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Lessons from a Miserable Pregnancy: Lesson Three – Assert Yourself

If you have ever left your doctor’s office with unanswered questions and unheard complaints, then you are very much not alone. I spent my entire first miserable pregnancy feeling as though there was a wall between myself and my health care providers. Perhaps it was my general inexperience with doctor’s visits. Growing up I very rarely had to visit a doctor because my family physician mother was my general health care provider. I also believe that doctors have been placed on a pedestal for much of recent history, and as patients we feel less than empowered to speak our minds and question their decisions.

But if there is ever a time in your life when you need to be candid with your health care provider, it is during your pregnancy. Here is why:

1. Unsatisfactory pregnancy outcomes are leading to a medical malpractice crisis that is eliminating patient choice and the availability of qualified and experienced obstetricians.

A 2006 ACOG (American College of Obstetricians and Gynecologists) liability survey of physicians found that 65% of ob/gyns have made changes to their practice because they feared malpractice claims being made against them. This fear is not unfounded. In fact, nearly 90% of ob/gyns have had claims made against them. Despite the fact that they have been cleared in nearly 70% of those cases, the fear is real, and the costs to doctors are staggering. Those costs are being passed on to women in the form of lack of medical choice. Due to this increased risk of liability, 33% of ACOG certified ob/gyns have decreased the number of high-risk patients they will see, 33% have stopped offering the choice of VBAC’s to their current patients, 37% have increased the number of Cesareans they have performed, and 8% are simply no longer including obstetrics in their practice.

What can women do to change this now? Speak up. At the 2008 ACOG Clinical Meeting, the chief risk officer for the University of Michigan’s health system pointed out that time and time again studies have shown that women who sue their obstetrician generally do so because they feel as though their complaints have not been heard; they have not received answers to their questions. By taking a proactive approach to this problem as a patient, not only are you helping to solve a larger issue in the community of women’s medicine, but you may also be preventing harm to yourself or your child.

2. There are a myriad of health risks to your fetus that can be mitigated through early intervention.

Speaking to your doctor honestly and early about symptoms such as bleeding or cramping may result in doctor imposed bedrest to stave off a threatened miscarriage in the early weeks of gestation or a pre-term delivery later in pregnancy. Women should not be embarrassed to speak with their doctors about frequent and copious urination, which may be a sign of gestational diabetes, simply because they think that increased trips to the bathroom. Listen to your instincts, and talk to your obstetrician if you have questions or concerns. The earlier you share these concerns, the more likely it is that your doctor will be able to improve the chances of a healthy outcome for your child.

3. New mothers may suffer deleterious affects if they do not directly deal with their own health concerns during and following pregnancy.
The numerous conditions that affect women in pregnancy not only put the health of their children in danger, but women themselves may experience long term health problems as a result of symptoms they may have masked during pregnancy. One such condition is venous thrombosis. Women often neglect to tell their physicians about pain or swelling in their legs because they believe it is normal to suffer such aches while pregnant, but the consequences of choosing not to trouble your doctor with such complaints can be fatal. A heavy, painful feeling in the leg accompanied by swelling, sometimes only slight, can be an indication of a blood clot, which may be in danger of moving to the lungs. The best treatment in such a case is – prevention. The use of support hose and preventative exercises may be recommended…if you voice your concerns to your doctor as they arise.

4. Taking control of your health care during pregnancy will prepare you for your new life as an adult in charge of another human being.
Making the transition from adult to parent brings with it many new responsibilities. You are now responsible not only for your own life, but for the well-being and care of a helpless infant who will depend on you to be her voice. Pregnancy is a wonderful time to learn to assert yourself and begin to insist on your own needs being met. Someday your child will thank you.

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