I am pretty sure I know which night the diaphragm failed – and by failed I mean I was too exhausted to get up and put it in. My quick determination that I was in “safe” time of month was flawed. My periods were regular so when my period was late and I began to experience unusual urinary frequency I was strongly suspicious. Morning sickness was not far behind and the pregnancy was quickly confirmed. I was on my general surgery rotation and I had no idea what was ahead but I was very clear/hopeful that the pregnancy would not interfere with my responsibilities. There were only 2 other women in the general surgery, one in orthopedics, and no other women surgical subspecialties. No one had been pregnant in any of the programs yet so I was on my own.
The Chair of the Urology Department was congratulatory and I recall him saying something like “I hope you didn’t have as much trouble telling your husband as you did me?” I think the department faculty really expected that I would drop out of residency at some point before completion of residency.
The nausea was 24 hour sea sickness. I didn’t vomit. Food in my stomach helped and Orange Crush became the beverage of choice. I don’t recall any real increase in fatigue as I was already fatigued. At that time, Bendectin for morning sickness was available and it helped me AlOT. It was during my first trimester that safety concerns about Bendectin emerged. It was not taken off the market until early 1983. I continued to use it until the worst of the nausea subsided and I am not sure I could have worked without it.
I started showing pretty early. There was no self-care besides whatever sleep I could get. By 6 months, people started asking when I was due. Keeping food in my stomach was necessary for nausea in second trimester after I stopped the Bendectin. I gained weight. I don’t think it truly interfered in any way with my responsibilities until I got to my last month. I recall being on call on a Sunday. I was on my feet all day long running round doing preoperative admissions for the next day. At that time, everyone was admitted to the hospital the day before surgery and everyone got EKG and CXR. There were at least 10 admissions that day. By early evening I noted my ankles were very swollen and I started having false contractions. I tried to put my feet up and wait it out but I contractions did not subside and I was advised to go home and rest. I had to call my chief resident and ask for help. I recall he was gracious and came in for the rest of the night as we stayed in the hospital overnight for call. My contractions stopped and I was back at work the next day. I think I may have stopped taking overnight call at that point but I continued to work normal schedule until I delivered 6 days before my due date. I do recall having to sit or lean on high stools during some long operations when I was just there to hold retractors.
I am sure I have forgotten many of the comments and behaviors during my pregnancy that would be considered unacceptable today but two are hard to forget. The first was my chief resident on general surgery would make fake gagging/vomiting sounds every time he would see me. Of course I laughed it off – every time, but it was not funny or helpful. Worse was a comment from a urology faculty member. The conversation started as one that might have been genuine concern – he asked how I was doing. When I responded that I had significant nausea that Bendectin made tolerable. He responded with “you know your baby will be born with a birth defect don’t you?” To make it worse, this was at a time when I was assigned to the transplant service with exposure to cytomegalovirus that can be problematic for the fetus. He was as ass. Consults in the Neonatal Intensive Care Unit were challenging for me until I got to my last month when I felt it was unlikely that my child would require the NICU.
My assigned rotation for the last 2 months of pregnancy was the outpatient clinic so I was not in the operating room except when I was on call. This is what I would have been doing had I not been pregnant. I was very uncomfortable the last few weeks and at 38 weeks I tried every old wive’s tale to induce labor. I worked Friday and went into labor at 1 AM the following Monday delivering my son at 8 AM. I had no intention of having natural childbirth and had not done Lamaze. I did get an epidural as soon as I could and it worked well for one contraction. I was progressing too quickly to have it redone so I felt every other contraction. Perhaps the epidural diminished the amount of pain I had with each contraction. I retained solid memories of the pain for many, many years. My husband was in the delivery room and he took some photos of the birth. I am not sure I still have them.
As it turned out pregnancy, labor and delivery were the easy parts of my journey.
Stay tuned.
Tamara Unleashed 