More Information is Better

via Unsplash

Big content warning on today’s post for discussion of various pregnancy complications, some potentially fatal. As always, this comes with a disclaimer that I am not a medical professional, so my understanding of these conditions is only that of a patient doing her best to get educated   

One of the many challenging things about my birth experience and hospitalization was a feeling that my OB-GYN practice really dropped the ball when it came to explaining any of the factors that started making my pregnancy with LB high-risk. When it came to gestational diabetes (“GD”), COVID, gestational hypertension, the labor complications I encountered, postpartum preeclampsia, and what to do or expect when I still needed blood pressure medication after my six-week postpartum appointment, I got basically no explanation about the implications of any of those things from the doctors in their group. 

With regards to the GD diagnosis, my OB did at least refer me to the Maternal-Fetal Medicine (“MFM”) specialist at the major hospital system where I would deliver. The hospital had a structured GD program to ensure I could get all my questions answered promptly while receiving closer monitoring of my blood sugar results. There was no such help for any of the other things. 

Additionally, communication from my OB’s office about who exactly I was supposed to contact to get enrolled with the hospital GD program was almost nonexistent. I got a referral for that first conversation with the MFM, but no other guidance. I only learned weeks after my diagnosis that the OB-GYN actually intended to refer me for continued monitoring throughout the rest of the pregnancy, not just for a one-off conversation with the MFM. I then needed to call (and MyChart message) around at the hospital myself to figure out who I should talk to. 

Things That Are Different Now

LB was around 4.5 months old here. We love the Copper Pearl burp cloths (also here) and the Crane Baby quilted playmat (affiliate links).

As I mentioned recently on Instagram stories, I’ve finished my maternity leave and am back in the office. I'm also hoping to get back in to blogging, now that I'm a bit more adjusted to being a new parent. And let me just say, it's all been an incredibly wild ride. Among other things, K and I moved out to the NYC-area suburbs a few months earlier than originally planned. We've had tons of help from my in-laws, both with the move and with caring for LB, but it's still been intensely difficult to get everything done. 

For obvious reasons, I'll probably be writing mostly about things related to parenthood and baby care items in the near term. There will be a fair bit about personal finance management too, at times, and some talk about fashion and shopping as well. It’s probably not surprising that my clothing-related needs and preferences have changed significantly, given everything that's new in my life! 

It's been surreal going back to the office, walking to and from the train station, when the last time I was in any of these places was in late November, before LB was born and before my long hospitalization. My life has been completely transformed, in more ways than I can count, but the office and its immediate surroundings are still largely the same. I sort of can't believe I'm no longer living in NYC, and I feel like I never really got to say a proper goodbye to my old life. 

Our Little Bean is One Month Old

Our Year of the Tiger baby all ready for his second ever car trip.

Well, it's now been a really, really long time since I last wrote here! I hope that everyone had a wonderful holiday season and is having a good start to their new year. For the past few weeks, K and I have been completely absorbed in learning to be parents to our newest family member. 

As some of you may have seen on my Instagram stories, our little bean ("LB") arrived roughly a month ago - at 37 weeks and 5 days - after I was officially diagnosed with gestational hypertension the week before. That particular diagnosis can lead to a recommendation to induce at 37 weeks, which was what my OB-GYN also recommended, so off to the hospital we went just after Thanksgiving. It ended up being a bit of an adventure, something I think it's safe to say no one really wants from their labor and delivery. 

My induction took around 30 hours before it was time to push, then ended with an urgent c-section not long after due to fetal distress. Thankfully, LB turned out perfectly healthy, and he's been that way since. 

I was recovering well and fairly quickly from surgery, but the night before my original discharge date (after the standard three nights in the postpartum unit, including the night I delivered) my blood pressure started climbing up again. It escalated into postpartum preeclampsia, and before my blood pressure ever crossed into the 170s systolic and before I ever experienced any of the additional "red flag" symptoms of preeclampsia outside of the high blood pressure, I was sent back to labor and delivery for a 24-hour magnesium drip.

Afterwards, my blood pressure proved somewhat resistant to being stabilized, and my doctors would not discharge me until that was accomplished. Including the time it took to administer and recover from the magnesium drip, I ended up staying a total of seven extra nights in the hospital. LB was able to stay in the hospital with me throughout, though his doctors had declared him fully ready for discharge even before the day we were originally meant to go home. Once the doctors adjusted me up to the correct doses of blood pressure medication that I could continue taking at home to keep my blood pressure stable at reasonably healthy numbers (mostly under 140 systolic and 90 diastolic), LB and I were finally able to go home. 

The Cost Of: Prenatal Care, First Two Trimesters

Coach wristlet (affiliate link) 

With any medical care-related expense in the US that's billed through health insurance, it's not necessarily that meaningful to hear about anyone else's experience. So much depends on the vagaries of one's own health plan, something I personally find nearly impossible to decipher or predict before my bills after insurance actually come in. (That's as someone who litigates multi-million dollar commercial contract disputes at my day job, no less!) 

Nonetheless, I always like to read about how much things cost, including American healthcare. I was originally hoping to do a post like this earlier in pregnancy, potentially one for each trimester. As it turns out, the billing department at my OB-GYN's office can be quite slow, so it was only recently that what I think(?) is the last bill from before the end of my second trimester - nearly 7 weeks ago - was finally processed with my insurer. 

This kind of timing isn't necessarily a huge shock in the American system, either. For instance, it was only this June that I finally saw a record pop up with my insurer for a PCR COVID test I took last December, during the start of NYC's Omicron surge. (That length of delayed billing is pretty unusual though, in my experience. There wasn't actually a bill to me involved either, because COVID testing in NYC was generally still free to the patient with government support back in December 2021.) 

For my prenatal care throughout the first two trimesters, through 26 weeks of pregnancy, the amounts I paid out of pocket for expenses that were - or could have been -  put through insurance was: $1,827.68. 

Unfortunately, I think this solidly establishes my health plan as being "not very good," in terms of the extent and quality of my coverage. Which is something I did already know beforehand. Many biglaw firms are known for offering associates extremely expensive health insurance plans, sometimes with poor coverage. My health insurance premiums aren't as bad, but the co-pays and other terms keep getting slightly worse by the year. For one random data point of comparison, a YouTube vlogger I follow who also lives in NYC only paid around $366.00 out of pocket on her insurance for prenatal care through roughly the same point in her pregnancy.