From the moment you become pregnant, you face an endless series of choices. Some choices you make alone or with your partner, such as when to share the news or what color to paint the nursery. Other decisions, especially the medical ones, take place when you talk with your health care team. Your team, including your ob-gyn, can recommend medical treatments and explain their risks and benefits, but only you can express your desires for health care and make the decisions that are right for you. Doctors sometimes call this “shared decision-making,” and it’s especially important during pregnancy.
Building a Partnership
Many people were brought up to believe that doctors get to say what’s going to happen, and patients have to go along with it. Today, two-way patient-physician relationships are the norm in obstetrics, gynecology, and other health care fields. When I first meet with a pregnant patient, I start by saying: “I’m here to give you the birth experience you desire and to help make sure that it’s safe. What questions do you have for me?”
When it comes to making medical decisions, I’ll explain my recommendations and the pros and cons. Then the patient has her turn to express what she wants, and why. If the choice isn’t urgent, and I sense she isn’t ready to decide, I’ll suggest she take more time to think it over. And if we disagree, we keep talking until we come to a safe plan together.
This is the pattern you should expect from your prenatal care (and really, all health care). Think of it as one long conversation with your ob-gyn, midwife, nurses, specialists, and other members of your health care team.
How to Be An Empowered Patient
When it comes to shared decision-making, here’s how you can make your voice heard:
Share your vision. I find my patients often have very clear ideas for their pregnancies and birth experiences. It’s important for your ob-gyn to know what that vision is, so they can align your care with your wishes. Remember that you and your ob-gyn have the same goal: a safe delivery and a healthy mom and baby. Still, you should be prepared for changes to your birth plan as your pregnancy and labor progress.
Come with questions. Your ob-gyn is there to answer your questions. If you’re nervous, try writing down your questions in advance. If something comes up between visits, connect with your ob-gyn through email, phone, or video chat.
Gather information. There’s an enormous sense of empowerment that can come from doing your own research. Go ahead, look things up online. Pick up trustworthy books on pregnancy, like the new book from the American College of Obstetricians and Gynecologists, Your Pregnancy and Childbirth: Month to Month. Then take all of your questions to your ob-gyn for conversation.
Bring a support person. Invite your partner, a family member, or a friend to your appointments. They also could be on the phone or a video call during the visit, which is a good option while the coronavirus is spreading. They can take notes, ask questions, and help voice support for your choices.
Find the right fit. If your ob-gyn practice doesn’t offer what you desire, or simply isn’t a good personality match, then find one that is. You have the right to feel welcome and heard at your ob-gyn practice, and to actively participate in your prenatal care.
Working together
As the patient, your responsibility is to share your concerns and ask for your health care team’s best advice for your situation. In return, your health care team should listen carefully and give you the information and recommendations you need to make the right decisions for you. These days, that’s the goal for patient care.
Adapted from ACOG’s website for patients
Dr. Tamika Auguste is an obstetrician-gynecologist at MedStar Washington Hospital Center in Washington, DC, where she serves as Interim Chairwoman of Women’s and Infants’ Services, among other leadership roles. She is a professor at Georgetown University School of Medicine and a member of the Board of Directors for the American College of Obstetricians and Gynecologists.
