Shared Decision-Making for Healthcare Decisions

by: Jessica McNeil-Santiel, DNP, APRN, CNM, RNC-OB, C-EFM

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Few things are more frustrating than having a situation planned in your head, just to have absolutely nothing occur as you hoped. When this happens during pregnancy, it often leaves people feeling disappointed, angry, and not heard. To help establish and set expectations, there’s a push for pregnancy care providers to use what’s called in medical terms, “shared decision-making,” which is where your pregnancy care provider shares information about your pregnancy, and you make decisions together based on your preferences. This can help avoid unmet expectations.

Say goodbye to the days when healthcare providers simply told you what to do and you happily comply without question. Today’s technology allows you to access your medical records and review treatment choices. You may then research information that places your personal desires on the opposite side of a care plan that your healthcare provider has outlined for you. And that’s ok.

Here’s how you can engage in shared decision-making with your pregnancy care provider:

Interview Healthcare Providers

Most parents would never allow someone to babysit their child without ever meeting them or at least talking to them beforehand. Selecting a healthcare provider, especially one that will support your baby’s birth, should be no different. Most providers offer consultation visits. This is a great opportunity to ask questions and get a feel for the provider and their values. Ask your family and friends for referrals. Select a provider that respects you, makes you feel comfortable, and uses shared decision-making.

Tour the Birthing Hospital

Who you choose as a pregnancy care provider may also mean you’ve chosen to birth where that provider has access to provide care in certain hospitals.

Touring hospitals allows you to feel the culture and vibe of the staff and facility. Ask the nurses questions about labor and birth to learn if you have requests that the staff are unable to accommodate. It can be difficult to change providers, so take the time to choose a pregnancy care provider and hospital that works for your desired birth.

Ask About the Visitation Policy

The spread of COVID required facilities to alter their visitation policies, limiting the number of visitors. Visitation can also be limited at birthing centers and home births. Routinely check this policy of the facility where you’ll give birth.  

Be Certain That Your Provider & Hospital Accept Your Health Insurance

Healthcare providers and the facilities at which they practice may take a limited number of health insurance plans. Call your insurance company in advance to ensure that both the provider and the facility in which they provide care are within your insurance network.

A great patient experience can be ruined when you receive a large, unexpected bill from an “out of network” plan or a facility that doesn’t accept insurance. Check with your insurance plan to learn specifically what they cover, including discounted medical supplies like breast pumps.

Remain Flexible

Remember, your healthcare provider is human and their goal is to ensure that you have the safest possible birth outcome. Some providers prescribe alternative treatments. Ask your pregnancy care provider to share more information with you — to watch or read about topics you’re interested in — this is how you can make informed decisions about your care together.

Lastly, flexibility is always required if you experience a health emergency. In circumstances where an emergency occurs, schedule a time to talk with your provider to discuss what occurred, and allow them to explain why certain decisions were made.

It’s important that you feel comfortable with the decisions that are made regarding your care, even when they are not your first choice. All in all, you should always feel empowered to take an active role in your healthcare decisions.

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AUTHOR

Jessica McNeil-Santiel, DNP, APRN, CNM, RNC-OB, C-EFM

Jessica McNeil, DNP, APRN, CNM, RNC-OB, C-EFM, is a certified nurse midwife and adjunct professor. Her career focus is on maternal-child health and she’s served in positions ranging from perinatal educator to women’s services manager. In 2015, Jessica was selected as an AWHONN Emerging Leader and was the AWHONN Convention Host Committee Chair in 2016 and 2020. Currently, she serves as an AWHONN section advisory leader, an ACOG maternal levels of care surveyor, and on the Institute for Perinatal Quality Improvement Advisory Board. Previously, Jessica served as a contributing author to the 7th edition of Foundations of Maternal-Newborn and Women’s Health Nursing. In 2019, she was recognized as a D magazine top 100 nurse.