I have heard too many times from families that they are not getting the information or respect that they want from their care providers. I see this most often online – women asking other women for help, wondering what their symptoms mean, help decoding the sliver of information their OB gave them, or help interpreting their lab results if they are lucky enough to have gotten copies of them in the first place. Just today on a forum I saw something along the lines of, “oh, I’m not sure if I’ve had my B12 levels tested. They never tell me what they are testing for.” This is a bad sign. As wonderful as online and in person support groups are, I can clearly see that there is a lack of education, discussion, and informed choice taking place in OB (and midwife!) offices all over the US.

Well, the tides are turning, and more and more of you want to take responsibility for your own health. So here are a few basic steps that I think will help speed up the transition to a more consumer oriented health care system:

1. Before a doctor, midwife, nurse, doula, or friend does something to your body (whether it is an observation, a hands on exam or a test of some kind) ask what they are doing and why they are doing it. Until you fully understand, keep asking questions. If you don’t understand, or don’t want them to do what they are proposing, simply say “no thank you”, “let me think about this one” or “I do not consent”.

2. After an exam, or after a test, ask the care provider what their findings were, and what they mean. Again, ask questions until you are satisfied that you understand, or feel like you have been offered enough resources to look into when you have time later. A lot of times someone will take your blood pressure, go write it down on your chart, and not tell you what it was. If they don’t tell you, ask. And if you don’t know what it means, ask.

3. Request a copy of all notes they have taken, chart forms they have filled out, and labwork results from the visit at every appointment (or most every appointment). This way, you can keep a binder of your own information to refer to, which is useful when you want to do your own research, if you switch care providers during pregnancy, want to show your pregnancy health history to another care provider or specialist, or later in life if you want to review your charts but the original care provider may have already destroyed them. Other countries have a system where this is the norm, and people are more empowered about their own health as a result.

4. If you don’t agree with your care providers interpretation of something or a recommendation, get a second or third opinion. Do your own research and make up your own mind. Also, don’t believe everything you’re told, because care providers often twist information or oversimplify to hasten a choice rather than creating actual dialogue where your unique concerns are discussed first. Again, the magic words are “I do not consent. Bring me the forms to sign”, or simply “Let me think about it, and I’ll get back to you”.

5. If your care provider has a problem with you making choices they didn’t suggest, you should probably get a different care provider, because they are a jerk. This goes for you{}”
even if you are 36 weeks pregnant and live in the middle of nowhere. Find someone else, who will respect you and your choices, even if it is hard, because your birth and your baby matter. I understand there are circumstances that are sometimes out of your control, but ask your family, your community, your church for help if you need it. Don’t wonder the rest of your life if you could have done more for you and your baby. You are the customer. The care provider is a consultant. They need to act accordingly or you need to FIRE THEM.

6. IF YOU ARE UNHAPPY WITH ANY ASPECT OF YOUR CARE, AND THE ISSUE IS NOT RESOLVED BY APPROACHING YOUR CARE PROVIDER TO FIND RESOLUTION, FIRE THEM AND FIND SOMEONE ELSE (or do it yourself, and plan a family birth). This might be uncomfortable, but this is part of being a grown up. We have to do what is right for ourselves and our children. If you don’t want a confrontation, send a letter explaining that they weren’t meeting your needs, and you’ll be taking your business elsewhere. You can courteously thank them for the time spent with you and ask them to forward your records on to your home address (unless you followed my advice and already have all your own records!!!). Continuing to see a subpar care provider, someone who is going to be with you during your child’s birth, is not be the same as “sticking out” a bad semester in college or finishing a bad meal just because you’re hungry – there are very real consequences. I have literally heard people say “Well, NEXT TIME we’re going to choose “blah blah blah” when they are still pregnant, and have a few months to go before the birth. This is absurd. If you are already planning on using someone different for next time because you are uncomfortable or not 100% thrilled with your current choice, you need to make a change! You aren’t doing any anyone any favors by staying with someone you don’t love, just to save the possible awkwardness/financial hardship/hurt feelings. A smart midwife or doctor knows that there is a lot more room for bad outcomes when the fit isn’t right between a family and care provider.

I hope this helps someone out there who may be feeling like they are being an annoying “patient” who is asking for too much. You and your baby need to be heard, and respected. You don’t need to take anyone’s crap. You don’t need to worry about hurting your doctor or midwife’s feelings. I can’t wait until more of us assert ourselves in this way, until it is the norm, and care providers that don’t serve the needs of women and babies just move out of the way.

Have you experienced a care provider that put other needs above your own? Their own licensing requirements? Their personal beliefs and fears? There vacation schedule? Tell us about it in the comments.