Dr. Maestro

When I first started seeing a gyno, I was certain I wanted a woman. I felt that I would be more comfortable seeing a woman. Since I was still a teenager (gasp!), I chose to see the wonderful nurse practitioners (CRNPs) at Family Planning. I went there for years for my care, so many years that they used to joke about the thickness of my file and ask when I was going to start seeing a "real" doctor, as by that point I was in my thirties and had a job and insurance and all the things that usually made people jump ship. I told them that I would probably switch when I needed an OB. Although they had an OB on staff and could do prenatal care, their office was far enough away from where I now live (back in my hometown), that I wouldn't want to make the long drive as often as one does for prenatal visits (once a year for my annual I didn't mind) and I'd want to deliver closer to where I live. But since that wasn't an issue yet, year after year I kept going to see the CRNPs.

Then their office building burned to the ground.

I took it as a sign from the universe that it was time to grow up and find a "real" doctor. (I also took it as a sign from the universe that I was a virgin again, since every gynecological record that ever existed about me was destroyed in the blaze.) I asked around for referrals from my friends, and OldChristine practically begged me to start seeing her gyno. He was wonderful, she said. In fact, she couldn't praise him enough. But I still thought I'd be more comfortable with a woman doctor.

So I asked my friends who are doctors themselves who they would recommend (since these friends are also women themselves). They recommended a woman they had gone to medical school with, who was our age, and who I was able to meet socially first to see if we clicked before making an appointment. This was the doctor that started treating me for infertility. We went through a few cycles of testing and early treatment and she directed me to call to schedule an HSG if my next cycle failed. Which it did.

So I called her office (a group practice) on cycle day one and was told she had quit the practice and moved to Hawaii.

I was practically in tears (okay, I was in tears), trying to explain to the nurse that I was supposed to schedule a test, that I didn't want to lose a cycle, but that I didn't think they had another woman doctor on staff. I offered to call back when I was more collected, but the very sweet nurse would not let me off the phone until she helped me. She scheduled an HSG with a woman doctor at a nearby practice with whom they were affiliated. This new doctor was fantastic. She did my HSG (without having even met me first), immediately scheduled me to come in to her office to discuss further treatment, and best of all, she prescribed the Clomid regimen that got me pregnant with the Monkey.

When I called her office to report I was pregnant and schedule my first prenatal visit, they told me "Congratulations! But this office won't be doing deliveries anymore in a few months, so although we can start your prenatal care, you'll need to find a new OB."

At this point, I was starting to think I was cursed. In near desperation, I called OldChristine and asked for the name of her OB, the man she worshiped for his reported god-like gynecological and obstetric abilities. He'd been in solo practice in the same location for years. When I asked OldChristine what would happen if he was, say, on vacation, when I went into labor, she replied, "He doesn't take vacations. He will be there for your birth. Wait until you meet him. He loves what he does and lives for his job."

I scheduled my first prenatal appointment, but when I got to his office he had been called away to deliver a baby, so I had my introductory pelvic done by his PA. I met him at my next prenatal visit, but he never saw me with my pants off until the birth. The god-like abilities so praised by OldChristine? All true.

I've finally christened my OB with the pseudonym Dr. Maestro. I believe that the birth of the Monkeyboy went easily because of his skill (part of the credit also must go to my uterus, though). The HSG he did last fall was a dramatically less painful -- actually, not painful at all -- experience than my first was. And, I must add, the most impressive feat of all was that ten years ago, he delivered OldChristine's twins vaginally. (You hardly hear of such a thing anymore). When dealing with other medical professionals, he's got a touch of the diva in him (which can be seen in the final installment of the Monkeyboy's birth story), but with patients he's understanding. He's got years of experience, but a forward-thinking mind. And he's been gifted with the hands of a master.

* * * * * * * * * *

Yesterday, Dr. Maestro walked in the exam room, opened with "So, we're having a big baby, aren't we?" and chuckled.

Not what you want to hear from your doctor.

Dr. Maestro has always been good at quelling my fears and not letting my mind run away with worst-case scenarios. He's got a skeptical mind and presents things very straight-forwardly. I was hoping he would pooh-pooh the ultrasound as being only somewhat accurate in its estimation of the baby's size, but instead he seemed to put a reasonable amount of faith in it. Part of the belief is based on the fact that the Monkeyboy was big for his gestational age, so logically it follows that this baby could be slightly bigger. Which it is.

When he measured my fundal height, he said I was measuring at 35 weeks, which isn't as far behind as the PA thought. I told him I was worried about the baby's size, but he said, "Maybe when I'll check you you'll be four centimeters and we won't need to worry." I told him I doubted it. What he found? No surprise. Long, closed, firm and posterior. The only positive is that the baby has finally dropped a tiny bit: to a -1 station. I'll take what I can get at this point.

We discussed the big baby scenario and discussed my pelvic size. I reminded him of the "small pelvis" comment he made during the Monkeyboy's birth; since he'd just finished doing my pelvic, he nodded and said, "True."

"Let's hope you go into labor on your own soon," he said. "How does 37 1/2 weeks sound?" I told him it sounded great to me, but that based on my lack of progress, it didn't sound like that was going to happen. And if it didn't, did we have a plan? "Because I'd really like to not end up with stuck shoulders or some other complication."

"I don't want stuck shoulders .... they're no fun for the doctor either," he said.* "What I'd like to do is induce you at 38 weeks, if you're inducible."

I can't believe how quick I jumped at this option. My response? "I'm very open to that idea, if I'm inducible."

For those of you playing along on Bishop's Score: The Home Game, I'm not inducible. Even adding a point for having a previous vaginal birth only nets me a 3. The fourteen days to 38 weeks seems so long, and yet, so short when I think of how I've shown no progress so far. So many second-time moms are walking around 50% effaced and a few centimeters dilated at this point. Me? The girl who had such a hard time keeping a baby in last time? Showing no progress. However, I know that nine days before breaking my water with the Monkey, I was long, closed, firm and posterior. Even three hours after my water broke, I was still only one centimeter, yet I made it to ten centimeters dilated in the next five hours. I didn't think to ask the doc what he personally means as "inducible." That will have to wait until my next appointment, when I'm sure it will come up again. Until then, I'm thinking "open" thoughts. I'll even take one centimeter. Please.

As he left, he made the usual comments about calling the office if I have any regular contractions or any leakage of fluid before my next appointment, to which I responded, "I wish."

Other stats: Weight up a pound at 155 1/4 (30 1/4 gain total); blood pressure an awesome 122/58; baby's heartrate 148; Strep B test negative.


*Although I'm thinking that they're really a whole lot less fun for the mother and baby. And while we're at it, I'd like to say, what's up with the "We're having a big baby" comment? Only one of us has a uterus.