Positive Communication
Sweet Pea Births - ...celebrating every sweet pea and their birth
RSS Follow Become a Fan

Delivered by FeedBurner


Recent Posts

Postpartum Wellness Series: Nutrition
World Kindness Day 2017
Postpartum Wellness Series: SLEEP
In Their Own Words: Erica ~ Part 2
In Their Own Words: Erica ~ Part 1

Most Popular Posts

An Inside Look: Modern Mommy Boutique
Breastfeeding Support Groups: La Leche League
A Look At the honest company
An Inside Look: Placenta Encapsulation
Mommy-Con Phoenix Ticket Giveaway

Categories

Acupuncture
Affirmation
Allergies
Amniotomy
AROM
Artifical Rupture of Membranes
Ask the Doula
Augmentation
Avoiding harmful substances
Baby
Baby blues
Baby Concierge
Baby games
Baby-led weaning
Babymoon
Babywearing
Back Labor
Bag of Waters
Bedtime Routine
Belly Cast
Berman's Law
Big Latch On
Birth
Birth center
Birth Centers Phoenix AZ area
Birth Circle
Birth Mantra
Birth News
Birth place options
Birth plans
Birth Story
Birth Story Listening
Birthing From Within
Blog Carnival
BLW
Bradley Day Family Picnic
Bradley Method®
Bradley Method® birth story
Bradley Method® for next baby
Bradley Method® for second pregnancy
Bradley Method® outcome
Bradley® Coaches
Bradley® Dads
Bradley™ classes and the next baby
Bradley™ classes for next pregnancy
Bradley™ classes for second pregnancy
Breast Pumps
Breast Pumps and Workplace
Breastfeeding
Breastfeeding 101
Breastfeeding Awareness Month
Breastfeeding Challenges
Breastfeeding in Public
Breastfeeding support
Breech presentation
Breech turning techniques
Cassandra Okamoto
Cephalo-Pelvic Disproportion
Cesarean Birth
Cesarean Support Group
Cesarean Surgery
Child Spacing
Childcare
Children's Books
Chiropractic Care
CIO
Circumcision
Co Sleeping
Coaches
Coaching
Coach's Corner
Comfort Measures
Communication
Contest
Cord Clamping
CPD
Cry It Out
Crying
Dairy Allergy
Debbie Gillespie, IBCLC, RLC
Dehydration and Pregnancy
Delayed Cord Clamping
Depression
Doulas
Drinking during labor
Due Date
Eating during labor
Eclampsia
ECV
Engorgement
Epidural
Episiotomy
Essential Oils
Exercise
External Cephalic Version
Eye Drops
Eye Ointment
Eye Prophylaxis
Failure to Progress
Family Bed
Family Fest
Family Fun
Fear-Tension-Pain Cycle
Fertility
Fetal Distress
First Birthday
First Foods for baby
First stage labor
First Trimester
Flower Essences
Fluid Retention
FTP
Full term
Fussy baby
Galactogogues
Gestational Diabetes
Giveaway
Going to your birthplace
Gowning
Green Nursery
Grief Counseling and Support Services
Healing
Healthy, Low-Risk
Hearing Screen
Heat Comfort Measures
Herbalist
Homebirth
Hospital Birth
Hyperemesis Gravidarum
Hyperthermia and Pregnancy
IBCLC
Immediate Cord Clamping
In Their Own Words
Increase Breastmilk
Induction
Induction of Labor
Infant Care
Infant Classes
Infections and Pregnancy
Info Sheet
Information Center
Information Sheet
Informed Consent
Inside Look
Jaundice
La Leche League
Labor Augmentation
Labor Induction
Labor Marathon
Labor Sprint
Labor Support
Lactation Consult
Lactation Consultation
Lactivist
Managing or coping with natural labor
Mantra
Maternity Keepsake
Meditation
Meet the Doula
Membranes
Midwife
Midwifery Care
Midwifery Scope of Practice Committee
Milk Supply
Miscarriage or Stillbirth
Modern Mommy Boutique
Mommy-Con
Monday Mantra
Monitrice
Morning Sickness
NAP
Natural Alignment Plateau
Natural birth
natural labor coping mechanisms
Natural labor coping techniques
Nausea
Neonatal Eye Drops
Neonatal Eye Ointment
Neonatal Eye Prophylaxis
Newborn
Newborn Care
Newborn jaundice
Newborn Procedures
Next baby
Next pregnancy
NICU
NIP
NPO
Nursery
Nursing
Nursing and Maternity Bras
Nursing In Public
Nursing Strike
Nutrition
Obstetrical Care
Oxytocin
Pain
Pain management
Pain management natural labor
Parenting
Past due date
Patient Bill of Rights
Perineum
Phoenix Mommy-Con Mini
Photographer
Placenta
Placenta Encapsulation
Planning for Baby
Playing with baby
Postdate
Postmature baby
Postpartum
Postpartum Depression
Postpartum Doula
Postpartum Plan
Pre-eclampsia
Preemies
Pregnancy
Pregnancy Loss
Premature Baby
Premature Ruptture of Membranes
Pre-term Labor
Prolonged Labor
PROM
Q&A with SPB
Rally to Improve Birth
Relaxation
Relaxation practice
Repeat Bradley™ classes
Rights for Homebirth
ROM
RSV
Rupture of Membranes
Scavenger Hunt
Second Stage Labor
Sensory games
Sibling Preparation for Newborn Arrival
Sleep Sharing
Sling
Soft-structured carrier
Starting Solids
Stripping Membranes
Support Groups
Sweeping Membranes
Sweet Pea Births
Swelling in Pregnancy
Tandem Nursing
Teething
The Bradley Method®
The Bradley Method® classes
The Bradley Method® pain management
Third Trimester
Thoughtful Thursday
Tongue Tie
Tongue Tie Procedure
Toxins, pesticides, chemicals and pregnancy
Traditions
Transition
Twins
Upcoming Events
Use of vacuum extraction
Uterine Rupture
Vaccines
Vaginal Birth After Cesarean
Vaginal Birth After Multiple Cesareans
Variations and Complications
VBAC
Vitamin K
Warning Labels
Waterbirth
WBW2013
Weaning
Webster Protocol
Weekend Activities
Why we chose the Bradley Method® childbirth classes
Wordless Wednesday
World Breastfeeding Week
Wrap
powered by

