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    "This Dismissal 100% Contributes To Maternal Mortality": An OB-GYN Went Viral For Sharing How To Respond When Your Doctor Dismisses Your Concerns, And We All Need To Hear This

    "This is how you're going to respond the next time you bring a symptom or complaint to your OB provider and you're just told, 'That's normal.'"

    I tend to use the term "gaslighting" lightly because it's so overused, but that is often not the case when it comes to reproductive healthcare. Too often are patients dismissed, and even gaslighted, about their symptoms, especially during pregnancy.

    Pregnant woman sitting on a hospital bed, holding her belly, looking down

    As one creator put it in a viral video that's now been viewed over 1.2 million times, "Being pregnant is going to your doctor and saying anything, and them going, 'Yep, that's normal.'" Many others agreed, with, uh, several concerning responses:

    Two user comments sharing personal medical experiences, one with "normal" high blood pressure that turned out to be preeclampsia, and the other shortness of breath that turned out to be a severe pulmonary embolism

    Fortunately, Noa Sterling, MD, FACOG, stepped in and stitched the video with a bit of advice. She laid out exactly what you should do when you have a concern that your OB-GYN or another doctor dismisses as normal.

    @drsterlingobgyn / Via tiktok.com
    Sterling is an OB-GYN, so her advice is specific to reproductive health, pregnancy, and postpartum care, but I find her advice can also be applied to other healthcare providers too.

    She began, "This is how you're going to respond the next time you bring a symptom or complaint to your OB provider and you're just told, 'That's normal.'"

    Woman with glasses raising a finger, wearing a turtleneck top with a ring on the finger, with caption about how to respond to "your OB provider"

    She added, "By the way, I'm not joking. This dismissal of people's concerns and complaints 100% contributes to maternal mortality."

    Woman in glasses with hand gesture, wearing a high-neck top, in an indoor setting

    "Anyway, let's get back to what you're going to do when you have a concern that's dismissed as normal," Sterling continued. "This is what you say: 'I know that normal pregnancy symptoms can sometimes be an indication that something more serious is going on. What about my situation tells you this is not something serious and not something that I need to be concerned about?'"

    Two side-by-side selfies of Sterling speaking, with captions reflecting her advice

    "Second, you're going to ask what you should be looking for that might indicate this is a more serious symptom."

    "Now, the third thing is optional. If you would like your provider to do something about this symptom, you can say, 'I am glad that you think this isn't something serious, however, I would like to do something about this symptom. What do you suggest?'"

    Woman with large glasses and turtleneck, with caption detailing her advice

    In the comments, many people shared the heartbreaking, concerning, and scary consequences of being dismissed by a doctor that they experienced.

    Comments, including "My OB asked if anything was bothering me, I said my back has been killing me lately; 'Well hunny you are pregnant'" and "My ob told me 'try to enjoy your pregnancy' when i brought up that I might be leaking amniotic fluid"

    Others shared their own experiences successfully getting doctors to take them more seriously — some of which of course included getting a man involved (🙃).

    Three comments, including "Me 'so who does my husband hold legally responsible if something happens to me or my child?' Immediately was taken more seriously"

    And many were thankful to hear Sterling's advice.

    Comments expressing appreciation and adding personal notes related to the original post's topic, including "I need this in my ear when I go to my next appointment"

    Sterling told BuzzFeed that when you speak up and tell your provider you aren't feeling heard, that should result in a change. She said that if it doesn't, it might be a red flag. "If you've expressed that you are feeling dismissed and they continue in the same manner, it might be time to find a provider who is a better fit for you," she said.

    Woman with short hair sits working on laptop atop a chest of drawers near a window, wearing patterned blouse and black pants

    In the case of pregnancy, Sterling stated that practically every "normal" symptom could imply that something more serious is occurring, which is why many symptoms are dismissed as normal without further investigation. She emphasized how crucial it is for your provider to follow up with questions and concerns about your symptoms.

    Pregnant person at a checkup with a doctor viewing an ultrasound

    If you're struggling to make the most out of your often hasty and quickly cut-short visits with your provider, Sterling suggested making a list of your concerns and questions and bringing it with you to your appointment.

