The heart beats

Good news, a heart exists and is beating. It’s pretty amazing to me to imagine this tiny little organ that sustains a being the size of a lima bean or grape. Yet if all goes well, will sustain an individual through many decades of life. It’s pretty mind-boggling to me.

They did both the external and the transvaginal ultrasound. I was glad they did the transvaginal, since this early on, it provides much better information.

It didn’t look like much more than a bug. The technician referred to it as a sac. I saw a little thing off to the side and asked what it was. I believe she said it was the yolk. She said it’s attached to the baby and feeds it for now, but will disappear when the placenta develops more. It’s a lot like a chicken.

I asked if she could see any indication of gender and she said no. She said the arms and legs haven’t even developed yet. There is a head and a future body and a heart. That’s about it. She said I could find out the gender at 20 weeks, which seems ridiculously late to me. I told her they were able to tell me at 10 weeks in Bolivia.

“They were probably guessing,” she said.

“But they were right.”

“This is a top of the line machine.”

Personally, I didn’t think it was a top of the line experience. I still think my experience in Bolivia was far superior, which US medical professionals hate to hear. But I think we need to recognize that it’s not all about technology.

In Bolivia I looked at the screen together with the doctor. He told me what he was seeing as he was seeing it. I felt involved, informed, and respected.

Here, I was handed a plastic card at the counter that said my family could not come in for the ultrasound until after the diagnostic parts were done. Thanks a lot, since the main reason to bring family is to have support when something is wrong, or to share the joy of positive news together. By the time the diagnostics are done, I’ve had to absorb the good or the bad by myself.

The technician was nice enough, but she turned the screen away from me and did her work without telling me what she was doing or what she was seeing. Efficient, yes. Personal, no. I felt insignificant and not respected. She eventually showed me some images and at the very end, called in Mark. Mark got to see nothing more than an image or two on the screen.

I asked her how many weeks I was and she said she wasn’t supposed to comment on those things. In Bolivia, I was told exactly how far along I was, when I was due, and how large he predicted the baby would be at birth (and he was very accurate).

I’m glad to find out it’s alive, and am hoping it’s healthy. But I’m pretty much dreading going through another round of the U.S. maternity medical system.

Mark still doesn’t want to bond with the sac/embryo/lima bean/whatever it is until the genetic tests are done. If anything is wrong, he doesn’t want it. I would need to be sure something is wrong before getting rid of it. I think it would be a horrible decision in any case. But I think it would be slightly easier not having suffered much this time around. To suffer through weeks of nausea and then say forget it, let’s try again in another round, must be a very difficult thing to do.

The big day approaches

Tomorrow is the first sonogram, at which we’ll find out whether or not there is a heartbeat, whether or not we can become excited about a potential future child.
I was looking at a week-by-week website the other day and learned that it’s the size of a lima bean. Despite that being remarkably small, somehow it made it more human for me to be able to imagine it as a lima bean. It also said that it still has webbed hands and feet and that the elbows are just now forming. When I tried to tell Mark these things, he didn’t want to hear them. “I don’t want to become attached until I know if it’s OK,” he said. I thought it was cute that it’s even possible to become attached to a lima bean growing inside someone else.

If I was in Bolivia, I’d probably be able to find out the sex tomorrow, since they use trans-vaginal ultrasounds here. I really don’t know why they don’t do so here, given that they are more accurate and not at all painful. I’ll ask tomorrow.

Searching for Quality Maternal Care

My husband and I had another pre-natal doctor’s appointment today and again, the quality of the visit was disappointing compared to Bolivia. At my last appointment in Bolivia I received quite a bit of information. In addition to 3-D pictures, the doctor spent a good 45 minutes examining the fetus, he provided detailed and helpful responses to my questions and I learned a lot. I was told the fetus was almost one kilo, and was in the top 3% for height-weight at its point in development. He showed me a chart indicated that if that rate of growth continues, I could expect the baby to be between 3.5 and 4 kilos at birth (postnote: he was correct, the baby was born at just under 4 kilos).

The American doctor listened to the heartbeat and measured my abdomen, saying “OK.” That was it. The answers to our questions were extremely terse and I had the feeling we were taking his valuable time. We asked if there were any doulas he’d recommend. He gave us a single first name.

“Any ideas on how we could locate Gloria?” Mark asked.

I asked why he recommended this particular person. “Because she knows my name,” he said. “The other don’t.”

