Response to Cynthia and Sheena
Sally Edsall (SEDSALL@nswtf.org.au)
Wed, 27 Mar 1996 12:23:56 GMT+10
I couldn't agree more with Cynthia's and Sheena's comments about the
need for better advice and skills on the part of OB nurses.
I also recognised the comments made by a previous poster re "not
upsetting" prospective parents in ante natal classes.
I developed "fulminating pre-eclampsia" in my 29th week, and
fortunately it stopped short of the full H.E.L.L.P syndrome, but it
was very touch and go whether I was going to suffer eclamptic
fitting. Of course, the only cure is delivery, as Cynthia said.
What does one learn about such possibilities during the ante natal
experience? In my experience, NOTHING. Classes are conducted around
the assumption of the perfect pregnancy. I attended "earlybird
classes" which aimed to prepare you for the 2nd and 3rd trimesters. I
never got to the birth classes - the first one was held the night
Ben was born!
One woman in the class was regarded as a bit of an oddity because she
had the most terrible morning sickness! We were asked at one stage if
we "felt positive about the pregnancy and our ability to go full
term". Well, of course we did! And any other thinking would have been
discouraged! Really, who goes into their first
pregnancy EXPECTING something to go wrong?
The fact is that 10% of first pregnancies result in some degree of
pre-eclampsia, to name only one complication, and, as we know, there
are many. This makes me believe that it is negligent of the health
professionals with whom we come into contact during pregnancy, most
especially obstetricians, to not fully inform women of what to be
attentive to.
It wasn't til after the event that I realised the real reason I was
taking that urine specimen in every month, and why my blood pressure
was being monitored (fat lot of good it did anyway!).
I hold the authors of books on pregnancy responsible too. The only
clue I had that something was amiss was due to one paragraph in
Sheila Kitzinger's "bible" on pregnancy and childbirth. It said not
to ignore upper abdominal pain, or gastric like illness, nausea,
vomiting etc in "late
pregnancy". Now I ask you - is 29 weeks "late pregnancy"????
Fortunately I decided it did mean me and sought help.
Every other symptom experienced in pre-eclampsia can occur in an
otherwise normal pregnancy : swollen feet and ankles, what appears
to be indigestion (in fact dangerous epigastric pain fromm the
swollen liver - I was downing Gaviscon thinking it was indigestion),
headaches,nausea, and the list goes on. It's the high blood pressure and
protein in the urine that's a good indicator, but you don't FEEL high
blood pressure.
Likewise, sitting at home you don't know about the protein. It's the
combination of all this that counts. When I looked at my swollen
feet and legs, I thought of my friend who had put on 30 kg in her
pregnancy, and was unrecognisable to friends! Then there was another
acquaintance who had "morning" sickness throughout.
So like Cynthia, you shut up and put up with it, not wanting to
"bother the doctor" between visits.
Maybe if we had a system of informed and well-educated nurse-midwives
and/or GPs in our communitites with whom we felt a close
relationship, rather than falling for the trap of expensive,
specialist obstetricians whose secretaries spend more time extracting
money from you than the doctors do in actual consultation, we'd be better
off.
I NOW know about the really terrific services available to me in
Sydney should I enter a second pregnancy. All this is available for
free as an outpatient at public hospitals. Didn't help the first time
round though.
I feel that in this day and age, women don't need to be protected
from the sort of knowledge that allows them to take responsibility
for the informed management of their own, and their foetuses' health.
Health professionals should not be allowed to assert that we
shouldn't worry our vacuaous, pregnant heads about it, and we should
demand to be fully informed!
That's my soapbox pronouncement for today. Great to have this forum
available to help work through our issues. I'm even happy to acede to
the American term "preemie", though I will admit I've had a couple of
posts bounce back undeliverable when my fingers have forced me to
type the more familiar "Premmy" !!!
Sally Edsall
> With my first pregnancy I was told repeatedly by nurses in my OB's office
> that the upper-gastric pain I was experiencing was either heartburn, ribs
> spreading or the baby's foot hooked in a rib. I let the pain go on for a
> week and the cause turned out to be a greatly enlarged liver (H.E.L.L.P.
> Syndrome). Because it was my first pregnancy I didn't know how much
> discomfort to expect and I didn't want to be a whiner so I put up with the
> pain until I just couldn't stand it any more. In fact I came close to death
> and obviously Trevor's well being was compromised too.
> So, my answer to you, Sheena, is a resounding YES!!! I think that better
> advice, more education and better listening skills on the part of OB nurses
> could help to prevent early delivery or at least help to catch pregnancy
> diseases and complications in earlier stages of development.
>
>