Postpartum Checkup

December 2023

How hard can a 16 minute appointment be?

You make the drive to the gynecologist’s office, it’s fine, totally normal, your dermatologist is in the same building and you’ve been there since Oliver was born. You make it past the front desk without having to answer any questions except to confirm that you still use the same pharmacy. The intake nurse asks questions like, “I see you are 6 months postpartum?” and “Are you still breastfeeding?” You answer these “Yes” and “No” and do not elaborate. She takes your blood pressure—normal—and weight—so much higher than you want it to be.

She hands you a gown. It’s the larger size gown. You’re swimming in it. But you are no longer within the range for the normal gowns. You undress. You use a tissue to wipe away whatever trickle of blood is still coming from your period. It’s Day 5. Before Oliver, Day 5 meant light spotting. Now, Day 5 apparently means moderate flow. The office had said you could come in if your flow was light but should reschedule if your flow was heavy. You have been puzzling over how to classify your flow for the last 24 hours and so you just stand in the room, wiping and wiping and trying to hide the bloody tissues under the discarded paper from the last patient.

The doctor comes in, you asked for him because he was kind and compassionate when you were pregnant with Oliver, plus he’s somehow related to someone your sister went to high school with. He says: How’s the baby? You take a breath. You say: He died. You cry. His cheery demeanor cracks and you see him thinking, why didn’t we know this? You say: He was born with Tetralogy of Fallot. He had surgery at 3 months. There was bleeding, and he died. He says: I’m so sorry. This was diagnosed post-partum? You say: Yes, the pediatrician heard a murmur when he was doing discharge rounds. You say: We had gone to the maternal fetal medicine doctor, and they couldn’t get all the pictures they needed of his heart, and they had us come back, but they were having a bad day and rushed us through and didn’t get the pictures they were supposed to. He says: Usually we tell people to wait 2 years between pregnancies, but in this case you are free to start trying. He says: We’ll monitor you here, and you’ll go to a different specialist, and you’ll get a fetal echocardiogram. He’s typing furiously, you hope that means you won’t have to repeat this conversation when you see other midwives and doctors. You are crying. He doesn’t ask but you sense him wondering and so you say: I am in a lot of therapy. He says: Have you talked about medication? You say: My therapist knows I’m trying to get pregnant, so we’re trying to avoid it but it’s there if I need it. He says: If you need it you need it and if you need someone to write you a prescription I can help with that.

He decides it’s time to lighten the mood. He does the fastest cervical exam in history and you apologize for your period. He asks about vacation plans, you say you’re going to Paris and he is visibly relieved to be in safe conversational territory. He says, if you don’t get pregnant after 6 months come back and we can talk about IVF. He says, the oldest patient I delivered was 53. He leaves as quickly as he can.

You sit. You sob.

And then you get dressed and go back to work.