April 1, 2011

Talking Openly and Honestly With Your Care Provider

For years I have been advocating for women to have an open and honest relationship with their care provider, both before and during labor. Needless to say, I was surprised that I had such a hard time communicating with my midwife when I felt displeased with the way things had been going. Specifically, most of my visits thus far had been with her assistant, a Labor and Delivery nurse turned student midwife. While I was completely satisfied with the care my midwife’s assistant was giving me, and I had full trust in her clinical capabilities, I wanted my prenatal visits to be with the person that would be attending my birth. This was one (of many) reasons I went with a solo practitioner instead of a large practice.

However, I found myself hemming and haw-ing about the situation and talking to everyone but my midwife. After several days of contemplating what I wanted to say to her, I finally gathered my nerves and spoke with her. I was worried she would be angry with me, or even ask me to leave her practice. I was also afraid that I was branding myself as the “difficult patient.” Instead, she was completely open to my concerns and reassured me that my care will go on as requested. I now feel like a huge weight has been taken off my shoulders, and that my body and baby are in the right hands.

I do not think my situation is uncommon. I often hear from my students that they are not really comfortable with their care provider, and that there is a lack of communication. Either he/she is not on the same page with their birth philosophy, or the student sometimes feels bullied into making decisions she is not comfortable with, such as labor induction. Additionally, students are frustrated that they cannot reach their care provider directly to ask a question, just only speaking to the receptionist or a nurse.

What I realized for myself is that if I didn’t speak up to my midwife and voice my concern and dissatisfaction, who would benefit? She would not have been aware of my feelings, and it would likely taint my relationship with her. I could not imagine having distrust and resentment hanging over me during my labor and delivery. I firmly believe that if a woman is uncomfortable with the people in her labor and delivery space, it is going to affect how easily she is able to open up and birth. This is something to consider when picking the people that will be present at your birth, which includes your care provider. I cannot tell you how many times I hear students explain that they hope to have a certain doctor from their practice present at their birth because they don’t like the other ones.

I feel fortunate that my midwife and I are now on the same page, and I am completely satisfied with the care I am receiving. If things were not progressing how I wanted, I was prepared to switch practices, even though the idea of changing at 26 weeks into my pregnancy overwhelmed me. I had one doula client switch providers at week 38! But, she was very glad she did. This client just felt that the practice she started with was not hearing her concerns and desires for the birth that she wanted.

This idea goes back to what I was saying earlier- it is important to feel supported by your provider and have clear communication. I think it is very brave of those women that switch to a new care provider. I applaud them for their ability to take care of their own needs and not be intimidated by what others may think of their decision. For those I know that have switched, no one has ever expressed regret in their choice. I think this inclination to change care providers if you are not getting what you desire is the start of a mother’s intuition: to do what’s best for her and her baby.

Regardless of the final decision – to stay or not to stay with your current care provider – it is only going to make your prenatal care and birth experience better if you and your provider can talk openly and honestly about what you need, the pregnant mother and laboring woman, to feel heard and supported.

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