Playing God?

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How do IVF babies turn out?
I would like to say that, in my 10 years as an L&D nurse, I never saw an IVF mom have what we call "An uneventful pregnancy". I saw more than I would expect (even given the age and other medical issues) of pre-eclampsia, gestational diabetes, dysfunctional labor - and a cesarean rate that approached that of Brazil (greater than 75%).
I wondered then, and still do, if some infertility is God's way of protecting some women's health and life?
I made the decision that, as a midwife, I would not take as patients women who had needed this major of an intervention to get pregnant. I think that the midwife is a specialist in normal pregnancy, and that these pregnancies are not normal and should be cared for by specialists in abnormality. I have gotten a little flak on that from some of my colleagues.
One of the interesting things I have learned in studying natural fertility in depth is how many protective measures the body has! Cervical mucous is designed to speed healthy sperm to a waiting egg, while trapping and destroying malformed or unhealthy sperm. One of the most common assisted fertility techniques, IUI (intrauterine insemination) bypasses the cervical mucous. Why not use measures to enhance the health and quantity of that mucous, rather than bypass?
Or why not help men to have healthier sperm through lifestyle measures such as avoidance of excessive heat, avoidance of harmful chemicals, etc?
The infertility industry exists to bypass normal fertilization, not enhance it. It is a sad commentary on our culture.


What drives me really crazy is how many fertility experts don't try to use the body's signals first before stuffing women full of Clomid or invading the body with IVF.

I'm a Billings Ovulation method user, and studying to become a certified instructor. A few years ago, I went to see a sexual health spoecualist because intercourse was extremely painful after I had my first (and I had a c-section!) I brought my charts, assuming the doc would be a little familiar with NFP charting and its uses in determining hormonal cycles, deficiency, etc. He didn't know anything about it! (But he was quite eager to learn, to his credit.)

dyspareunia is extremely common after childbirth whether baby comes from above or below. there are hormonal changes that contribute. breastfeeding may also contribute to dryness and temporary loss of elasticity that can contribute to discomfort or outright pain. there are also some very simple therapies for these issues that most midwives can recommend.

Alicia, would you happen to know if there are any "official" statistics about cesareans etc on women who required assistance to get pregnant? I know that there is a statistically greater risk of birth defects, but I'd never heard about problems with delivery too. Might it be that a woman who used technology to become pregnant has an incredible love of technology, given that it enabled her to conceive her baby, and therefore wants every possible intervention in her high-tech pregnancy? Or that a woman who needed intervention in order to become pregnant intrinsically mistrusts her body and therefore sabotages her own delivery? (You know, "I can't do it," therefore she doesn't?)

Family Foundations said a few years back that it ought to be considered malpractice when a doctor immediately prescribes clomid to a woman who merely needs to lose or gain ten pounds in order to have regular ovulatory cycles.

It may not entirely be the fault of the doctors that they immediately jump to the medical treatments, though. Living a healthy lifestyle or losing/gaining weight are not quick fixes, and the patients themselves might be demanding drugs and high-tech intervention. "We have to get pregnant now Now NOW NOWNOWNOW!!!" It only follows that if we can prevent conception with powerful drugs until the exact moment is right to conceive, then we must not rest until we achieve pregnancy immediately the split-second we decide the time is right. Right? And losing weight or nurturing healthy sperm takes time. Time is the enemy in the common American perception of childbearing--either we don't have enough time to start our career, or else we don't have enough time to have a child before our biological clocks run out. But that's another rant. :-)

I've never seen statistics on this, I don't think anyone is collecting the numbers. It is just my impression from being 'at the board' at hundreds of daily rounds (where one shift of health care workers - doctors, nurses, midwives - reports off to the next shift).
As far as Clomid being malpractice when weight loss is the issue - I don't think that is quite fair to the women with PCOS (who are the majority of women in this category). Getting to and maintaining optimal weight is not that easy, and won't always help. For general health, it should be a goal. However, I would focus more on healthy eating and lifestyle choices because even while maintaining the same weight, shifting the fat:muscle ratio can have a significant effect on ovulatory function.
But I do actually understand the doctor's frustration. I've had women ask me to prescribe Clomid. It is touted in some internet forums as a fairly risk-free wonder drug and the side effect of multiple ovulation is seen by many infertile women as a bonus, not a drawback. Two for the price of one. I have heard that there is actually a bit of an underground market for fertility drugs. What is interesting about Clomid is that while it is forcing ovulation, it also reduces the quality and quantity of that important cervical mucous, leading to the 'need' for IUI. It's the medical merry-go-round again.

I honestly had not thought of PCOS--that's clearly a different case and medical intervention is clearly required because the body is not functioning properly. I was thinking more of someone like myself, whose body was functioning properly but the person in charge of the body was eating a diet of garbage foods. My cycles have gotten more regular through the years as I've lost about thirty pounds. I don't think it's necessary to reach an optimum weight before the cycles come into control. (I still need to lose about twenty pounds, but I'm in a range where my cycles are consistent and not between 22 and 92 days.)

It's scary about an underground market for fertility drugs. :-( Even scarier about the clomid reducing the quality of cervical mucus. "See, my body really doesn't work--I couldn't even conceive with clomid. I probably won't be able to give birth either." (*aaaaagh*)

These aren't easy issues. No one wants women who desperately want children not to have them. It just seems that the medical system treats babies like commodoties rather than children.

Funny I should read this after seeing a short bit on the news last night about a 57 yo woman who is expecting twins via IVF. (no mention of a father or father figure for the kids) The reporter gave the caveat that this isn't for every woman - this was a special case because she was an exceptionally fit personal trainer and life coach. And the the interview sound bite in which she talked about how she had now done everything she wanted in life and was ready for children was just so......mondo bizarro. Very sad.

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This page contains a single entry by alicia published on November 6, 2004 3:58 PM.

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