When a woman is having a baby, it’s important that she not only listen to her healthcare provider but that the provider listen to her needs and concerns.
Dr. Courtney Barnes, physician and associate professor of clinical OB/GYN at the University of Missouri, said she teaches future physicians how to listen to patients.
"I think the biggest thing is teaching people how to listen. Women are so smart and intuitive about their bodies and their health. And yes, we have the clinical expertise, but really, it's the patient that helps you make good changes," she said. "So, I think it's really about listening. And a lot of that has to do with like cultural humility as well, learning how to listen to perhaps people who come from a different culture, a different socioeconomic base. So, I think probably the most helpful thing is just teaching people to listen to the moms, which is a hard skill to learn."
And she recognizes that, even though people go into health care because they want to help and do good, everyone comes in with their own biases and experiences, and those can have an impact on care. She tries to teach her students what she calls cultural humility.
"It is hard to be a Black woman being taken care of by this little, like, privileged White person from, you know, the suburbs of Kansas City," she said, "so, I like to just acknowledge where I'm coming from and say, 'hey, I'm trying my best. If I'm doing something wrong, if I'm not saying it in a way, if you think I'm overstepping my boundaries or making assumptions, please tell me because I'm constantly learning, and I want to take really good care of you.' And I just find when you have an open dialog with patients, they're pretty open about how you can improve and how you can take care of them better. So, my patients teach me every day."
Veronica Peterson had her son Brendan around seven months ago. This wasn’t her first pregnancy, so she knew what she wanted – a natural birth with no medicine to induce labor, no epidurals and little intervention.
At about 39 weeks, Brendan didn’t respond during a stress test the way Peterson’s health care provider thought he should, and the recommendation was made for Peterson to be sent to Labor and Delivery. While she was concerned about the test results, she trusted her instinct.
"Sometimes science is science. But then you also — you have that connection with your child," she said, "and your body is also your body. And so, I knew that he was more active at night than that day. So, I wasn't as concerned as maybe the staff was to not see those signs."
"There's this thing in the process of being pregnant and having a baby where, you know, you have to have a care team that supports you and that trusts you, and you have to trust yourself," she said. "I think that's the...most important lesson I had. Have patience and trust yourself."
She made it to 41 weeks but ended up having to be induced after all.
Peterson said it was her nurse at Mercy Springfield, Tiffany Matthews, who made sure Peterson’s voice was heard during the birthing process.
"When I walked into that room, she listened to me, she asked me questions. She said, 'what is it that you really want?' And I told her, and she clarified with me," said Peterson. "I cannot say how important and critical that was to my experience and automatically even put us in a position of being able to trust one another, which was amazing."
Peterson felt like the OB/GYN on staff when she was in labor wasn’t hearing her concerns. She feels that women should trust the experts, but doctors should also listen to the mom.
"While I was suggested, 'hey, you should do this. You should have these types of, like, interventions to move this process along faster,' I was really on the side of patience like I had been my entire time," she said. "And Tiffany stepped in. The nurse stepped in, which was amazing. So once the physician left, she sat down next to me and she told me, 'listen, I understand this is a tough time, and that was a hard conversation, and I want you to know that you do have options, and I want you to know that you can do it this way. As long as we're trying to progress, you can do it this way.' "
She said her nurse talked to the manager, and the manager came to the room to talk to Peterson personally. The care Matthews showed made a big difference in Peterson’s experience.
"You can be kind of detached and just say, 'okay, I checked your vitals. I gave you your, I gave you your meds. I looked at your screen. I'm out the room.' And they didn't choose to do it that way. They chose to make it more personal and personable for me and like I said, listen to me," she said. "And so, because of that, I ended up switching providers and went with the hospitalist that was in rotation."
Her nurse stayed two hours later than she was scheduled just to be there for Peterson. But before she left, she told Peterson she’d check in to see how she was doing. After many hours of labor, the birth stopped progressing. It turned out Brendan’s arm was up by his head, and he was stuck in the birth canal.
"I ended up having the hospitalist come in, and she just said, 'you know, you've gone about as far as this method has gotten, and I think it's time to take this next intervention step.' Now, this intervention step that she recommended to me was one that I had done with my firstborn. And it was very uncomfortable. And so that was one of the reasons why I didn't — I shied away from it," she said. "But I think the courage that you have to have in the labor and delivery room to get through and realizing that whatever is stalling me, on the other side of that, both my nurse and my doctor were confident that if I made this one push and made this one pivot, we could see some progress."
After lots more pushing and feeling like she was making progress, Brendan got stuck again.
"A nurse comes to the side of me, and she's just like, 'okay, Veronica, he's right there. You know, I want you to take a deep breath, and on this next contraction, just bear down and give it all you've got.' And I just, like, click in, I'm like, 'okay, we got to get this done. We got to work together.' And at the same time, I'm talking to him and I'm like, 'come on, baby. Come on Brendan, let's go.' And so, three, two, one like the biggest I can, and (his head) comes out and then it's like stuck again. You get stuck one more time," she said, looking at Brendan who's in her arms. "And she's like, 'okay, come on, one more, one more. Deep breath, deep breath. Three, two one.' And then finally, like, he comes out, this beautiful baby boy."
Soon after, she was able to turn to see who was in the room. It was Matthews who had come back two hours before her shift was supposed to start and was able to be there for the birth.
Peterson said women need to find a provider they can build a healthy rapport with. She suggests writing down questions and bringing someone along who can speak up for you if you need them to.
"It's always encouraging when you feel seen. And I think that healthcare providers who take the time to let you know that I do see you, and I do realize that there's a difference, but I respect you, and I know that that can be intimidating, but I'm here for you, that's always good. That's always good," she said.
Dr. Jennifer Brooks, an OB/GYN with Mercy Springfield, said a good provider is someone who’s willing to listen to their patients, "and really learn who they are as a person, what's important to them, as opposed to just looking at a patient as their problem list. That's that is a person we should know them as a whole and find out what they want, and we can come up with a shared decision-making plan. It shouldn't ever be a provider saying this has to be done, but offering the recommendations, the pros and the cons to each recommendation, and then letting the patient decide what they feel is best after they are well informed."
Dr. Barnes said women shouldn't be afraid to seek another care provider if they feel like it just isn't working.
"Sometimes it's hard to get a new OB appointment so you get what you get, and you don't throw a fit, you know? So sometimes, you know, you just take what you can," she said. "But one thing I have to say to women is trust yourself. Trust that feeling that you have. If you go to your appointment and you feel like you're not communicating well, you're not connecting, you're not getting the answers you want, maybe your concerns are being dismissed. Really, if that's true for any health care/patient relationship, but if you have that, seek a different provider."
"Sometimes your personality just doesn't jive," said Barnes. "And so I encourage those patients, if you don't feel supported, then we need to change that up for you because it's better for you and also better for the provider as well."
