I cover maternal health. Here’s my plan to ensure hospital staff listen when I’m in labor – News India Times

Recently, two videos went viral on social media showing Black women in labor pleading for help as medical staff appeared to ignore their pain. In one clip, a woman sits in a wheelchair, visibly in distress, while her mother complains of a nurse dismissing her daughter’s concerns. In the other, a woman is also in a wheelchair and crying in pain. The woman later said she was released from the hospital and gave birth to her child in the car less than 15 minutes after leaving. As a health reporter who covers maternal and infant health, I spend my days talking with doctors, researchers and families about the consequences of not being heard in medical settings. It’s helped shape the way I plan on walking into my own delivery. Since this is my second birth, I have learned how to speak up early, document my concerns and make sure my voice is taken seriously at every step of care. Here is what experts recommend to protect yourself, strengthen communication with your medical team and improve your chances of receiving timely and appropriate care during labor and delivery. – – – What should you do when your concerns are dismissed? It is well documented that women’s pain is not taken as seriously as men’s, and that is even more true for Black and Indigenous women, who are more likely to have worse pregnancy complications and face higher rates of maternal death compared with White women. So when a person feels like their concerns are not being addressed the first step is to ask for an explanation, according to Michelle Ogunwole, an assistant professor of medicine at the Johns Hopkins University School of Medicine whose research has focused Black maternal health. “State the request,” said Ogunwole. “For example, say ‘I am having this symptom, I have this history and because of that I would feel safer if we did this test or this evaluation.’” If the response still feels dismissive, she recommends asking the clinician to explain their reasoning in plain language and to document in the chart that you raised a concern. It can also help to bring in another person, whether that is a doula, a partner, a trusted family member who can speak to a clinician. And if you still feel ignored it is appropriate to ask, “Is there someone else I can talk to about this, or can I get a second opinion today,” Ogunwole said. – – – How a doula or support person can amplify your voice Having a doula is associated with a decreased likelihood of cesarean, a shorter labor duration and less need for pain medication, according to a Health and Human Services issue brief from 2022, and doulas positively impact several maternal and infant health outcomes. Doulas are not medical providers, but they play a role in supporting patients through labor, helping them communicate with clinicians and they help to ensure that a person’s birth preferences are respected. You should start researching doulas as early as possible. This gives you time to interview a few people before selecting one, according to Joyce Dykema, director of communications at DONA International and a certified birth doula. She said most expectant parents begin contacting doulas during the second trimester but emphasized that the most important aspect of finding a doula is choosing one who fits your needs. “Picking the right doula for you is a matter of personality. If you’re deciding between two doulas, choose the one who matches your personality best,” she said. I had a doula during my first pregnancy, and I’m using the same doula again for this birth. Having her in the room made me feel safe and grounded in a way nothing else could. For me it was reassuring to have her there because she had witnessed countless births, understood the rhythm of labor and knew what to expect. My husband had never seen a birth before, and while he was supportive, I needed someone with experience who could advocate for me, anticipate my needs, and help me stay calm when things felt overwhelming. This service was something I had to pay for out of pocket since many private insurers do not cover doula services. Several states cover doula services through Medicaid, including California, Maryland and New York. There is no overarching regulatory body, but many doulas get trained through organizations such as DONA International, CAPPA (Childbirth and Postpartum Professional Association), Lamaze International, Birthing From Within and International Childbirth Education Association. I understand I am lucky to be able to afford a doula and that many people do not have that option. If you cannot get a doula, experts recommend clearly telling the person who will be supporting you during delivery what your needs are and what you want from your birth experience. That means explaining what helps you feel safe, what you want to avoid and how you want information communicated to you. Maternal health experts also suggest teaching your support person how to ask questions when something does not feel right and how to make sure your concerns are heard before any decisions are made. – – – What experts say about advocating for yourself in the delivery room Advocacy starts before labor and delivery by choosing a provider who makes you feel seen, valued and heard and, if possible, building a support team that can help amplify your concerns, such as a doula or a trusted partner. Ashanda Saint Jean, an OB/GYN and co-chair of New York City’s maternal mortality review committee, said she tells patients that their voice is not optional. Once you arrive at the hospital, she encourages people to use the tools they already have. Bring written questions on your phone or on a paper and ask the staff to slow down and explain what is happening. And do not be afraid to say when something feels off. “I love when patients come with questions,” Saint Jean said. “Peace of mind is priceless. I would rather you come to the hospital 20 times than not come that one time.” Saint Jean said in a noisy, fast-moving labor unit, advocacy often looks like insisting that your discomfort matters. If a monitor, blood pressure cuff or intervention is making you panic, it is reasonable to say so and ask about alternatives or adjustments. She said sometimes advocacy will include asking whether a test has been done taking your medical history to account or asking to speak with another clinician. What matters is that your team recognizes your agency and that you are informed, Saint Jean said. “No one should ever feel like they would rather take their chances at home,” Saint Jean said. “You deserve to be treated like a VIP in that room and to have your fears taken seriously.”
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