I’ve let my blog lapse these past few weeks. However, I think I have a good excuse: a few weeks ago my husband and I welcomed into the world our son Nicolas Charles Grépin. It has taken a while but I am starting to have interest in the outside world again and it has now given me enough time to reflect upon my own personal experience of the medical care that both Nicolas and I received during my pregnancy, during the delivery, and in the subsequent weeks. More importantly, the ability to string more than a few words together into a sentence has returned and I have learned how to think again during his extremely adorable naps.

I think by most people’s standards, I had an uncomplicated pregnancy. I had no morning sickness (probably the longest stretch I have ever gone without getting sick). I ate just about everything (except chicken, which was so repulsive I once had to leave the room when it was served). I drank coffee (to the chagrin of the local baristas who at times refused to serve me). I traveled (if airlines awarded air miles to fetuses, my son would already have qualified for elite status on 2 airlines). That is until I hit 34 weeks – at which point things fell apart.

First it was insomnia. Then it was my stomach. Then the contractions began. Then it was tendonitis. Then it was the swelling in my legs and hands. Then it was high blood pressure. Finally, at 36 weeks, despite the findings of previous examinations, I learned that my baby was breeched (positioned the wrong way). Throughout my entire pregnancy I had been adamant about avoiding a c-section, and then I discovered I had one of the indications for which there was nearly universal agreement of the need for a c-section. I was devastated.

In the subsequent weeks, my life was consumed with trying to turn the baby. I tried everything. I had nearly daily treatments of moxibustion and acupuncture. I sat around with bags of ice on the top of my belly. I lay upside down on an incline for as long as I could. I bounced on an exercise ball. I even subjected myself and Nicolas to a barbaric procedure known as an external cephalic version where 2 doctors tried to physically turn the baby in the operating room with an epidural. But nothing worked. So at 39 weeks, in the early hours of the morning, my husband and I hailed a cab and arrived at NYU medical for a scheduled c-section. The epidural was inserted at 8:59 a.m. and by 9:11 a.m. we had a happy and healthy baby boy.


Despite all of my issues, in the grand scheme of things my problems were relatively minor. I don’t think any point either myself or my baby were at any real risk. In the back of my mind, however, I kept asking myself: what if I lived in a poor country, was a poor woman, and knew little about the medicine I was receiving. How would we have fared then?

A few things really struck me about this whole experience. First, I went from having a completely uneventful pregnancy to one with so many issues in a very short time period. In total, I probably had about 12 antenatal care visits – if women in poor countries get antenatal care most get far, far fewer than this – would they get the help they need? Second, would the antenatal care have caught the breech position? A manual evaluation at 34 weeks concluded that my baby had been in the right position, but I realize now that he never was. Most women in developing counties do not have access to the ultrasound technology that I had. Finally, while yes, the c-section was a relatively straight forward operation, I really wondered how such procedures can be delivered in resource poor settings. We hear talk about midwives and other lower skilled professionals providing such services – I had a small army of medical professionals in the room during mine – how feasible is this and is it better than the alternative?

Next week, health professionals, policy makers, government officials, celebrities and a pile of regular folks as well are converging on Washington, DC to discuss these issues at the Women Deliver Conference. I hope the discussion does get beyond a focus on the statistics or whether abortion is a part of family planning or not and get to what really matters: how can we ensure that pregnant women do not die needlessly when they deliver their babies. The solutions are not likely to be easy, not likely to be “scaled-up” quickly, nor are they likely to be “low cost”, but they are essential and they are achievable.

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11 Responses to “Becoming a Mom”

  1. David Hercot says:

    Dear Karen,
    Welcome back. We are awaiting your next blog. But don't forget to enjoy family. Life is running fast. I guess you will see your role as a blogger for global health justice a little different after such an event in your life.

  2. Stacyann Forrester says:

    Karen,
    Congratulations to you and your husband. Baby looks beautiful. It's great to see how your experience giving birth allowed you to ask these questions about the experience of giving birth in the developing world. As women we are all truly connected in this way. I wonder how many mothers are attending the Women Deliver Conference?

    I believe more technology doesn't necessarily results in improved outcomes. Understanding the underlying science behind the technology is more important. Also finding those solutions that fit the context of a resource poor country is as important than simply adapting what works for us here in the developed world.

  3. Wolf and Anya says:

    Karen, this is probably the most moving and ethical account I have ever heard/read about the birth experience. I hope you are pursuing this agenda in your research/teaching. It is oddly enough also part of my research/teaching on feminist ethics and reproductive rights. If I may, do you have anything published on this topic?

  4. Tim France says:

    Hearty congratulations Karen, and welcome back!

  5. Kim Dionne says:

    Congratulations and welcome to parenthood. Sharing your birth story is a gift. Thank you.

    The questions you raise in retrospect about health access disparities are important. It should reinvigorate your passion for the research questions you're already asking.

    Glad to see you back blogging, but enjoy this time when baby is small. It's heaven.

  6. Karen Grepin says:

    Thanks everyone! It is good to be back.

  7. Aya says:

    Congratulations Karen! It is important for all of us to recognize and not take for granted the resources we have in an industrialized country. Thank you for sharing your story. I hope you're able to enjoy time with your beautiful son and family.

  8. Carl Jacob says:

    Wonderful news – congratulations!
    Jack

  9. Andrew says:

    Congratulations!

  10. Eresso says:

    Congratulations Professor Grepin. May the Lord watch over you and your family.

    Eresso

  11. Cheasty says:

    Congratulations on your beautiful baby boy, Karen. Looking forward to reading more of your thoughts on your experience as a mother, and of health care as a mother!

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