Doctors need to stop bullying pregnant women and start treating them with kindness and respect.
Did you feel bullied during pregnancy?
Though everything I read (and everyone I talked to) promised morning sickness would subside at the end of the first trimester, at 24 weeks pregnant with my first baby I was still feeling miserably nauseous.
I was at a prenatal visit. The hospital midwife told me I must take a glucose tolerance test.
Just the idea of drinking a sickeningly sweet sugar solution that contained 50 grams of glucose made me gag.
Sensitive to sugar
I explained to the nurse midwife insisting on the test that since the beginning of my pregnancy I’d been really sensitive to sugar.
Her eyes looked bored. But I told her that after reading up on nutrition, I was eating high quality protein, organic whole foods, and whole grains.
My diet consisted of lots of fresh vegetables (I’d make my husband get up with me in the middle of the night when I was so sick to my stomach but paradoxically hungry that I couldn’t sleep. He would sit with me while I ate a plate of raw broccoli, pineapple, and green beans), fruit, brown rice, whole grain bread with no sugar added (I was reading ingredient lists), plain whole fat yogurt, nuts, beans, and fish or red meat when I craved it, even though I’d been a vegetarian before getting pregnant.
I wasn’t eating any sugar, I explained.
I was so sensitive to sugar I was even avoiding overripe fruit!
I’d had low blood sugar all my life, I explained. I needed to eat small amounts of food often to keep my blood sugar even.
Granted I was feeling particularly vulnerable and emotional. Pregnancy hormones can do that to a person. But the idea of intentionally spiking my blood sugar and bringing on an inevitable crash made no sense to me.
If a woman develops diabetes during pregnancy the baby can get dangerously large because it is getting more sugar than it needs.
But my fundal height—the top of the uterus to the top of the pelvic bone—had been measuring just right.
I’d even lost weight in the first trimester.
There was no indication that our baby was abnormally big. I had no diabetes in my family.
At that time, gestational diabetes only occurred in about three to four percent of pregnancies.
I was low-risk and I did not want the test.
The nurse midwife tells me I’m going to “buy” myself a C-section for refusing a glucose test
The nurse midwife responded I would need to go on a sugar-restricted diet if the test showed I had gestational diabetes.
“But I’m already on a sugar-restricted diet,” I pointed out.
“You’re going to buy yourself a C-section,” she huffed. “Is that what you want?”
I don’t know if her intention was to be a bully, but that is exactly what it felt like. She was treating me like I was stupid, and threatening me with a surgical intervention she knew I didn’t want if I didn’t comply with what she wanted me to do.
I wondered how many other times she had been bullying pregnant women that day.
Years later I read Ina May’s Guide to Childbirth. In that excellent book, Ina May Gaskin talks about how unreliable the gestational diabetes test is, explaining that fifty to seventy percent of women will have a different result if they are retested.
The best way for a pregnant woman to bring down her blood sugar levels, Ina May Gaskin writes, is to get up and exercise.
After that upsetting and bullying exchange with the nurse midwife, we switched to the doctors. We mistakenly believed they would be more competent and logical. And less unkind.
The doctor orders an “emergency” ultrasound when there’s no emergency
“For intrauterine growth retardation,” she said offhandedly. “You’re measuring too small.”
Retardation? I looked at her in confused shock. After six and a half months of nausea, I felt so good I had started biking long distances every day on the bike path that cut across downtown Atlanta, fast.
“Could I be measuring small because I’ve been exercising?” I asked. One friend who had taken up running during pregnancy told me she had measured small, and I remembered reading that athletes who continued to train during pregnancy tended to have small babies.
“Not a chance,” the doctor said. Then she hurried away to “help” another patient.
Did that doctor know she was bullying me?
How many other times had she been bullying pregnant women that day?
In the waiting room, I couldn’t stop crying. My husband and I clung to each other.
We barely spoke but the worry on our faces belied what we were both thinking: What if there was something wrong with the baby we both wanted so badly and had waited our whole lives to have?
After twenty-five minutes, my name was finally called.
The sonogram tech snapped on her latex gloves and squeezed blue goop on my abdomen with the air of someone who knew exactly what she was doing.
She looked at my tear-stained face and softened. Then she clucked her teeth in disapproval as she looked at the screen.
“Everything’s fine,” she dismissed. “Baby looks perfect. Nothing to worry about. Now get dressed and go on home.”
Doctors and other care providers often start bullying pregnant women to get them to comply.
They scare us with the threat that our baby will die.
They shame us with the idea that if we don’t behave, our baby won’t make it.
These doctors want pregnant women to do things their way.
But often their way is based on habit, fear of liability, or expediency, not best health practices.
In fact, doctors are now saying that a mom in America today is 50% more likely to die in childbirth than her own mother was.
Obstetricians have it wrong
Unlike homebirth midwives, obstetricians almost never request their patients keep a food and exercise log.
And also unlike homebirth midwives, obstetricians usually don’t know any more about nutrition than you do.
Most doctors practice what one obstetrician I interviewed called “reactive instead of proactive medicine.”
Unlike his colleagues, this doctor uses a homebirth midwifery model and delivers babies in the privacy and safety of their own homes.
There is a profound lack of logic in reacting to problems after they arise instead of preventing them in the first place.
Yet if the patient rejects a routine test or suggests an alternative strategy, no matter how logical the objection is for this particular case, many pregnancy health care providers will use scare tactics and bullying to try to force the patient to change her mind.
They’ll accuse you of being irresponsible, become angry at what they perceive to be your lack of intelligence, label you a problem patient, and tell you, “If you don’t do it my way, your baby will die.”
(Doctor and nurse midwife friends who are reading this, this post is not about you.
This is a post about your colleagues who have probably treated you the same way when you disagreed with their professional opinion.
This post is about the physicians who routinely engage in bullying pregnant women.)
It’s time to put people over profits
If we had a healthcare system based on good health and good outcomes, instead of good profit margins, our doctor might have taken the time to involve us in the conversation.
“I’m surprised by your small measurements,” she could have said. “At this juncture I’d recommend an ultrasound to make sure everything is okay. What do you think?”
My husband and I would have most likely agreed. Even though the ultrasound turned out to be a completely unnecessary and anxiety-provoking.
But as partners in health, we could have done it willingly and without the overwhelming and unfounded fear.
Doctors and nurse midwives, it’s time to remember that your pregnant patients are just as intelligent as you are. We know just as much, if not more, about our bodies than you do.
It’s time to stop bullying pregnant women.
Let’s start treating pregnant women with dignity and respect.
First published: June 4, 2012
Post updated: August 12, 2020