Mamas on Bedrest: “Well Behaved Women Rarely Make History!”

September 30th, 2011

“Well Behaved Women Rarely Make History!”

Sitting behind a car at a red light I read this sticker and chuckled to myself. Then I began thinking about women in history, many of whom I admire, and I had to admit that most of them had caused quite a ruckus in their time for their causes. But one think is certain-Their voices were heard and in the end they got what they wanted. It seems to be true, well behaved women rarely make history.

And sometimes, they don’t make babies either.

Mamas on Bedrest, sometimes you have to “misbehave” to get what you (and your baby) need!

Case in point: A mama on bed rest has been admitted to the hospital with uterine irritability and suspected preterm labor. After stabilization, the doctors are recommending that she be sent home. She is only 22 weeks and this is not the first incidence of preterm labor. She was placed on modified bed rest at 18 weeks with her first episode of preterm contractions. She also had a stillbirth at 26 weeks several years ago and has a 2 year old at home, born at 32 weeks. Finally, she lives over an hour away from her hospital and physician.

This mama is petrified. She is afraid to be sent home, where she spends most of the day alone with her toddler. She has no support. She has vivid memories of going into preterm labor with her first born and not making it to the hospital in time to save that little life, as well as the emergent delivery of her son. She desperately wants her baby and doesn’t know what to do to convince her doctors to let her stay on hospital bed rest.

So what can this mama do to ensure that she and her baby receive the best care possible and both survive and thrive?

1. Make A LOT OF NOISE! The addage that the squeaky wheel gets the grease is true. While it is sad and quite tragic that this mama has to “fight” for medical care, the fact remains that her life and the life of her baby may very well depend on it. Our health care system is so broken that hospitals are often more concerned with their numbers and bottom line than doing what is best for patients. Unfortunately, this often leads to “cost cutting” decisions that often aren’t in patients’ best interest. Such decisions can be reversed. Ask to speak with social services and ask them to help advocate for you. Ask for your case to be reviewed by the chairman of your department, in this case, the head of the OB/GYN department. You can also request outside review from external medical boards. Once you start drawing attention to your case, many times, you can get the care that you want and need.

2. Have an Advocate. For some patients, this kind of self advocacy just isn’t possible; they may be too shy but more often, too sick to speak on their own behalf. Whenever possible, have an advocate. This can be your spouse, a family member or a friend who will knows your health care wishes and desires and will stand up for them and defend you in the event that you can’t defend yourself. If possible and economically feasible for you, you may want to hire a doula or birth attendant. While the initial outlay of cash may seem daunting, in the end, they may save you much more than cash.

3. Know you health history. The mama above has a strong history of preterm labor. That alone makes her a candidate for inpatient care if she has no one at home able to monitor her. What further strengthens her case is if she knows the cause of her preterm labor, any reactions to medications or treatments and the outcomes. Since most patients don’t know or recall all the details, I advise them to have a copy of their medical record to share with attending physicians. Many patients will say, “Well my doctor said they sent my file over.” This may or may not have happened and the file may or may not have reached the obstetrical floor. If you have copied of your records, you can give them to those taking care of you and they can make copies and have the information immediately on hand (DON’T GIVE THEM YOUR COPIES TO KEEP! Have them make copies or have copies made for them.)

4. Don’t Stop until you get what you want and need. This can be the trickiest part. Many patients don’t know who to talk to when things are not going well. Of course you should always try to talk to your health care provider. They are your first line of defense. But when they are not acting in what you feel is your best interest, move on. Speak with other attending physicians, speak with patient advocates, speak to hospital administrators. Keep talking. Keep asking questions. Keep pressing until you get what you want and need.

These and more tips are available in our Bedrest Coaching program. Try a complimentary Bedrest Breakthrough Session and see how together we can help you navigate your pregnancy. To schedule an appointment, e-mail info@mamasonbedrest.com

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