Bright and early this morning, I headed off to the hospital for the shot that I had to wait two hours for but took less than two minutes to administer. It's a simple shot, people! First of all, WHY does it have to be done at a hospital anyway? I'm not sure what has become soooo untrustworthy about OBs in recent years that they are no longer allowed the onerous task of sticking a needle in my butt and sending me on my way. Secondly, what is the necessity of a two hour waiting period for said shot? It's not like they were busy at outpatient care; I saw a total of three people sitting in the lobby and two more came in after me - one was a visitor.

After waiting an hour, the nurse came out to tell me that someone had just gone to get the RhoGAM and it would probably be not more than another hour. I'd have been willing to walk the thirty yards to where the lab stored it's products myself if I'd known it was that difficult to get away. For the most part I was a patient patient because I expected this (patient patient, wha ha ha - I make me laugh), but at one point I suggested they just bring me the needle and the serum and I'd administer it myself. And they might have too, but I don't think the nurse had much confidence in me after our initial exchange when I walked through the door:

Nurse: "How many weeks are you?"

Me: "39."

Nurse: *looks up at me with one, slightly raised, eyebrow*

Me: "Oh wait. 29! I'm 29 weeks! Well, actually, it's closer to 30, I guess. So 30, write down 30." *pointing to paperwork and tapping on desk* "30."

Nurse: *laughs* "Oh sweetie, it only FEELS like 39. So when was your last menstrual cycle?"

Me: "Good heavens, that was like seven months ago! I can't be expected to remember that if I can't even remember how pregnant I am."

So I guess telling her that I used to administer vaccinations when I lived in South America fifteen years ago and throwing out the words 'intramuscular' and saying I happened to know it worked just like Gamma Globulin so I was sure I could just jam it into my thigh then be off to go get some breakfast, didn't mean much in the face of such a damning initial impression.

Other than one or two lingering "conditions", which don't really have much to do with my day to day health, I'm generally a well person. I don't even have a primary care physician - that's how often I see a doctor when I'm not pregnant. So I don't really understand why when it comes to pregnancy, I manage to complicate even the simplest of things.

Last Sunday at church I was sitting down (because I lacked the breath control to stand) waiting for my daughter and a woman who is also pregnant was standing next to me. I don't know exactly when she is due but she appears to be approximately 57 weeks pregnant - I think she may have the gestation period of an elephant. Someone else close by asked her how she was doing and mentioned that she looked really uncomfortable. She contradicted, "Oh, not at all! I have had no complications whatsoever and I feel GREAT!" It was all I could do to keep from giving her the finger, right there in front of Jesus.

I am not one of those people pregnancy treats well. I have a million and one complications and can't even get the whole "making blood" thing right. I have an unusual blood type with a negative Rh factor. Because I was short-sighted enough to not check out my boyfriend's blood donor card for a negative mark next to his blood type before agreeing to marry him, I've doomed myself, and possibly my children as well, to the possibility of Rh disease without a series of shots during pregnancy that provide antigens to keep the mother's blood from attacking the baby's blood should the baby turn out to be Rh positive. (There's your Physician's Desk Reference lesson for today... I graduated from Mini Med School... as I'm sure you can tell.)
When the disease is moderate or severe the fetus can have a more marked anaemia and erythroblastosis (erythroblastosis fetalis). When the disease is very severe it can cause morbus haemolyticus neonatorum, hydrops fetalis, or stillbirth.
What amazes me about all this is the following statement on the Wiki entry:
With the widespread use Rho(D) Immune Globulin, Rh disease of the fetus and newborn has almost disappeared.
It's incredible to me that something as commonplace as a mother and father with two different blood types could cause such serious problems in labor and delivery. Granted, it would only happen if for some reason the baby's blood were to cross the placenta and enter into the mother's bloodstream, but up until even a few decades ago, that was kind of a commonplace thing to happen from what I understand. Now, however, there's this simple jab in the ass that takes a few seconds to administer and since 1968 when the serum was introduced, Rh disease is no longer a serious issue for people in this risk category. During my first pregnancy, when I went through the RhoGAM experience, my mother was surprised to find out what Rh disease was. She'd never even heard of it. I don't want to date myself too far, but I came around right around the time that serum was introduced and my brother well after. I guess it just hadn't made it to rural northern states by then.

I'm not sure where I finally come down on the whole vaccination issue. I've chosen to have my child vaccinated because, for me, the risks of catching one of those diseases - especially in childhood - outweigh the risks of issues that might arise from a vaccination. I know people who do not agree with me on that fact and are currently dealing with issues that quite possibly may have been caused by the vaccinations they allowed their children to receive. I respect their opinion insomuch as it's developed by informed intuition. It's not even as black and white as that because there are dozens of options from choosing only specific vaccinations, to not giving them all at the same time. As with pretty much everything in child rearing, what's right for one, may not be right for another.

What I do know for sure is that I'm grateful for the options that medical science gives us. Growing up, my neighbor had quite a pronounced limp. One day I asked about it and learned the story about polio before Jonas Salk came up with a vaccine. Iron lungs, paralysis, electrotherapy, tendon lengthening, nerve grafting... she was just a child when she was diagnosed; it sounded horrible.

Obviously, I don't think medical science has all the answers or I would be bitching a lot less on this weblog about my doctors. I also believe that there is a place for faith and science to meet - after all, they're not even trying to answer the same questions. But I am acutely keen to the advances in recent years which benefit me as a parent every time I strap my child into a car seat and some older-than-me passer-by tsks and comments, "We never had to do that with our kids when they were young... they all just rode in the car without a seatbelt and they were fine. In fact my newborn slept in the back window of our VW bug and nothing ever happened to her." And what I don't reply with (less because I am polite - more because I am a wussy) is: Perhaps, but there were a lot fewer cars on the road then too. And there was a lot less concrete. And more fatalities when there were car accidents. And frankly, I'm willing to be inconvenienced just a little bit each time I get into the car if it means my child's brains won't be splattered all over the highway when some drunk guy makes an unsafe lane change because my uncle was a funeral director and hearing just one of those stories is enough to make you a car seat aficionado for life.

We live in an age when there is more information available to us than there ever has been before. This can be good, like when you want to avoid a $150 doctor visit and need a quick Google answer to "how many Tylenol can I take for round ligament pain before I get liver damage." But can also be bad, like when your unborn child has just been diagnosed with some as yet unknown problem and you Google "chromosome disorders" to try and figure out what it might be and realize there are 1,990,000 results. Ultimately, after all is said and done, I'm grateful to have the option.