on my first action item and paused midway through to run to the bathroom. I figured, I’d check the first thing off my list, have lunch, and then really dive in.
That all changed when I got to the bathroom because, you see, I was spotting.
Spotting is common in early pregnancy, even more common in twin pregnancies. Reasons for this vary–cervical sensitivity, old blood clearing out, one’s body being a COMPLETE JERK–but most of the time, it doesn’t mean anything, as long as it’s not (a) bright red and (b) accompanied by cramping. Still, when you’ve had as many miscarriages as I have, seeing any blood–brown, pink, or red–automatically sets off klaxons in your brain.
I called my doctor as soon as I got back to the office, and the nurse on the line told me to come in for bloodwork to make sure that my HCG numbers were still high. I thought this was pretty odd–I’m 10 weeks along, so HCG should be kind of besides the point by now, right? But I needed answers, so I went, in a rush of panic; and once I’d gotten my blood drawn, I went home to rest and wait for the results. To my surprise (they’d told me that I wouldn’t get results until at least the next day), the office called me back less than 20 minutes after I got home, largely because the nurse had spoken to my doctor personally.
Let’s rewind some. My doctor, Dr. Solano, was my obstetrician when I was pregnant with Sam. I hadn’t planned to see him, but the doctor I had planned to see had apparently decided that she wanted to be a urologist instead of an obstetrician, which was weird, but okay. Dr. Solano immediately put me at ease with his friendliness and straightforward responses to my questions. He didn’t sugar coat things, but he also gave me information in a kind of enough manner that I could digest it without an ounce of panic. Even towards the end of my pregnancy with Sam, when my body went completely haywire, he stayed calm and optimistic, while still maintaining a realistic view of what was going on and making sure to get me the help I needed.
So naturally, when we found out that we’d FINALLY managed to get pregnant, I called his office right away. I couldn’t imagine seeing anyone else for my prenatal care, even though he’d since moved to an office that was farther away than the one I’d seen him at when I was pregnant with Sam. As soon as the RE’s office released me (that’s what they call it when you’ve successfully gotten pregnant and can start seeing a regular obstetrician instead of the REs), I called Dr. Solano’s office to set up appointments.
The new office handled appointments a little differently than I expected. When I’d been pregnant with Sam, I’d gone in for a blood test to confirm the pregnancy and then gone in for a complete physical with Dr. Solano a couple of weeks later, around the 8 week mark. By simple merit of the process I’d been through, I wouldn’t have been able to have an appointment at 8 weeks, but it turned out that they don’t really do that anymore anyway. Instead, I’d go in and see a nurse (in my case, a pair of nurses) ASAP to go over the whole pregnancy process. At around 10-11 weeks, I’d have an ultrasound with a nurse practitioner. I wouldn’t see an actual doctor until around 16 weeks, two weeks into the second trimester.
Odd, I thought, but alright. I went to the first appointment on Friday, September 22, and it was… well, it happened. A pair of nurses sat down with me and went through all the dos and don’ts of pregnancy with me, all of which I know by heart and could probably teach a class on. They gave me a booklet about those dos and don’ts, a slightly revised copy of the one I’d received four years ago, when I’d giddily gone in for my first appointment with Sam. The primary questions I’d had referenced any way in which twin pregnancy might be different from singleton pregnancy; mostly, their responses were “I don’t know” or “I’ll have to look that up.” When the appointment ended, they sent me to the building’s lab for bloodwork and a urine test, and then I was free to go.
That appointment left me feeling something I’d never felt during my pregnancy with Sam: processed. My appointments with Sam were never particularly long, but that’s largely because I didn’t really have any questions 99% of the time. When I did have questions, Dr. Solano answered them quickly and thoroughly, and I never felt the need to do more of my own research when I got home. The nurses were friendly and joked around with me a lot, and we all established a good rapport that continued when I went into the hospital to deliver.
This stood in stark contrast to what I’d heard about the differences between obstetricians and midwives in terms of prenatal care. For those not in the know, the obstetrician vs. midwife debate tends to be a hot one in pregnancy communities. People complain that obstetricians are too cold, that they leave patients feeling processed and rushed, that midwives are warmer and more caring and will take as much time as you need. I don’t have much experience with midwives (one checked me for dilation when I went to the hospital contracting at 36 weeks, and I later called the check “the fist of justice” because I imagine only God or an embodiment of Justice could cause that much pain to a person’s cervix), but my experience with obstetricians has always been enough for me to argue against this stereotype. Maybe some doctors are like that, but not my doctor.