Sweet Peas, Pods & Papas: All About Birth, B@@bs & Babies

Positive Communication

Communicating with your Care Provider  

Tonight’s class was about Variations & Complications of Labor.  The Bradley Method® believes in teaching this topic so that parents are prepared for the outside possibility of a variation of labor.  We strive to introduce these in an informative way while leaving out the flashing sirens of fear and doubt.  

In previous posts, I have written about choosing your care provider and your rights as a patient consumer of health care in a hospital setting; both will affect your outcome when faced with critical decisions during the birth process.  Bruss suggested I write about communication since it’s tied to making a good decision if you face decision points in your pregnancy and/or labor.  So let’s expand on a related topic: talking to your care provider so you can assess the recommendations they are making at any point in your pregnancy or labor.  

There are many variations in labor.  Some women will labor quickly, others slowly.  Some women dilate continuously, other women dilate a centimeter or two every few hours, some women might even experience what is termed “reverse dilation”.  Women manage the pain of labor differently – some moan, some chant, some scream.  Some women have the water break early, other women have the water break as they are pushing, and rarely babies are born “en-caul”, having their bag of waters intact and then it’s broken after delivery.  

Possible complications in labor are things like placental abruption, uterine rupture, a baby in a transverse position, a baby in fetal distress that has been determined by having the doctor listen with a Doppler or fetoscope…we aim to cover the things that are true medical complications when a cesarean is medically indicated.  

I like Henci Goer’s definition of informed consent.  It means that any time an intervention is suggested, you have the legal right to know what is being recommended, and that it must be conveyed in a language that you understand.  You must also know why it’s being recommended, the potential problems and side effects, alternatives to handling the problem, the pros and cons of the alternatives, including doing nothing.  (See page 105 of Thinking Woman’s Guide To A Better Birth)  

Your frame of mind going into these situations needs to be focused on a Healthy Mom, Healthy Baby outcome.  The person in front of you is not the enemy – they are a person who is trained and is trying to do their job.  If there perception of a situation is different than yours, then it’s vital to clarify where you are in labor.  The most important questions to ask when you are faced with a “fork in the road” as Bruss calls them, are, “Is Mom okay? Is Baby okay? How much time do we have?”  

We tell our students to gauge the amount of time not only by words, but by actions.  If you have time, you will only see the nurse and maybe your main care provider, or the student midwife and maybe the main midwife in a homebirth.  If you are facing an emergency, there is markedly more activity.  There are teams of people monitoring both mom and baby, as well as maybe getting ready to move them.  

One of the reasons it is so important to take care when choosing your care providers and birth facilities is that sometimes there isn’t time to ask all these questions.  If Mother and Baby are already compromised and there is no time to ask questions, you must trust that the care providers and the birthplace will do the best for your family.  Do you have this level of trust with your care provider?  Do you have this level or trust with the birthplace?  If you answered “no” to either of these questions, it’s time to seriously consider making a change.  Although true complications are rare, if you are part of the small percentage, you want to ensure that you have the best chance for a good outcome despite any complications that may arise.  

I am going to pull from my post on Patient Rights for the rest of the conversation you can have with your care team once you establish there is time to talk and consider your options:  

If both are well enough and there is time, then you can continue with questions such as:
 - “What is the problem?”
 - “What are the symptoms or test results causing concern?”
 - “Could this be normal?”
 - “What is the most likely cause?  Are there any other possible causes?”  