Is that really a reason why we’d hire someone? Because she knows the doctor’s name?

Mark’s impression is that the doctor is flakey and he isn’t impressed with the knowledge levels displayed by the staff we’ve had contact with. Now, when we still don’t have full confidence in our primary doctor, we have to begin to rotate through the other four doctors in the practice, so that we’ll have had at least five minutes of contact with the random person who will deliver our child.

It’s understandable, with such a low level of personalization, with no single individual really paying attention to the needs of the couple throughout the pregnancy process, that demand is growing for non-medical staff like doulas. I almost look back nostalgically to the local country doctor – the person who knew his client well, who was available to come in the middle of the night if necessary. Since doctors have moved so far from this model, people have to look elsewhere to find a person who will listen, provide personalized advice and promise to be available over a period of several months.

Ultrasound canceled by a strike

I read in the paper today that the regional assembly declared a 24-hour general strike for this coming Tuesday. From what I could understand, it’s in support of Sucre. Several regions will be joining in, paralyzing the majority of the country.

I called Maria to ask what that means. “There will be no transportation,” she said. “Neither government agencies, nor private companies will be working.”

“So we have the day off?”

“Yes.”It doesn’t do much good to have the day off when there is no transportation and you can’t go anywhere. I’m going to have to cancel the appointment I had for an ultrasound on Tuesday afternoon. That’s disappointing since I was looking forward to getting a good view of the baby for the first time. I hope it will be possible to reschedule before leaving. The same service of a 3D or 4D ultrasound that costs $25 here in Bolivia costs $400 in the U.S.

I asked one of my roommates why she thought the strike was being called.

“Every region wants to be independent, to manage its own resources,” she said.

“So Bolivia could become a bunch of miniature countries?”

“Yes.”

I asked if there would truly be no transportation available during the strike. I imagined some of the drivers must need the money.

“They make an agreement that anyone who is out driving will get attacked, will have their tires burned. So everyone stays home.” Guess I have no choice.

Note: I did eventually get the ultrasound done in Bolivia, it was professional and modern, and it cost $25. Seeing the baby as he really looked helped me to see him as a person much more so than the standard ultrasounds that show something resembling a bug. If you find yourself overseas during your pregnancy and it's the right time (24 weeks plus) you might be able to get a 3 or 4-D ultrasound at a very competitive price.

A Bolivian Baby Shower

I went to a café in the popular Montsenor district of Santa Cruz, Bolivia with my colleagues from work. We were going to attend our co-worker's baby shower. In the blocks heading away from the giant Christ statue, the streets are filled with one café after another, as well as a selection of great restaurants – Italian, Mexican, duck, frozen yogurt. About 20 people got together to celebrate the baby showers of two women, both named Claudia, and due in August and September respectively.

I was really curious to see what a Bolivian shower is like. The fact that they refer to it as a “baby shower,” in English, made me think it was probably imported from the States. For much of the time, it wasn’t much different from any other gathering of friends at a café, except that two of the attendees were visibly pregnant. Both males and females came, they ordered coffee, tea and snacks, and chatted amongst themselves.

At one point they presented congratulatory cards to the two women, which everyone had signed. And they presented them each with an attractive green baby carrier, purchased through a collection. There wasn’t too much planned or personalized about it – no games, no stories, no pictures.

Toward the end, the Claudia who is due in September made the rounds around the tables with a gold chain. She swung it over the palm of both men and women to predict the number and sex of the children that person would have in the future. After raising and lowering the chain toward the palm three times, she let it move of its own accord. If the chain swung up and down, it would be a boy, if it swung in a circle, it would be a girl, if it didn’t move, there wouldn’t be any children.

My colleague Maria was upset, because when she’d had it done the previous day, it hadn’t moved at all over her right palm.

“I’m never going to be a mother!” the 29-year-old, currently without a boyfriend, lamented. “Try my left hand,” she insisted.

There, she received the answer that she’d have one girl. They explained that since Maria is left-handed, her energy came only from her left hand.

When they did it to me, they told me I’d have a boy, then a girl. The third time it didn’t move, which meant two biological children would be it. I told them I’d get back to them in several months to let them know how accurate their predictions were. But they seemed to believe pretty strongly.

Only my German colleague, Helen, refused to be tested – either not believing in the game passed down by Bolivian grandmothers, or not wanting her reproductive future to be made public knowledge.