Finding my boundaries

“Oh my daughter was in the NICU!” I said, sort of cheerily, finding something in common with my patient who has worked in a NICU.  The moment the words were out of my mouth, I knew they were a mistake.  She didn’t respond- I don’t know if she had read the sign and felt it was inappropriate for me to be bringing it up, looking for pity.  My instinct was just to find some common ground, but I realized after I said it, if we elaborated any more, I would have to say my baby died, which wasn’t fair to the patient.  The visit was about her and her pregnancy- not about me and my daughter.  Recognizing her unease, I quickly changed the subject and went on to the next order of business.  She asked about exercise in pregnancy– something I have strong opinions about.

A patient once told me how one of my colleagues told her to stop crossfit in pregnancy.  I told her the exact opposite.  In the absence of complications, most exercise routines can be continued with some modifications.  I encourage my pregnant patients to exercise- continue their regimen or start a new one.  I had a patient who ran half marathons while pregnant.  I, myself, was very active in pregnancy.  Again, I wanted to bond with this patient sitting across from me and mentioned I did bootcamp through the end of my pregnancy.  This time I quickly transitioned away from me, not giving her a chance to respond, focusing the attention back on her.   She asked about deep squats in the third trimester.  I wanted to say so much more- about how I would exercise in the hospital while hooked up to the monitor.  And if a baby with no fluid could tolerate it well, an uncomplicated pregnancy should have no issue.  My high-risk doc thought I’d make a great study- showing the lack of any fetal distress in the presence of exercise and oligohydramnios.  These thoughts whizzed through my head, but I kept them to myself.  I just thought they’d hammer home the point of just how OK exercise is in pregnancy, but I also knew saying them out loud could lead to more questioning.

It did make me wonder what would I have said if I had a baby at home.  Would I have talked more easily about my pregnancy because it wouldn’t cause discomfort to others?  What do other providers say to patients, if they themselves have had a baby?  Before Mabel I could only talk in generalities or tell other people’s stories, but now I have personal experience.  I recognize over time, as the memories of my pregnancy and labor fade, I’ll be able to speak in more generalities again.  But how do others do- those who have just had babies.  Do they bring in their own experience?  And do patients find it helpful?  I can see how in some ways it might not help at all- providers who say- well this is how it was for me so this is how it should be for you– might come off as insensitive.  But in that exercise example, I thought it would support her.  In the future, someone dealing with loss- would it help her to know her provider had a loss too?  I wouldn’t want to take away the attention from her, only show her I can understand on a different level.  I think it would have helped me when I was a patient, but would it help others?  For the future, I wonder if when I want to reference my pregnancy, I could say “I know someone who…,” [meaning me, but not actually saying it’s me]?

To everyone in general, how do you feel when/if your provider to brings in a little personal experience sometimes?

To those who have experienced loss, have any of you had an experience with your providers (nurse, doctor, midwife, etc) who have had a loss and shared about it?  If you haven’t, would it have been helpful?

Thoughts?

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14 thoughts on “Finding my boundaries

  1. I might not be everyone, but I like the personal connection you would bring. I like thinking that my doctor and I know each other. Any little tidbit of their life that they share makes me feel a little less like just one of the patients en masse and more like an individual. But if you’re unsure, you can definitely use the “I know someone who…” scenario.

  2. I was followed by a team of two midwives during my pregnancy. One had children, the other didn’t. It showed in the way they cared for me and i appreciated both of their approach. We talked about it with them and the one who didn’t have children felt it was a strength in her practice to be able to stay in the realm of generalities.

    I really appreciated her work. She was competent and professional and caring. But at times, i really appreciated the input of her teammate who had children. It was great to hear her opinion on what was going on in my pregnancy — a mix of her professional opinion and experience. When i lost my baby, i also felt that she was, perhaps, better able to grasp the enormity of what was happening to us.

    So i know i would appreciate a midwife/nurse/doctor who would share about their loss. The doctor who cared for my baby in his last days told us about his children, i think in an effort to let us know i knew we were in pain, and even though it wasn’t perfect, i appreciated it.