If the care provider agrees that Mother and Baby are well enough to let labor proceed and let nature take her course, continue to trust that Mother and Baby are working together and that you will be meeting your baby in due course.  You can address other probable causes – is mom hydrated?  Is she emotionally ready and relaxed enough to accept her labor?  Are you using the best positions in the appropriate stage of labor to allow gravity and physiology to move things along?  

If after asking this series of questions Mother and Coach decide that further action is worth exploring, then you can continue with these questions:

“What exactly are you recommending?” – Paraphrase it back to ensure you understand what the recommendation is. 

“What are the benefits of this procedure or drug?”  - You want to listen well, and paraphrase again.  You can also ask if their opinion is based on fact or observation.  

“What are the risks and known side effects of this procedure or drug?” – Ask to see the insert if it is a drug and there is time to read it – you may be surprised at what is in the fine print and the care provider fails to mention. 

“Is this an established procedure (or drug) or is it being offered as part of a trial?” – This is very important to know, especially if it is something whose short-term or long-term effects on an unborn child or a newborn are unknown.  

“What are alternatives to this procedure or drug?” – Again, care providers have routines based on what their protocol is – sometimes there are other options that they don’t mention, not from malice, it could be simply because they are not accustomed to being asked for alternatives. 

“What are your qualifications for making this recommendation?” – Who are you talking to?  Student midwife or Professional Licensed Midwife?  Nurses come in many varieties: a student nurse, an LPN (one year of schooling), an ASN nurse (two years of schooling), a BSN (four years of schooling).  Beyond that, how long have they been working as a nurse?  If you are talking to a doctor: are they a resident (student) doctor, or an attending (more experienced) physician?  How long have they been a resident or an attending?  

“Who would be performing this procedure?” – This is an especially important question to ask if you are in a teaching hospital or at home with the professional + student midwife.  Every family needs to make a decision regarding their comfort level with students literally practicing on you based on their individual preferences.  On a personal note, while I am all for students learning, when it come to my body and our child, I want a trained and experienced professional to work on us.  I am okay if a student wants to observe, however, only someone with extensive experience and knowledge is going “to do” something or administer something to us.  

“What else can we expect to happen, or which other interventions typically follow as a result of this drug or procedure?” – In the interest of full disclosure, this is a very important question.  1.) You want to know how they will measure the efficacy of the intervention.  2.) When you accept one intervention, it is likely that other interventions or compromises will follow.  If there is time, you want to hear all of the other interventions or protocol they will have to follow that may be a result of the first intervention you agree to have.  

“What happens if we choose to do nothing at this time?” – Back to full disclosure – there are ways to phrase things that force you to make an immediate decision.  If you ask this question, it tells you the other side of the story, or the whole story in regards to their recommendations.   

You have a couple of options in the event that you want to choose differently than your care providers are recommending and/or if you feel like your concerns are not being heard by your care provider. 
1.  If you have done your research and you have heard the benefits and the risks of a procedure or drug, and you are confident in your decision and want to refuse, hospitals have documents called “Against Medical Advice” that you can sign.  You accept the risks inherent in your decision and relieve the hospital of liability.  I have no idea if midwives have a  similar document…I will have to ask!
2.  In the hospital setting, you can ask for an Independent Patient Advocate.  This person acts as a liaison between the patient and the care providers.  It puts someone in between you and the care provider, and it is implied that they would convey information in a neutral way.  Sometimes taking away the “authority” of the person conveying the information relieves the pressure and lets a patient make a decision without feeling the pressure of “The Doctor” or “The Nurse”.  

Whether you are experiencing a variation of labor or a true complication, effective communication with your birth partner, with your doula, with your midwife, with the nurses and doctors will directly affect your outcome.  If you are knowledgeable about what normal variations of labor are, then you can have conversations about your care to determine the best positive outcome for your situation.  If you are not confident or trained in what to expect during the labor process, you may wish you had known a little more.   

Do you have any communication tips to share?  What are they?

Disclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.  


We are now enrolling for our
Spring Series
March 5, 2012 to
May 21, 2012  

For more information or to register,
please call us at
602-684-6567
or email us at
krystyna@sweetpeabirths.com 

2 Comments to Positive Communication:

Comments RSS
0x0000008e on Sunday, January 29, 2012 3:22 AM
Positive communication is critical during childbirth. Rude, cold-hearted staff is not just depressing, it can even be fatal.
Reply to comment
 
Krystyna on Friday, February 24, 2012 11:07 PM
I imagine that taken to the extreme it could be. I hope you do not have personal experience with this - if so, I am so sorry.

Add a Comment

Your Name:
Email Address: (Required)
Website:
Comment:
Make your text bigger, bold, italic and more with HTML tags. We'll show you how.
Post Comment
Website Builder provided by  Vistaprint