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This is just a question and a challenge! From my point of view, as a gynecologist-obstetrician, I can say that the doctor treating a pregnant woman should be absolutely up-to-date with the recommendations regarding medications used during pregnancy or prescribed tests.
Nowadays, these recommendations are often changed and updated. Ignorance of the current guidelines may quickly lead to a patient’s legitimate claims against the doctor.
I am sorry to say that not all doctors handle pregnancies with the same care. What about sophisticated diagnostics and tests if a woman does not even have her blood pressure measured or is not weighed at every visit? It’s trivial but common. So first of all – the doctor should be reliable and act in accordance with the current state of knowledge.
Another problem is the availability of a doctor. Nowadays, it is difficult to require full availability from a doctor. Nevertheless, the patient should be able to contact her treating physician at least once a week, and should be examined by him immediately in case of any doubts. Of course, in independent situations (life circumstances, vacation), the doctor may not be available. Even then, however, the patient should know what to do in an emergency and who to contact for advice. The role of the attending physician is also to provide the patient with maximum information that will make her feel safe. For example, she needs to know that if she starts to stain or bleed, she should go to the gynecology and obstetrics ward of the nearest hospital and not wait for the doctor to come back from her vacation. So, secondly – the availability of a doctor.
Another problem is mutual trust. Not only the patient must trust the doctor, but the doctor must also trust the patient. Otherwise, their cooperation will never be fruitful. Sometimes patients present with symptoms that can be treated conservatively at home – provided that the pregnant woman complies with the doctor’s instructions. In the absence of trust in the patient, the doctor may refer her to hospital treatment, which will be exactly the same as home treatment – only in hospital conditions. Such ailments include, for example, abdominal pain, spotting, urinary tract infections or mild hypertension. If the patient does not want or is unable to follow medical recommendations – during the leave she does not take care of herself, works hard, performs household duties, the doctor may refer her to the hospital. So third – mutual trust.
Of course, mutual trust is connected with the other side of the coin, i.e. the patient’s trust in the doctor. For example – if there are no other indications for it, the doctor recommends standard ultrasound examinations 3 times during pregnancy. Then it makes no sense to demand an ultrasound scan from him at each subsequent visit – it will not really bring anything new. The patient must trust her doctor. So fourthly – from the patient’s point of view – trust in the doctor.
Usually, the doctor’s communication skills are of equal importance to the patient. Undoubtedly, it is extremely desirable, but it must be supported by reliable knowledge and knowledge of the subject, and not only readiness for a pleasant conversation.
Finally, for many pregnant women the continuity of care is important, ie a patient who visits one doctor throughout her pregnancy wants him to accompany her during childbirth. For the time being, this is not a common practice in Poland yet. However, there are already such hospitals that allow the doctor who guided the patient throughout her pregnancy to come to the delivery.
The topic of choosing a doctor to conduct a pregnancy is extremely difficult and raises a lot of controversy. Because there are as many as pregnant women, as many concepts of cooperation with a doctor and as many individual expectations. Undoubtedly, the priority is the safety of the woman and the child from conception to delivery and during the puerperium. Only under this condition can it be said that the woman successfully passed the most difficult exam in her life and gave birth to a healthy child.
Text: lek. med. Ewa Zarudzka