Written by Stefan Semchyshyn, M.D. and Carol Colemann from “How To Prevent Miscarriage and Other Crises of Pregnancy” from Dell Publishing
I recently attended a medical conference where after I described my “partnership” with my patients and my emphasis on patient education, a colleague turned to me and said, “I’m afraid that if I told my pregnant patients to watch out for everything that could go wrong, I’d be caring them half to death and, not only that, I’d be on the phone with them for the next nine months explaining away every ache and pain. Does the average patient really need to know about this in such detail?”
His question is a good one and it gets right to the heart of my partnership-pregnancy program. My purpose is not to frighten mothers-to-be into a frenzy. Nor do I want my patients to spend every waking hour fixated on their pregnancies, ever watchful for signs of trouble. On the contrary, I encourage my patients to lead as active and normal a life as they possibly can. My goal is to educate patients so that they can differentiate between the normal signs of pregnancy and any abnormal developments that may threaten the health and well-being of their babies and themselves.
Through the years I have learned that an educated medical consumer makes the best patient. Women who truly understand the pregnancy process-who know the difference between a benign vaginal discharge and one that signals trouble, who can recognize a preterm labor contraction – rarely waste their doctor’s time with unnecessary calls. The truth of the matter is that an educated patient can help a doctor save time and lives. At the first sign of real trouble, she will pick up the phone. She is “pregnancy literate” – she knows how to describe her symptoms in terms that are meaningful to her physician. Most importantly, she will alert her doctor to a problem while there is still time to do something about it. Very often, we are able to intervene before the minor headache becomes a major problem.
Patient education, however, is not just for the convenience of the physician. Patients are starved for it. It dismays me when women complain, as they often do, that they feel that their obstetricians are too busy to talk to them. Pregnant women – perhaps even more than other patients – have a strong need to feel knowledgeable and in control. Over the course of nine months, their bodies are undergoing a major metamorphosis. It is only natural for a woman to be concerned about labor and delivery and impending motherhood.
Much of her anxiety stems from our natural fear of the unknown. When it comes to pregnancy, ignorance is not bliss. The more a patient knows about pregnancy and the working of her body, the more relaxed and secure she will feel. Since I believe that stress plays a major role in the outcome of a pregnancy, the prognosis for this educated patient is better than for one who is kept in the dark.
There are some people – doctors and patients alike – who may dismiss this kind of patient education an unnecessary. They may ask, “Since some pregnancies are uneventful, do we really need to educate all women to the warning signs of trouble? The answer is yes. We can’t always pinpoint which pregnancies will make it to the home stretch without a hitch and which will hit a snag. While there are some women who may be at higher risk of miscarriage and premature labor than others, the fact of the matter is, these occurrences can happen to anyone.
The goal of patient education is to prevent problems from happening in the first place. As the saying goes, knowledge is power. This is especially true when it comes to pregnancy. In many cases, the educated patient has the power to stop a threatened miscarriage, or to spare her child from the risk of premature birth. I believe it is the right of every patient to have this knowledge, and it is her obligation to put it to good use.
