Tips for a Healthy Patient-Provider Relationship
Navigating a high risk pregnancy can be very stressful, but having a healthy patient provider relationship can ease that burden significantly and can make a tremendous difference in your pregnancy experience. Here are a few tips to help you cultivate a healthy patient provider relationship.
Be polite. Try to pay attention, be involved, and avoid using your phone in the exam room. While you are paying your health professional for their time, make sure that you are also giving them the courtesy of your attention and manners. It is so easy for us to want to zone out while waiting or when we are stressed, but remember to give the provider your full attention.
Breathe. You have valid fears, concerns, and questions, but it’s much harder to discuss them if you are talking really fast, crying, or getting really stressed. Take a few deep breaths before your appointment. Write down all of your questions, and ask them one by one giving the doctor plenty of time to respond before moving to the next one. Listen carefully to what the health professional is saying, and if you don’t understand, be sure to ask him or her to clarify or to rephrase it.
Be prepared. It is easier to have an active discussion with your health care team if you are prepped and ready for your appointment. Keep a notebook or folder with all of your past test results. It will go smoothly when you want to discuss your rise in titers, if you can quickly show what your values have done over the past several weeks. In some cases, you may have a copy of your results before the doctor does, especially if your OB and MFM are at different hospitals. Having a print out of the results from the lab allows them to be easily copied and add to your record. Keep track of your PSV and MoM scores too. The doctor has all of this information in his computer, but it may it can be helpful for both of you to be able to see what your MoMs have done over the past month. A PSV of 50 is more dangerous at 20 weeks vs at 32 weeks - it may be reassuring to you to see if they are stable. Along with having a copy of your past test results, have a spot to write down any questions that you have. You won’t be worried about forgetting something important if it is written down. We have a Care Record that you can download here (link).
Learn all that you can. Knowing what your baby needs can go a long way towards getting him or her here safely. Look through information on the testing done during an alloimmunized pregnancy. Make sure that you understand how often titers or MCA scans should be done. Be certain that you understand if you have an antibody that is known to cause false coombs test results. Make sure that you know about the need for a medical alert and your increased risk for hemolytic transfusion reactions. Discuss with your doctor how difficult it will be to find blood for you, and if you need to bank your own blood or if extra can be ordered for delivery. Understand the ins and outs of your specific antibody. If you have anti-Kell, make sure that you know that it can cause severe anemia even at low titers. If you have anti-E, make sure that you know about the rebounding jaundice that many anti-E babies experience. Your health professional may not have a lot of experience with your specific antibody, so you have to take responsibility for ensuring that you get the care your baby needs. If you are uncomfortable with the care plan, or if you feel that not enough is being done, don’t be afraid to discuss it with your doctor. By the same token, don’t be afraid to look for a new doctor if you need to. Many women travel hours to see a specialist, so you aren’t alone if you choose to travel to a larger area or a different hospital. You won’t know what an acceptable level of care is if you don’t take the time to learn about your disease.
Bring information. As part of being prepared, bring any articles you wish to discuss. In some cases, you may have a really good article with information about a treatment that hasn’t been offered to you. Discuss with your doctor the risks and benefits of that treatment and see if it is an option for your unique case. There are also cases where you will have to refuse treatment. If your health professional is offering iron supplements to your newborn and you have to decline, it will be helpful to provide him with a copy of one or two articles showing that iron supplements are dangerous to infants with hemolytic anemia. Health professionals are usually happy to read any new information that you bring, especially if it is from peer reviewed medical journals. Avoid saying things like, “someone on Facebook said”, or “Google says”. It is much more helpful to bring articles from good, credible sources. Peer-to-peer support groups are a wonderful way to get support and to educate yourself about your antibodies. Remember to ask things like, “where can I find a copy of that article to show my doctor?” or “Can you help me find articles about IVIG to bring to my appointment?”. Personal experiences can be very helpful, but articles used by other health professionals can go a long way towards advocating for your baby.
Cultivate a relationship. We’ve all been scared and worried for our babies before. It is one of the hardest things to do and you feel so helpless. Developing a good relationship with your health care team is so important. They can be some of your baby’s biggest advocates if you can all work together to get your little one here safely. Long after your child is born, you will still remember your care team and if they made it easier or harder for your family.