Communicating With Your Healthcare Team
No woman is happy to hear the news that she will be placed on bed rest for a portion of her pregnancy. Gone instantly is her hope for an idyllic pregnancy, where she can work up until the day before the birth, feeling energetic and looking glowing the whole way through.
As for my experience with having bed rest prescribed, I had called the doctor’s office around 10 a.m. on a Monday because my blood pressure had been up over the weekend. The nurse told me to come in right away. I can remember asking, “How long will this appointment take?” The nurse replied, “Clear your calendar for the rest of the day.” This should have been a clue to me, but I did not pick up on it. When I went into the doctor’s office, I was informed that I would be on bed rest for the remainder of my pregnancy. I was 22 weeks pregnant at the time. I was told that we would try bed rest at home first, and then bed rest in the hospital if home treatment wasn’t sufficient. I learned that my baby would probably not survive if I delivered at 22 weeks. If the baby or I got very sick, I would need to deliver immediately. The doctor hoped I could make it at least two more weeks so the baby had a chance at survival.
After the shock wore off, I realized how important it would be for me to understand – specifically – the bed rest plan that was laid out by my doctor. My advice as a bed rest survivor is to ask questions and get specific answers. Here are some common questions you may need to ask in order to understand your situation:
- What does your health care provider mean by “bed rest?”
- Do you need to be in bed at all times?
- Can you sit up?
- Do you need to lie on your left side for a certain amount of the time?
- Will you have restrictions on visitors or stimuli?
- What about activity restrictions? Will you be permitted to: shower? If so, how often and for how long each time?
- Sit up to eat?
- Talk on the phone?
- Use the computer?
- Watch TV?
- Walk to the refrigerator, bathroom, up and down stairs, etc.?
- How long can you expect to be on bed rest?
- Until the end of your pregnancy?
- Until a certain gestational age is reached, at which time delivery would be induced?
- Can you be home alone?
Once you understand what your care provider means by bed rest, then it is time to ask some questions about the treatment plan. For example:
- How will you know if bed rest and/or medications are working?
- How often will you be seen in the doctor’s office?
- What testing will be done, and how often?
- At what hospital will you deliver? (It may not be the one you originally planned on if they do not have a NICU there.)
- Do you need to see a specialist (maternal-fetal medicine doctor or perinatologist)?
- How will you know when it is time to deliver?
- What is the likelihood that your baby will survive?
- What can you expect if the baby is born at, for example, 24, 30, or 32 weeks gestation?
It is critical during this time to communicate your concerns to your health care team, and to be able to ask the questions that will help you to take good care of yourself and your baby. Some general tips for communicating with your health care team are:
- Write down your questions before each appointment.
- Remember that no question is silly or unimportant.
- Don’t be afraid to ask too many questions.
- If you don’t feel comfortable talking with your doctor, find one with whom you can communicate openly.
- Share how you’re feeling, not only physically, but emotionally.
- Share your fears with your doctor. He or she will address them and tell you if your fears are founded or not.
- Bring someone along to your appointments to give you moral support.
Communicating with your healthcare team will decrease your anxiety and, therefore, improve the outcome for you and your baby. You become a parent long before you give birth to your child. By taking good care of yourself through communicating with your healthcare team, you are advocating for your child.
Ann Marie Ronsman is a NICU nurse in Menomonee Falls, Wisconsin. After being on bed rest for 15 weeks, she delivered a healthy boy at 37 weeks. He is now almost 2 years old, and her greatest joy. Ann Marie says, “Bed rest is by far the hardest thing I have ever done, but it has also brought the greatest rewards.”