Sunday, January 17, 2010

Birth Activism: Better Late Than Never

Any longtime readers of this blog will remember the fiasco of last January, when I was madly trying to find a consulting OB who would treat my hyperemesis while being okay with the fact that I was receiving prenatal care from a (*gasp*)...... midwife (oh, the horror!). It was not easy. The large OB practice that I visited dropped me like a hot potato as soon as the m-word was mentioned. In fact, it went something like this:

Me: "I have a midwife"
Doctor: "Okay, goodbye"

Anyhow, I've been meaning to write to the practice about this ever since, and I finally (over a year later), got around to it! And so, without further ado, here is the letter which will be hitting the mailbox Tuesday morning. We'll see if it disappears into a black hole, or if it gets any response! I'll post on the end results.

In this letter, I have tried my best to use my three rules for activism letters:

(1) Be clear and concise
(2) Be calm, polite, and respectful (spiteful letters generally produce only angry readers, not true heart-change, which is the end-goal of all activism)
(3) Begin and end nicely, even with a complaint

(The name of the practice is two last names put together, so in the letter it appears as
-------- & --------)


January 15, 2010

Dr. ------------ --------------

--------- & -------- OB/GYN

Re: My Experience With -------- & --------

Dear Dr. ----------,

I wanted to bring the following situation to your attention regarding my experience with -------- & --------, and I apologize for the tardiness of this letter.

In December 2008 I discovered that I was pregnant with our second child. During our first pregnancy I had received prenatal, labor/delivery, and postpartum care from an excellent Licensed Midwife, and I planned to do the same with our second.

However, with our first pregnancy I had suffered from hyperemesis, and I knew that I would need to find a consulting OB/GYN to prescribe medicine to control this condition, as Licensed Midwives do not currently have prescription ability. I posted this need on, and your practice was recommended by several valley mothers as having doctors who were extremely skilled in dealing well with hyperemetic patients.

I immediately called to make an appointment with your office. However, I knew that my situation was somewhat unorthodox, so I explained my needs in detail to the receptionist over the phone so that everything could be cleared before I came in. I told the receptionist in particular that I would not need prenatal care or birth attendance, just prescriptions and care to deal with hyperemesis. She spoke to a supervisor to clear my situation, and then told me that my situation had been approved by the supervisor and that a doctor would see me for this purpose.

I came in to the ------- location for my appointment the following day, on Thursday, January 8, 2009 at 9:10 a.m. I was immediately impressed with the efficiency and attractiveness of your offices. My appointment was with Dr. ------- --------, and she told me her general protocol for treating hyperemesis. I was extremely happy to have found a practice that treated hyperemesis efficiently and aggressively.

However, wanting to make sure that she understood my needs, I asked her if she had been made aware that I was not needing prenatal care, only help with hyperemesis. It became immediately clear that she had not been told anything of the situation and believed that I had come to -------- & -------- as a regular prenatal patient. When she learned that I was under the care of a midwife and would not need prenatal care, she immediately told me that she could not prescribe for me and that I could not be her patient. Our appointment then ended, though I was left with a very positive impression of your staff and offices.

I continued my search for a consulting OB elsewhere, and found an OB with a different practice who took me as a client and prescribed Zofran for my needs during my pregnancy.

Based on my experience, I would like to suggest the following:

(1) That patient needs be carefully communicated to doctors, so that confusion and wasted time be avoided, and

(2) That doctors at -------- & -------- would consider providing consulting care for clients of the valley’s Licensed Midwives. We have a wonderful community of Licensed Midwives here in Arizona who are always glad of the partnership of competent and caring OB/GYN physicians in order to be able to co-manage client care. I hope that in the future, -------- & -------- will be willing to provide consulting care for the patients of midwives and that I will be able to recommend your practice to friends who need pregnancy co-management.

Thank you very much for the services you offer to Arizona’s mothers and babies!

Sincerely Yours,

Diana J.

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