Wednesday, May 25, 2011

Not broken by default

Okay, I'm still spun up and stressed out about yesterday, but I'm trying to come to grips with my frustration and come up with a game plan for dealing with the medical establishment. Because it's not like this is going to get easier.

My philosophy going forward is in line with Angelo Coppola's catch phrase: "Humans are not broken by default." The thing that really bothers me about medicine+pregnancy is that the most natural and important human function, MAKING MORE PEOPLE, is treated as a condition, an illness, something to closely monitor and test and treat and overanalyze. Sure, a lot of people today, even women of child-bearing age who should be in prime health, are pretty sick. They're sick because of the way they eat, because they don't sleep enough, because they work too hard, because they forgot how to play and have a good time. But when you address those lifestyle issues, when you eat a healthy, ancestral-inspired diet, get the rest and the play you need, and take care of yourself, you will not be sick. You do not need to be fixed, or supplemented, or monitored, or tested.

If something goes wrong, as it sometimes does, that's when medicine is there for you. This is the country to live in if you have a preterm birth or delivery complications or neonatal illness. That's modern medicine's job, and I consider myself very lucky to have access to that kind of advanced care and technology. But a healthy, normal, well-nourished, well-rested, strong pregnancy? Stay the hell out of my business.

I call bullshit on:
  • Prenatal vitamins. If you're eating a grain-free diet, your body is actually able to absorb the nutrients you need from the food you eat. Supplementing is unnecessary, often doesn't work (for example, minerals and fat-soluble vitamins are notoriously hard to absorb from a pill), and can even be harmful if you get too much of certain nutrients. I make sure I'm getting plenty of folate from eggs and meat, and I supplement Vitamin D, fish oil, and magnesium. I don't have a problem with supplementation per se, and multi-vitamins may make sense for some people, but the idea that every woman needs to take a prenatal vitamin is wrong.
  • Heart rate restrictions. Don't get your heart rate over 140! That's absurd and outdated. Toss that heart rate monitor. There are much better guidelines for avoiding overexertion.
  • One-size-fits-all lifting restrictions. Strength training is invaluable during pregnancy. No, you won't be going for your PR back squat or repping out heavy snatches. But challenging yourself and lifting at 50-80% of your max (depending on various circumstances) feels great and keeps you strong. Yes, what you can do depends on how strong you are when you start out. That is common sense. I did 65# push jerks the other day and didn't really think about it. If you've never hauled a barbell over your head, that would be a bad idea. But the combination of your own intuitions and a coach who knows your abilities is a better guide of what you can do than a doctor who's never seen you lift more than your purse.
  • Oral glucose testing for gestational diabetes. Fat burners are naturally insulin resistant. Giving someone who is not used to large doses of carbohydrate a huge dose of glucose and then seeing that they have trouble releasing insulin to deal with it does not mean they have diabetes or dysfunction of any kind. It just exposes them to an unnecessary physical stressor and introduces a not-small likelihood of a false positive diagnosis.
  • Iron testing. Testing for iron in your blood does not test how much iron is in your body, as your body hoards heavy metals (this is very bad in the case of lead and mercury) and releases them selectively into the blood. If you are eating eggs and red meat and not blocking nutrient absorption with grain consumption, you are getting enough iron. Supplementing with iron can be dangerous, as you can end up with too much, or it can be useless if your body can't absorb it, not to mention iron supplements have some nasty side effects.
Yeah, there are more, but I'll burn those bridges when I come to them. Now, I know a lot of women are willing to follow their doctors' guidelines even if they are active and strong and eating healthy. You know what? I'm fine with that. We should all be able to make our own decisions about our health without some know-it-all (me included) telling us what to do. I support every woman making her own decisions. But what I hate is when doctors have this air of authority and use that to bully capable, healthy women into doing things they don't want or need to do.

I was willing to go along with some of it, especially testing, just to keep my doctors happy. But I knew I was going to draw a hard line on the glucose testing. And since I got such a negative reaction, I'm going to draw a hard line on everything now. I AM NOT BROKEN BY DEFAULT, so my default now is that I'm a healthy pregnant woman who doesn't need every test and intervention in the book. If I'm convinced that something is medically necessary or useful FOR ME, I'll do it. Otherwise, I'll pass. And yes, I'm looking into switching to a different practice, though I might not follow through since I only have about 3 months left and there could be insurance issues. But I am looking into it.

Let's make this post a little more positive. I've found a few resources that have been much LESS about frightening women and much MORE about women being empowered adults.
  • CrossFit Mom. A great resource on real fitness during pregnancy and postpartum.
  • Alpha Mom. A no-nonsense blog about pregnancy and parenting with a wonderful sense of humor peppered throughout.
  • The Strong Mama. My friend Alex's blog. She is my role model when it comes to strong pregnancy, standing up to modern medicine, and sensible parenting.
If you've found other sensible resources, please let me know about them in the comments.


Now, I need to do something other than rant on here. So here are some in-progress knitting photos. See, I'm really a sweet, mild-mannered domestic type. Ha ha.

The front and back of a pillow. Still needs to be blocked, sewn, and stuffed.

