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Redefining The Patient-Provider Dynamic

Have you ever talked to a provider who you swear wasn’t listening?
Or who expected you to do everything by the book, specifically, their book, or you could take a hike?

The NIH Consensus Panel for VBAC in 2010 emphasized over and over that communication between clients and their providers is urgently necessary in medical care. In order to further the accuracy of information, the understanding of treatment and the informed decision-making process, women and their providers need to talk.

Some of the obstacles moms run into can happen in the first appointment. “Do I really NEED to be weighed?” or “I don’t choose to be weighed at this time” can be met with such adversity as to make them seem biologically imperative for pregnancy to continue! And later in pregnancy, choosing not to have a genetic test, not consenting to a gestational diabetes (GD) or group B Strep (GBS) screening can make providers come out of the woodwork of informed decision-making and right into we don’t want you as a patient”. And as for having input on her due date, many women find that even careful charting, knowing their cycles or having a good understanding of ultrasound dating procedures cannot save them from their provider ignoring their opinion.

And clients find themselves being labelled as non-compliant or difficult rather than finding providers who are willing to discuss their reasons and assent to them, note them in the chart and moving on.

So redefining this situation is important and it matters. Start locally. Talk to your providers ahead of time, before pregnancy or care if you can. Discuss with them the importance of a partnership in care rather than a parent-child relationship. Explain that it’s important that you understand all procedures before consenting and that no, you won’t consent to all procedures as a blanket action but that you will consider them and will change your mind if they become necessary.

It’s of utmost importance that you remember at all times that the informed consent/refusal/decision-making process is to protect YOU, the patient/client. It’s for you to know what is going on, what the possible risks are, what the possible outcomes are, even if you should choose to do NOTHING. This is your moment to ask what you need and require documentation in writing. If a doctor is going to tell you that you have a 25% rate of something, feel free to ask them to put that in writing or show you the research involved. One of the most positive actions you can take is to say “I understand that’s your information, do you mind sharing with me where you got that so that I can make an informed decision?” After all, if they cannot provide it, they shouldn’t be using it.

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