    • i was the same way typhanie- two midwives I was particularly close with- one who had kids and one who didnt. they both met different needs for me, and still do. i am so thankful I had them both to lean on in different ways

  3. This is tricky, I sometimes wonder if I reference my own pregnancy/birth/parenting experiences too often with patients. Everyone’s experience is so unique, just because I’ve been pregnant doesn’t mean I actually know what they’re going through. I do feel like I express much more empathy when people talk about discomforts that I went through- nausea and vomiting for WAY more months than seemed fair, hips that hurt like bloody murder the last two months. Like, yes, I can understand that this pain is REAL. And when I make a suggestion, I might add “this helped me a ton” or “I personally didn’t get a lot out of it, but some women do”. And my god, I am free with Zofran prescriptions.

    I find some women seem to relax and get more comfortable when they learn I’ve had a baby, and some women have a lot going on and don’t want to hear about my stuff. It’s really individual. I bet you have an excellent sense of who’s sitting in front of you and I don’t think you should worry too much about it. You have good intuition MOC.

    • I have trouble even referencing my pregnancy and labor because I’m afraid it will bring up questions (Oh! you ave kids? or How old is the baby?) which will lead us down the uncomfortable path. While pregnant it was easy to relate and validate. Now I want to- but hesitate out of fear of further questioning. which all of course makes me more sad. yet another thing I have lost- i dont even get to acknowledge my pregnancy liek I would if my baby had lived.

  4. Yes, it would have been helpful if my doctor/nurse/midwife had the same experience & shared about it. It always helps to talk about our baby & what we went through and still going through after the loss. And it’s specially helpful if you’re talking to someone who can truly understand since she has gone through the same thing.
    We lost our baby a month ago due to under developed lungs. She lived for 5 hours. We were diagnosed anhydramnios at 20 weeks, but baby was strong & carried to term.
    Btw, your karate carrot & I have the same name. ^_^

    • I had to do a doubletake when I saw “mabel” commenting on my blog! how I love your name. I’m so sorry to hear about your daughter. Sounds like you and I had a somewhat similar journey. I hope you find some peace each day in some way, in these early days of your grief. I considered it a good day if I got up and brushed my hair.

  5. With this pregnancy, our OB Has shared a few things that have helped to increase our respect for him and have added to the personal-professional boundary:

    1. He shared that he and his wife, too, had kids later in life and all went well. (The hub and I are both over 35.)

    2. He’s a fellow swimmer and his face lit up when I told him of my swims. He was beyond supportive.

    3. He noted that his military families are his most easy going. (Hub and I are Navy brats and hub served 13 years in the SF.)

    All of these were simple moments that made me/us feel great and as if we had the best doc for us beyond qualifications especially when, due to insurance realities, our options were very limited.

  6. With regards to the experience you bring with your loss, I think that you would be super helpful to others who experience pregnancy loss. I felt so incredibly alone when our loss was happening and longed to find people who “get it”.

    When I would go on prenatal visits or any doctor visits, I usually ask if the medical professional has had any personal experience in what I am going through or I definitely ask what they would do if they were in my situation.

    To play it safe on the boundaries and to make sure a patient’s visit is as much about them as possible, maybe just wait until they ask you for your experience. Your experience is extremely valuable.

  7. I always always always want their personal experience. In the end, the question I really want answered is, “What would you do?” So often they give suggestions or lists of options. What I really need to know is what they would choose if they were in my shoes. I had an OB for my first two pregnancies who had no children. I always wondered why, but never felt it was my place to ask. After her, I had men, who I also felt couldn’t REALLY relate to what I was going through. At least my woman OB had had her feet in the stirrups! Personal experience trumps knowledge any day.

    • good! I”m glad to know you like to hear about their opinions. It’s so hard as a provider, we want people to feel comfortable with their own choices and so sometimes I hesitate giving my opinion. but today I gave my honest opinion as to what I would do- I gave it to a friends, but still of course felt worried, hoping if she chooses the same it would be right for her too. and yes, there is something to be said about going to a woman! (though I know a great many male physicians and some midwives even who are wonderful too)

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