Working in health care has become a more daunting task as both physical and emotional needs must be considered when diagnosing and treating patients. As a psychologist working with moms that are pregnant after a previous loss, I hear about what goes well and what is appreciated when working with a provider as well as what might have been experienced as more harmful. In a previous article, I talked about how important it is for doctors and health care providers to exercise patience and manage anxiety during a pregnancy after a loss. Here are some thoughts (from a patient’s perspective) to help manage a subsequent pregnancy.
Do’s:
- Make sure that everyone interacting with the patient has read her chart. It’s really painful to have to educate a tech about one’s history when that wasn’t something that was expected.
- Ask how she is doing, and make sure you have time to listen to her answer.
- Offer alternatives that might not just be medication. She is already afraid for her baby and most of the time, she doesn’t want to add in anything extra to the pregnancy.
- Give her immediate feedback after a Doppler or ultrasound. She’s anxious and waiting makes it worse.
- If you are able, call her in between appointments to check in on her. She will appreciate the gesture of caring.
- Most practices with more than one physician require that patients move around the practice for appointments. Acknowledge this with her, and then arrange for her to meet with one “primary” provider after she has met others so that she feels a continuity of care in her pregnancy.
- Have several conversations about what she needs to be different about this pregnancy and this birth. Assume she might not know, so come to the conversation with some ideas.
Don’ts:
- Treat her like she’s never had losses. She has lost her sense of ignorance and bliss during pregnancy and it is important to take this into account.
- Make her feel unheard or belittled. She is an expert in her body and she is worried that it might betray her again.
- Keep her waiting if it isn’t necessary. She’s anxious. Waiting will not help the dynamic when she sees you (especially if testing/screening has occurred).
- Come into the room not knowing her history.
- Discount or belittle her anxiety. It is normal in a pregnancy after a loss.
This is great. I have two to add that are probably encompassed in a couple of the above, but a lot of providers need it spelled out for them. Don’t: Tell her to relax and try to enjoy her pregnancy. She is terrified and doing the best she can. Do: Tell her this is hard for anyone in this situation, her fears are normal, and we’re here for you and we’ll monitor you as closely as you need to feel safe.
OK, one more. All pregnant women are special and should be treated as such. But Do: Treat her as specially special, because she is.