I often call myself the "poster child" for the power of education. When you juxtapose my first pregnancy, managed by a very nice, somewhat elderly doctor who euphemistically patted me on the head and made me feel like everything was always all right, against my second pregnancy, managed by an equally nice, albeit younger and more knowledgeable doctor, there are some startling differences beyond age and experience that have everything to do with patient-provider communication (yes, they were both men so ditch the gender stereotypes).
Both pregnancies resulted in severe pre-term preeclampsia. In the first, my baby died. In the second, my baby lived, albeit with a two-week stay at Hotel NICU. There are obviously lots of nuances to each of my pregnancies, but as I look back, I can say with certainty that one of the critical factors for a successful pregnancy is the patient/provider partnership. This sentiment is echoed in a series of "Committee Opinions" produced by the American College of Obstetricians and Gynecologists (ACOG).
What does a "patient-provider" relationship look like?
Here are 10 Things You Can Do to Be a Partner with Your Health Care Provider.
1. Trust yourself. Do not be concerned that you might appear weak, ignorant or overly sensitive for reporting symptoms you are concerned about. Expect diligence and sensitivity on the part of the provider responding to those concerns.
2. Tell the truth. Full disclosure with no "little white lies" about your physical activity, diet, drugs, medications, stress, mental illness, reproductive history, and compliance with the treatment plan are all very important. Your provider will not judge you.
3. Describe any pains or symptoms as specifically as possible. Is it stabbing or burning? Sudden or constant? Tingling or hot? Intensity, exact location, if anything provoked it and how long it lasted are all helpful indicators.
4. State up front all your concerns and desires, best accomplished by writing down your questions ahead of time. Don't leave with unspoken concerns. Do leave with notes or printed materials reinforcing what you've learned.
5. List all the medications you're taking, even vitamins and herbal supplements. Bring supplements to your appointment to help identify ingredients since those products aren't standardized. Medication errors are the largest source of preventable adverse events.
6. Be upfront about anything you disagree with or don't understand. Be sure to understand what options lie ahead if you are diagnosed with preeclampsia. Don't be scared to be honest instead of nodding your head, and then ignoring the plan.
7. Seek test results immediately if they are not provided when promised.
8. Understand the "basics" about your pregnancy body. What's your "normal" blood pressure? And why do you pee in a cup at every prenatal appointment? Which symptoms should you report immediately and what can wait for the next visit?
9. Don't be afraid to use After Hours resources for any concerns. Have phone numbers and locations handy.
10. Comply with the treatment plan. If you've followed all the advice above, you should have a plan that makes sense to you and one you're able to execute.
Do you have additional advice for engaging in an effective patient-provider partnership? Please leave a comment about what has worked for you.
To this day, I look back with great fondness on my second and third pregnancies, despite the scary repeat of preeclampsia, because of the healthy, open, trusting partnership I had with my phenomenal doctor and his like-minded staff.