PREGNANCY-BIRTH Messages for July, 1999: Re: Am I supposed to ask questions about baby?

Re: Am I supposed to ask questions about baby?

From: Noelle

anonymous@obgyn.net

Thu, 8 Jul 1999 09:54:41 -0500 (CDT)

>The point is that you can and should ask all the questions that you want
>(after all that is what you are paying me for), but be careful about the
>"what if" game. It can seriously distort your perception about what is
>going on with your pregnancy, distortions even more profound than
>complete ignorance.

Dr. McIntosh,

I agree that the "what-if" spiral can very easily get out of hand, especially given that parents in Cindy's situation are understandably nervous and scared and may need to know EVERY possibility. The parents have the responsibility to ask questions and to gather as much information as they need to make decisions. However, it is also the responsibilty of the caregiver to frame the information they provide appropriately. That is not to say "lie" or not tell the truth in any way, but it does mean to give the appropriate context of all the information. When going through scenarios #1, #2 and #3 as you described, I think it is the caregiver's duty to reinforce how remote any certain possibilities may be, based on the evidence and your professional experience and not based on what you think the parents "can handle" (my words, not yours).

Parents ask questions that I'm sure seem really stupid/ridiculous/"far out" to many caregivers. The caregiver is probably thinking, "Now WHY in the world are they worrying about THAT remote possibility?" But each person comes to the conversation with their own history and fears. (I know personally for me, for example, if I was told I had high blood pressure, yes, I would indeed worry about affects on the baby, especially since I've lost a baby already.) No caregiver can determine with certainty just what a patient/client "deserves to know" about their or their baby's care. To me it's an issue of patient autonomy and should be based on a relationship of mutual respect between caregiver and patient/client.

I do appreciate your being the devil's advocate. I am sure that your job gets very difficult in these kinds of situations. I'm sure many caregivers just don't have the TIME to go through all the "what-ifs" with every patient every time, much less having to deal with the thought that the information you just provided may have confused the patient more than they were before. It's got to be a fine line you have to walk. But just as the patient has the RESPONSIBILITY to understand their situation as fully as possible so they can make informed decisions about their care, it's also the caregiver's RESPONSIBILITY to use their experience and knowledge base to try to give a context to their patients to help them deal with the ifnromation and make informed decisions.

To Cindy, I really hope all is well with your baby. Go with your heart with this doctor. I thought Mary's advice was good - make an appointment to talk with the doctor face-to-face, to discuss all your questions and to discuss what the staffperson told you. Then, depending on that conversation and how the doctor respects your need for information, you can make a decision to stay with thie doctor or not. Personally, I would not stand for any caregiver who disrespected me in this way (if indeed the doc feels this way), no matter how much I liked him/her personally or respected his/her medical opinions.

Good luck,

-- Noelle Haland Mama to Ethan (stillborn 12/2/96), Max (born 10/28/97)... ...and Ellie due 4th of July 1999 (a girl!) <noelleh@earthlink.net>

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