Communicating with Health Care Providers
Women shared their experiences working with health care providers during their perinatal journeys. Those who told us about providers who ‘really listened’ and took their time to build trusting relationships, described more positive experiences.
Zoe felt grateful to her providers for their care, information and support.
Written testimony
So care, information and support. Those are I think priority. Starting from care we need, I was very lucky to fall on compassionate doctors, medical professionals who helped me, who listened to me, who understood me, who didn’t pathologize, over diagnose me, and over medicate me. Who got the full story assessed, were there to support and most importantly to give me accurate, reliable, recent research information. That was a godsend. That was just, I owe them a lot.
Amanda2 built a trusting relationship with her health care provider.
Transcript
I built a relationship with her over the – I think I saw her – so it would have been ‘20/’21. She just discharged me this past fall, no maybe after, oh, my gosh, early winter. So, I got to know her over the course of a year or more. […]
Foundations of Building Trusting Relationships
Women explained that to build strong relationships with their providers, they needed to feel that they were listened to without judgement, had regular check–ins and were followed–up. We spoke to women who wished their providers would ‘leave space’ during appointments to ask about coping and emotional adjustment to motherhood. Amanda2 appreciated virtual check-ins with “my family doctor – she was really good, a good support as I came home. She met with me within a day or two of getting home – sorry, didn’t meet with me, everything was over the phone or Zoom or OTN [Ontario Telemedicine Network]. So, she was really supportive. She did a good job of following up”.
Aurore's midwife did not leave space to discuss her mental health.
Transcript
I think had I brought it up more, and had I pursued it more with her, as part of the conversation, then there may have been space for it. But I didn’t feel that there was a space for it. I didn’t feel that there was space made at the […]
Candace felt comfortable talking to her family doctor.
Transcript
At one of my daughters’ appointments, I brought it up to my family doctor, who has always been excellent about checking in with me, as the mom … and how well you’re doing, or how well I was doing, and I had told her that I was experiencing a little […]
Andrea found a new provider who had more time for her care.
Transcript
A psychiatric specialist, because at the time I wasn’t being followed by somebody who specialized in medicine, since the doctor who had been following me during my pregnancy was so busy with other pregnant women and I wasn’t a priority anymore because I had given birth. I kept writing to […]
Challenges to Strong Provider-Patient Relationships
Women were disappointed when their maternal health providers missed ‘red flags’ for mental health and did not listen more sensitively to their stories. Other women raised fears about sharing honest thoughts and feelings with health care provider. Participants told us that the tensions caused by a providers’ duty to warn others when concerned for the safety of mother and child can impact trust and honest communications, until their symptoms are under better control. Joan says “this was the whole reason I didn’t want to tell anybody anything, because I know when people have a duty to report it, meaning ‘you’re a red flag’”.
Joan understood her doctor's duty to report when concerned for her safety.
Transcript
And again, like I’m not as bad as some people can be, but when you’re experiencing auditory… Like I get it, she had a duty to report because of auditory hallucinations. That should be sending up red flags for other people. Like I can now say all this because I’m […]
Candace wishes for a more supportive screening approach for mental health concerns.
Transcript
I wish that there was some way that the person that’s caring for you, whether that be a midwife, your family doctor, or your OB, when you’re pregnant and after your baby is born, to have better screening for postpartum and to be less focused on, ‘Are you having scary […]
Despite red flags, Krysta did not get support until she was really suffering.
Transcript
…to not dismiss red flags. I feel like I was pretty open with, you know, the possibility of having post-partum depression and anxiety and even when I had it, I feel like many doctors saw the red flags but just – I feel like it wasn’t until I was screaming […]
Sharing Information and Knowledge
Women looked to their health care providers to be knowledgeable and give them up-to-date information to help them make choices. Zoe wanted information about medication risks explained in ways that she could understand: “I would ask pharmacists the same thing. They take out the same book and say, hmm, you know there’s a risk. I don’t know if I was even, they never would qualify the risk as being low or high, they’d give me a number, but I’m not scientific, I’m not able to understand it”.
Zoe's doctor reassured her that her medication was safe for her baby.
Written testimony
Oh, I need to mention that my OBGYN was also very supportive when it came to medication and just my mental health, like so understanding. Like I have to, I mean ‘chapeau’, I tip my hat to this woman. I guess she’s a high-risk pregnancy doctor at the [hospital] and she again, heard me out. On my first appointment with her I said I’m taking Paxil and I’m pregnant and the first thing she said was it’s okay. You know what type of relief that it is to hear those words after being told by so many health professionals, including a social worker at some point after my miscarriage who questioned my, like are you sure you want to be pregnant on Paxil? I left that office crying tears like after I went outside to the parking lot. I was not very happy. Anyways, she said you know what we’ll do, we’ll do a cardiac echogram of the child of the baby’s heart in womb at some point in your pregnancy. She gave me a specific week to see if there’s any type of issues. Wow, okay, thanks. So these things exist. They’re out there. These possibilities, you know, so she was fully supportive, fully supportive.
Andrea shared that once she found a “lovely psychiatrist who did the ECT [electroconvulsive therapy] on me, he referred us to this fantastic psychiatrist who I still see to this day who prescribed a mood disorder medication, and that made all of the difference.” Unfortunately for some women, diagnosis was delayed due to providers without enough training and skill, causing some women suffer for longer before getting appropriate treatment.
Genna feels her psychosis could have been identified sooner.
Transcript
I think if the midwife was more aware of the signs and symptoms of postpartum psychosis that it could’ve been picked up sooner. I think she was unaware. I think she knew about the extreme cases of psychosis in terms of delusions of hearing or seeing things that aren’t there, […]
Amanda2 got diagnosed one year after her episode.
Transcript
I did fortunately find a psychiatrist who I saw I guess privately, although it was covered, but I’d seen her privately out of her office. And that would have been a year after my episode that I finally got in to see her and that was really a godsend. She […]
It took Josée-Anne five years before she had a diagnosis.
Transcript
Puis quand je suis retombée enceinte de ma deuxième, bien dans le fond, ça a recommencé tout de suite. Fait que là mon médecin de famille a dit : « Là ça suffit! Tu y vas en urgence! Tu ne peux pas rester comme ça. », et là j’ai commencé […]