Some silver-gray booties in progress:

Yet another MDK burp cloth. These things are like potato chips (can't stop at one), and even more fun in variegated yarn. When I knit from cones, Mike accuses me of running my own sweatshop.


Chrissy said...

I love this!! I was a CrossFitter before I got pregnant (now about 6 months) and I have all these stupid restrictions, don't lift over 25 pounds, make sure you can talk through your exercise routine, and your heart rate doesnt' get too high. I realize that most of these are too keep you from suing the doctor if anything goes wrong-but I listen to my body and it tells me when enough is enough.

Amy said...

Thanks, Chrissy. Keep up the fight, you know best what's right for you. The talking thing is a pretty good metric, I do think about that. You're right that a lot of the squeamishness is probably based on fear of getting sued. And most of these recommendations are aimed at the average out-of-shape person - 25 pounds might be too much for them, but not for someone doing CrossFit!

Amber said...

Hi Amy, My best friend dealt with a lot of this as well, she has an imbalance in her gut flora and that much glucose would have given her a ton of trouble.. so she fought, then she had one of her doctors poo poo part of her birthing plan, so a month before her birth.. she switched care. Then her little guy came a month early, a mere 2 days after she switched.. adventure! My point here is that I hope you are able to switch as easily as she, and keep fighting the good fight. It shocks me how much people assume we can't take care of our own bodies, just because we happen to be doing the thing we're MADE to do. Sheesh.

Sarah said...

You sound kind of like a guy I once knew who said it was cool if we had unprotected sex, because he knew his body, and "knew" he didn't have AIDS. Ha!

I know you don't like hearing what your doctor says, because it goes against your personal beliefs/obsessions. But from an outsider's point of view, you do sometimes sound like a cult member. You won't be "talked down to" by outsiders, you don't want to hear a different point of view (even if the person has good intentions), and you want to do exactly what you want to do for your own reasons, whether or not it alienates those around you. It makes me sad, and yes, I'm worried about your baby.

As one small example: the heart rate guidelines, as far as I remember from when I was pregnant, were about making sure you keep your body temp. in a healthy range. Too high, and it CAN risk damage to your fetus' brain. It's not some anti-Cross Fit conspiracy invented to give you, Amy, a hard time.

Also, I had a midwife for my first pregnancy, and believe me she was no angel. When I called her one night after the birth to ask a breast-feeding question, she got very annoyed with me for interrupting her dinner and actually told me I can't "just call her like that" to ask questions about something that was scary to me (as a first time mom). She was a crank and a quack. Just because you might find someone who will go along with everything you want, and will support your supposed "empowerment," doesn't mean that person is looking out for you. She may have just as much of an ideological agenda (on the other side) as you ascribe to the so-called western doctors who you presume are motivated simply by degrees of liability.

You are a smart woman, and clearly you have lots of ways to talk yourself into whatever you want. But there is nothing wrong with loosening up a bit for the sake of the helpless life growing inside you; he is completely at your mercy and your decisions now WILL affect his development. Go easy for a few months, then when the cord is cut and he's physically independent from you, go back to whatever harsh regime you feel you need to maintain to make yourself happy. What on earth do you have to lose?

Bluescaptain Joe said...

I don't know if Sarah is going to get the followups on this, but in case you do, ma'am, I direct this comment to you:

Is this what you do with your time? Explore the internet to seek out people with whom you disagree, then leave hurtful and misinformed comments on their blogs? If so, perhaps you may consider the wealth of other forms of entertainment available on the internet. For less than 10 dollars a month, you can get movies streaming to your computer from netflix, and their catalog is impressive. Hulu has a similar service available for free, though they impose commercials on the viewer. If you don't like to watch TV and movies, there are many options in journalism, likely including any number of newspapers that may or may not endorse your own views. Most of these newspapers have websites that feature interactive content in which readers can leave comments to each other, much like on blogger except with a much broader readership.

Interestingly, though, evidence in the neurosciences has indicated that dendritic branching in the neurons of a rat's brain is much richer and more dense when those rats are raised in an enriched environment. The difference is even larger when one compares lab rats to rats that live in the wild. I tell you this because if you truly want to enrich your brain and your life in general, it may help to move away from the computer and go outside, particularly when you feel the urge to lash out with hurtful and foolish insults at a complete stranger. If, however, you truly feel that every fetus is within your sole purview to protect, I suggest you stop wasting your energies on the internet and begin volunteering at pregnancy clinics, women's shelters, and anywhere else that your unique experiences and knowledge may be of benefit.

Finally, I ask you as a fellow human being, as a person who hopes for the very best out of his fellow humans, and as a person who likes to think that the internet has the potential to be a civil and mutually beneficial place -- in the name of all these things I ask you: Please do not compare my sister to your possibly HIV-positive ex-boyfriend. I ask you this for my sake, as reading such things is hurtful to me, for my sister's sake, as I wish her no undue stress, and for your own sake. For your own? Yes, for your own sake, because saying things like this make you appear more unreasonable, more mean-spirited, and more unduly nosy than you likely are in person (or as others call it, "real life").

Amy said...

"Sarah", I responded to your comment in my May 31 post.