Science writer Cassandra WIllyard is frustrated by the restrictions put on her during her pregnancy.
Cassandra Willyard is a freelance science journalist who likes long walks, international travel, and infectious diseases, the more neglected the better. She earned a BS in Biological Aspects of Conservation (and a certificate in drinking) from the University of Wisconsin and an MA in Science Writing from Johns Hopkins University. She also served as Peace Corps volunteer in Bolivia. You can read her work in Discover, Popular Science, and Nature. She also blogs regularly for The Last Word on Nothing. After spending several years in New York City, Cassandra moved back to Midwest. She now lives in Madison with her husband and daughter. But she still enjoys sarcasm and wearing black.
This story originally aired on September 14, 2018 in an episode titled “Following Directions: Stories about improvising.”
Story Transcript
So I’m sitting in the doctor’s office and the nurse is all business. She prints out this big stack of papers for me and she takes them to her desk and I see her whip out a green highlighter and she marks one line on the page. Then she brings the papers over to me.
She says, “I need you to read this,” and taps the page, the part that she's highlighted.
I look down and I see that what she's given me is a pamphlet that she's printed out from the Centers for Disease Control. The line that she's highlighted says, “Pregnant women are advised to avoid travel to areas with malaria.”
I am five months pregnant and I’m about to fly to Mozambique with my husband to visit friends. I've come there for advice about malaria medication. It’s my first public health lecture via highlighter.
There are things that you expect to gain when you get pregnant, like a bunch of weight, a rosy glow, but no one really talks to you about the things that you'll lose. I realize that the world now sees me as a vessel, like a human packing container whose sole purpose is to protect my cargo. As the baby who’s growing inside of me becomes more of a person, I somehow become less. And, ‘better safe than sorry’ becomes my guiding principle. No alcohol, no deli meats, no soft cheeses, no hot tubs. It was really hard.
Back in the nurse’s office, I can feel the disapproval. I don't even have a baby yet and already I've been deemed an unfit mother. What kind of person takes their unborn child for a joyride in Africa? I felt so ashamed. And then I felt something else. I felt angry. This is my body and my baby and my risk to take.
So I went to Africa and I took my antimalarial pills and I used bug spray and I kept us safe, but I worried too. I worried that I might slip and fall on a hike, I worried that I might contract something by eating fruit off the street, I worried about the ice in my glass. Each new adventure came with excitement but also this impossible-to-quantify level of risk. Like shark-diving was an obvious no, but what about a safari? I’m not a better-safe-than-sorry kind of person and I didn’t want to become that just because I was pregnant but I couldn’t fully shake the worry either.
Thirty-six weeks into my pregnancy, a new problem arises. I find out that my daughter is wedged butt down in the womb, which is not how they're supposed to come out, so I’m likely going to need a C-section.
This is not the plan. I do not want to have my belly sliced open like a watermelon. I have never had surgery. I have never even had an IV. So my doctor offers me this small, tiny, silver glimmer of hope. She says that if I go to the hospital, the OBs there might be able to sort of manhandle the baby into the right position. It’s an actual procedure. It’s called a version and it’s supposed to be excruciatingly painful, but I still have this vision of a natural birth. So I say, “Yes, sign me up.”
The next day, the nurse calls to sort of give me general information about where to park at the hospital and how to get in. And she also reminds me that I cannot eat or drink after midnight. This is not welcome news. I am thirty-six weeks pregnant and basically ravenous all the time. I’m also just not the kind of person who does well without food. I get hangry, like really, really hangry.
My husband once tried to take a half a sandwich from me in a train station and I growled at him. That’s not a figure of speech. Literally I growled at him and I wasn’t even pregnant.
But I decide I’m going to follow the rules because I rolled the dice already with Africa and I should be obedient.
So I fast and I go to the hospital. They do all the normal hospital stuff. They put me in a gown, they put me in a hospital bed, they do the IV, they put gel all over my belly so they can do an ultrasound. But when it comes time to actually do the version, they cannot find an OB to do it. The OBs come into the room and explain what’s going to happen and then their pager buzzes and they're out again and I never see them. It’s like a very Grey’s Anatomy day at the hospital.
So we arrive at 8:30 a.m. and four hours later I’m still sitting in the same hospital bed, my daughter is still breech, and no one has laid a hand on my belly. They finally tell me you can go home and come back tomorrow. And so I send my husband like we’re going straight to the donut shop.
So we do that. Then I go home but it’s hours later and I cannot shake the annoyance. I don't understand the rationale. I don't understand why I had to fast in the first place. I’m a science journalist so I channel my annoyance into research. I sit on my couch with my laptop sort of wedged below my belly and I Google.
I realize that the reason that they don’t want you to eat is that there's a very slim chance that when they're doing the version, it could go wrong and then they would have to do an emergency C-section. If they had to do that, they might have to put you under. If that happens then it’s possible, there's a slim chance that I might vomit, and then there's an even slimmer chance that I might aspirate some of that vomit, which would be really bad.
But the chance of this is so miniscule. It’s like one in a million. I ran the numbers. And the really infuriating thing about this is that this rule, this ‘no eating or drinking after midnight’, this isn’t even a rule anymore. The American Society of Anesthesiologists adopted looser guidelines two decades ago but many medical professionals are just like, “No, we’re going to follow the standard thing that’s from ancient times.”
Actually, when I was doing this research I stumbled across this online forum for nurses, like a nurse chat room, and one nurse was like, “So the rule about no eating or drinking after midnight, is that really necessary?” This other nurse responds, “It may seem like overkill but better safe than sorry.”
I just want to scream.
So the next day we have to go to the hospital again, first I tell my husband that I want to stop at the bakery. I get a chocolate croissant and I really want to eat it, and I know there's not like a real risk but I don't want to have to lie to the nurse when we get there so I just sort of cradle it in my lap and stroke it like a cat.
We go to the hospital and it’s the same sort of deal as the day before where we’re just sitting there waiting. An hour goes by, two hours go by and then finally an OB comes in and pulls up a chair next to the bed. She says she's looked at my scans and noticed my strange two-lobed placenta.
This is not news to me. I know that I have a weird placenta. I actually brought it up the day before with the resident and said, “Hey, you know my weird placenta? Like that’s not going to make it hard for you guys to do the version, is it?”
And the resident was like, “No, that’s going to make it easier.”
And now the OB is saying, “It’s too risky. We can’t do it.”
She tells me that the place where they need to put pressure to somersault my daughter is also the place where there's some vessels connecting the two lobes of my placenta. If they put too much pressure, she's worried that the vessel might rupture and it could create, in her words, “a silent catastrophe”.
I don’t even let her finish talking before I turn to my husband and say, “Hand me that goddamn croissant.”
I have fasted for two days in the hopes of having a procedure that she is now telling me would have been impossible all along. Like even a cursory glance at my scans might have revealed that I was not a candidate for this procedure. I am furious and I decide I’m not going to follow their rules anymore.
Seven days later, my water breaks. I know that I’m going to need to have a C-section in the next twenty-four hours. And I also know that as soon as I call my doctor, she's going to tell me that I can’t eat. So before I pick up the phone, I make myself a plate of eggs, I fix myself some toast, and then I dial her number. Thank you.