My Midwife/Dr isn't listening to me.
“My Midwife or Doctor won’t listen to me”. Unfortunately, something I hear all too often from clients just trying to navigate their way to a safe, positive, centred birth experience.
There a million reasons as to why this might be happening from staff burn out to issues with culture, under staffing to personal egos. But this post isn’t about them, it’s about YOU. How do you recognise when you’re not getting good care, and what can you do about it?
Red Flags: How to notice when you’re not getting good care
Sometimes it’s blatantly obvious that you are being coerced, ignored or gaslighted. Other times it’s harder to spot. If you are noticing any of these things- this is when I would start asking questions!
You feel frightened into a decision
You feel like there is only one option
You are told you ‘have to’ do something
You are told they ‘need’ to do something
You are told you ‘aren’t allowed’ something
Your instinct just feels ‘off’ or uncomfortable
You feel like saying ‘no’ would be very difficult
You’re not being given tangible figures for ‘risk’ (eg ‘double the risk’ or ‘high risk’ without any stats to base your choice on)
You are asking questions and they are being ignored/belittled/laughed at.
Your midwife/dr tells you what ‘they would do’ or what ‘other people would do’.
The suggestion/ reasoning just doesn’t seem to make logical sense to you
What to do if you notice this happening?
There are a few really easy things you can do to ensure you are having balanced, nuanced and personalised conversations about your care- both during pregnancy/postnatally AND during labour itself.
Say ‘I’m just going to jot down/record what you’re saying so I can refer back to it later’
Write down all your questions in advance of the appointment where possible.
Ask to be signposted to research. If it exists (it might NOT), you should be able to spend some time looking over it. If you have no idea how to look at research you can ask- ‘what did the research show, is it high quality research, how relevant is it to my personal circumstances?’
Ask for information to be presented in ‘absolute figures’ (eg 0.1% to 0.2%) not ‘relative figures’ eg (‘doubles’).
Ask if the recommendation is a ‘local’ one (eg just in this hospital) or if it might be different if you were giving birth up the road at a different hospital.
Ask ‘if I was to say no, what else could we do/try'?’ (There are often alternatives, but they’re rarely recommended as standard.
Use your BRAIN tool (Benefits, Risks, Alternatives, Instincts, Nothing).
Never make a decision on the spot. If during pregnancy, GO HOME, sleep on it, call back with your decision in the morning. If during labour- ask everyone to step outside, gather yourself, breathe, make a choice without someone with ‘power’ looking at you.
If in labour and a decision feels ‘urgent’, ask the question ‘is this an emergency? Do we have a couple of minutes’. (If it is, they’ll say yes and it will make your decision making much simpler. But often it FEELS like an emergency because lots of people have appeared and you’re being asked questions.. but it turns out actually 5/10 minutes to yourselves is completely justifiable!)
Getting nowhere? Smile, say thanks, end the appointment/conversation and ask to speak again to someone else.
REALLY getting nowhere? Ask for an appointment with the consultant midwife, if there is one. Copy in PALS (google ‘PALS’ and your hospital name) and contact your head of midwifery. Reach out to birthrights for support.
I really hope you don’t need to use any of the tips on this list- but even if you’re supported by brilliant care providers, there’s lots here that ensures you stay right at the centre of the decision making process, and feel able to make decisions that are right for you in the moment. Even if that’s going along with EVERYTHING being suggested- if you do it because YOU want to, that’s very different to feeling like you had no choice.