    Person writing in a notebook beside a smartphone and coffee cup

    And if you're pregnant or thinking about becoming pregnant, Sterling stressed the importance of having a preconception evaluation with a prospective OB, which is an appointment where you'll review your health and any risk factors that might impact your chances of conceiving or affect your own health or the health of your baby. You'll also be able to determine if the OB-GYN is the right fit and makes you feel safe and cared for.

    Patient in conversation with a healthcare professional, seated in a clinic

    Still, Sterling warned patients that unless they pay cash, even the top OB practices frequently have limited time for prenatal and postpartum appointments. She thinks this is also why symptoms, particularly during or after pregnancy, are frequently overlooked or ignored.

    Doctor with stethoscope clasped hands over a medical document on desk

    Sterling believes that these factors — the dismissal of symptoms, the limited time doctors have with patients, and the cost of care — are all major contributors to the maternal mortality crisis.

    Seated woman gently cradles and looks at her baby in a peaceful room

    Dr. Monique Rainford, an OB-GYN, told Yale Medicine that overt and implicit bias affects the care that Black pregnant people receive, as evidenced by many stories where doctors ignored their symptoms and requests for help.

    “Implicit bias, in which a person isn’t aware of their bias, is particularly problematic," Rainford told Yale Medicine. "For instance, a caregiver may think they are doing the right thing for their pregnant patient, but their implicit bias against the woman’s race affects the care they deliver.”

    According to the CDC, more than 80% of pregnancy-related deaths in the US are preventable, highlighting the need for improvement in the quality of prenatal, pregnancy, and postpartum care. And more than half (53%) of pregnancy-related deaths occur up to one year after delivery, emphasizing the particular weaknesses in postpartum care. "Once the baby is here, it's almost like the mother is discarded," Karen Sheffield-Abdullah, a nurse-midwife, told NPR.

    Healthcare professional in consultation with a pregnant woman, both wearing masks, sitting in medical office

    This means that healthcare providers need to stay connected to pregnant patients throughout the entirety of the the pregnancy, and ensure that patients are quickly referred to follow-up care following delivery, according to the CDC. The CDC also recommends that patients be screened for postpartum depression and anxiety starting at the first prenatal visit and continuing throughout the year after birth.

    Another major observation from the CDC's data, which was collected between 2017 and 2019, was the need for extended free postpartum health coverage through Medicaid. 

    Until December 2021, free pregnancy-related Medicaid coverage typically expired two months postpartum, forcing postpartum people out of care. However, thanks to a provision in the American Rescue Plan Act of 2021 that aims to improve maternal health-coverage stability and address racial disparities, states were given the option to extend Medicaid postpartum coverage to 12 months. As of today, 46 states have implemented the 12-month Medicaid extension.

    Frustrated in her own efforts to address all of her patients' worries and concerns in one appointment, Sterling left her clinical practice to found Sterling Parents, an online platform where pregnant people can ask general questions about pregnancy and postpartum from a doctor outside of or prior to their appointments.

    Woman with glasses smiling, wearing a green top, with caption: "Pregnancy can be a time of increased anxieties and worries; that's why I'm here"

    And while it's true that doctors sometimes make missteps and dismiss patient concerns, Sterling reminded us that many doctors do care but are working within a broken system. She said, "I always tell the members of Sterling Parents that, for the most part, doctors are caring people who want to help but are stuck in a very broken system that prevents them from practicing medicine the way they want."

    Healthcare professional in scrubs looking out the window with a thoughtful expression

    So let's review: If you're a pregnant person, or simply just someone going into a healthcare appointment, and you're in a situation where you feel your symptoms are not being heard, here's what you say:

    Doctor: Your [insert symptom] is normal.

    You: 

    1) "I know that this symptom can sometimes be an indication that something more serious is going on. What about my situation tells you this is not something serious and not something that I need to be concerned about?"

    2) "What should I be looking for that might indicate this is a more serious symptom?"

    3) Optional: "I am glad that you think this isn't something serious, however, I would like to do something about this symptom. What do you suggest?"

    I don't know about you, but as someone who's struggled to get answers about my own reproductive health, I'll definitely keep this in my back pocket for my next OB-GYN appointment. One last hat off to Sterling, whom you can keep up with on TikTok and at Sterling Parents.

    Woman in a white dress smiling, holding a toddler, with a young child beside her, standing outdoors