Advocate for your health, save your life (at the very least, your mind)
The United States is infamous for its horrific maternal mortality rates – the worst in the industrialized world. The already trash statistics got precipitously worse during the pandemic. If you’re a birthing person of color, it’s considerably worse than rest of the population. That’s because – if you haven’t gotten the memo – the whole system is racist.
Behind these statistics are terrifying stories of botched procedures, pregnant people being dismissed when they’ve raised concerns, overburdened hospital staff who haven’t gone through correct protocol before administering a drug.
Many of us will know people who had unnecessarily terrifying experiences in the process of heroically trying to bring life into this world. It’s unconscionable. When the latest raft of headlines on rising mortality rates came across my screen last week, I thought about my own experiences with obstetrics and what I’ve learned from friends, doctors and my own experience.
I am here to tell you
IF SOMETHING DOES NOT SEEM RIGHT, GET CHECKED.
There is no shame in this. There is nothing wrong with this. You do not owe an explanation beyond the fact that you’re concerned.
You will be talked out of doing this, especially if your hospital/doctor/nurse is overburdened or if your concern seems like nothing to them based on their (respectable) experience.
For context, I tend to be a people pleaser. I like doctors to think I am a good patient. I want them to think I am cool, laid-back, relaxed. I want them to say ‘wow, if she wasn’t my patient, we would totally be friends.’ This was a hard facade to pull off amidst being a first time pregnant person during the pandemic. None of it is how I thought becoming a mom would be. Fewer scans to reduce face time in the office? Sure. I am so cool and chill and just like, totally, trust your experience. I won’t be nervously eating cheetos and counting the hours until I get another scan.
And then, I fell down the stairs in my second trimester. The nurse told me over the phone that I was fine. I didn’t want to ruffle feathers. She said to call back if I started bleeding. In hindsight, what the actual fuck? Unacceptable. Why didn’t I just say, ‘NO, I AM COMING IN’? Because I wanted to believe that the nurse on the phone knew everything about my exact situation, had seen it 1,000 times before and genuinely couldn’t imagine any possible way there might be a problem.
As it got closer to my due date, I got a bit more forceful, but not much, when I started leaking fluid. A different nurse suggested maybe I was just peeing myself and didn’t realize it? Pregnancy is so glamorous after all! After getting checked once, they said it wasn’t amniotic fluid. I felt stupid for wasting everyone’s time, even though deep down I didn’t believe them.
So, I tittered along ‘peeing myself’ until past my due date when I went in for a routine ‘stress test’ exam. I apologized to the tech for ‘accidentally peeing without realizing.’ She informed me that my water was likely breaking. Great. This makes absolute sense based on what my own body was telling me. Luckily for me and baby, everything was fine. When the result turns out OK, everyone just expects you to forget the one simple truth: I had been right all along and I should have trusted myself more.
I had a miscarriage last year. It was devastating (will write more on this another time). I had moved across country and was now with a new doctor and the miscarriage was our second interaction. From our initial meeting, I wasn’t sure how compassionate she was. I just resolved that this must be all doctors. They see so much, it’s just who they are. But I couldn’t be brave this time. This time, I cried in front of her. How embarrassing for me, I thought. I tried to hold it in. I didn’t want her to think I was being irrational. It wasn’t a viable pregnancy after all. So many pregnancies end this way. She offered me a snack and a tissue, but it all felt very perfunctory.
You are a warrior
And then, when the D&C was all over, my doctor looked me in the eye and put her hand on my shoulder and told me (and my husband) that I was a ‘warrior.’ She validated every feeling I had had about the whole experience. And for the first time in all of my time as a mom, I felt truly seen by my doctor…as a human being.
I’ve been lucky enough to get pregnant again and I will cross my fingers and toes that this pregnancy has a happy outcome. I truly believe that my doctor’s knowledge of the tragedy I experienced has completely changed how she treats me and how her staff treats me. Little things like reminding me to come in any time for scan if I am feeling anxious. Delaying my pap smear by a few months so I don’t get scared if I see blood. I wish we could give this to pregnant people at the outset. As the rule.
This experience, along with the strength and wisdom of friends has taught me a lot about how I need to advocate for myself in the future. I want to share some simple things with you now. I do so knowing full well that advocating for oneself and being confident to do so is *wrongly* a privilege afforded to only some of the birthing community. I am a cis-white woman using private health insurance. How my requests are taken may be heard differently than if the color of my skin, sexual orientation, insurance status, among other things were different.
And that is completely fucked. COMPLETELY FUCKED. That’s work for the rest of us to do. No one should feel like they can’t advocate for their own health and safety.
Say it with me: ‘get yourself seen’
I am going to put some guiding words here for anyone who needs to see them (Even if the only person who needs to see them is me, months from now):
If you are concerned that something is not right with your mind or your body, ask to be seen immediately.
If you are concerned that something is not right with the fetus you are growing, ask to be seen immediately.
If you don’t understand what your doctor is saying. Ask them to slow down and explain it better. Ask for a pen and paper if you need to take notes.
If you don’t want a first-year resident performing a procedure on you (like your epidural), ask for someone else immediately.
If you are concerned that a protocol is not being followed. Ask for a pause and clarification immediately. If necessary, ask for a supervisor.
Tell yourself: ‘I am in charge of advocating for my own well-being’ and ‘No one will make decisions on my behalf without my consent.’
All of these requests can be done with politeness and respect. Advocating for yourself does not equal yelling, insulting, or disrespecting healthcare workers. It does require standing firm, respectfully, on what you need.
There is nothing worse than leaving an encounter and wishing you had stuck up for yourself. If someone thinks you’re being bossy, entitled, rude, for advocating for your own well-being, then very kindly FUCK THEM.
For avoidance of doubt, doctors and nurses are amazing
What they do is incredible. If you want your doctor to behave like a shaman and chant verses at you while covering your belly with patchouli oil under a full moon while you give birth, you do not have a sympathizer in me. Find someone else to do that. Their job is to keep you alive, safe, calm and with minimal pain. Your advocacy for yourself helps them to do just that.