And yet, after that first appointment, I had doubt. The nurses seemed dismissive of the miscarriages I’ve had (“oh, but those were part of the IVF process,” they said, not writing down the number 4 when I said that was how many miscarriages I’d had. “Yes,” I tried to explain, “I was going through IVF, but I was also pregnant and miscarried.”) and didn’t know that I was having twins until I told them three or four times, despite it being written on my file. I didn’t feel like a person to them; I felt like a number or a checkbox, just another person to process before getting to lunch.
So I wondered if I’d made the right decision. Had medical care changed so much since Sam was born? Was this how all of my prenatal appointments would be?
And that brings me back to spotting on Wednesday. When the nurse on the phone told me I needed bloodwork, it seemed to confirm my worst fears: that nobody knew who I was, that nobody was going to actually treat me like an individual but simply as another cog in the wheel. And then she called back and said she’d spoken to Dr. Solano, and not only that, but he’d wanted me to come in immediately for an ultrasound and appointment.
Which, not to sound entitled to healthcare or anything, but that’s what I’d hoped for and expected.
Kyle and I hurried out to the car and drove all the way to Dr. Solano’s new office. The receptionist warned us that we might have to wait a while, but also told us that Dr. Solano was adamant about seeing us that day, even if we were his last appointment of the day. We did wait for about half an hour before being called in to the ultrasound, and though the technician didn’t know that we were pregnant with twins (honestly, I feel like I actually need to wear a shirt that says, “TWINS” or “#TWINNING” sometimes), we got to see that despite the spotting, they were perfectly healthy with strong heartbeats, tiny kicking limbs, and fingers.
(the tech said that those aren’t fingers on Baby B, but COME ON, what else could they be?)
That put my mind at ease, but not as much as the appointment with Dr. Solano about half an hour later did. Once we’d gotten our photo booth strip of pictures, we returned to the waiting room and were shortly called into a small, warm office. Kyle and I waited in there for about fifteen minutes, sipping from tiny bottles of Wells Fargo water (no, I didn’t know they made water either) and joking around about various methods of contraception until Dr. Solano came in and shook both of our hands, looking genuinely happy to see us.
Which is always a good sign.
He told us that everything looked fine, that I should take it easy and stay on pelvic rest to prevent further spotting adventures (Kyle looked sad), that heavy lifting and heavy activity were out. We all caught up on our lives since Sam was born–he was promoted to the head OB/GYN at a new hospital (which he explained using Star Trek metaphors that Kyle later nitpicked), we have a three-year-old and impending twins.
Best of all, he was able to answer questions, and was happy to do so. He told me that my pregnancy wouldn’t be very different from a singleton pregnancy, except that it would be shorter and involve a lot more ultrasounds (at least one a month to measure the twins’ growth). When I expressed my nervousness at the prospect of needing a C-section to give birth (nationally, twin births are a LOT more likely to be C-section births–about 60-75%, depending on what you read, compared to 30% for singletons), he told me that he likes to avoid C-sections for twins at all costs. He talked about having a 40% C-section rate for twins, which blew my mind–that’s a LOT better than average. And he said, “If you end up needing a C-section, I’ll be right there the whole way.”
It’s a silly thing to be comforted by, but it worked.
The appointment ended, and as Kyle and I headed back to our car, reassured, Dr. Solano made it a point to tell us, “Guys, I was really, really happy to see you on my schedule.” And all the doubt was gone.
It all reinforces some of my strongest beliefs about prenatal care, namely that it’s less about midwife vs. doctor and more about who makes you feel heard, cared for, and safe. For me, that’s an obstetrician (a very specific one, but still an obstetrician). For someone else, that might be a midwife. You really just have to go with whomever works best for you.
My next appointment is on Wednesday, an ultrasound and all that blood drawn for various prenatal tests (I still need to make sure that our insurance will cover Harmony–that’s the most accurate test for chromosomal abnormalities–even though we’re having twins). I’m seeing Dr. Solano’s nurse practitioner, whom he’s said is really great, so I have high hopes. Overall, I’m feeling a lot more confident about this pregnancy, and that’s a huge relief.