[Surfacing]

If you have a client who discloses to you that they have epilepsy, do you ask them if they are taking meds?

If you have a client who discloses to you that they have asthma, do you ask if they are using a puffer?

If you have a client who discloses to you that they have depression or anxiety problems, do you ask if they are taking meds?

Why or why not?

 

[MidwifeErika]

Not really. If they say they have these things going on I would likely ask if they feel they have them under control with their current treatment and then move on. As a doula, it is really not really my area. When I first started, I had gotten forms from someone else and they had all sorts of health questions and medication questions and I asked them all back then because it was on the forms. Then I realized that knowing this info didn't really change anything I was doing and so really then it seemed like none of my business. If someone tells me because they want me to know then I am game to listening and discussing it (for whatever reasons made them bring it up), but otherwise it isn't an area I ask about as a doula.

 

[Mrs.aLifeofReilly]

I do. I am also trained in herbs and aromatherapy, so the information about medication/conditions could change whether it is appropriate to use those skills with them or not.

But, if I was not trained in any other modalities, I suppose it would not be necessary as there would be nothing in my scope that could be contradictory.

 

[dewi]

The only time I ask specifically for brand name of medications is if after the birth there are milk supply issues. If there are Supply issues I ask a lot of questions aobut hormonal or other medical problems, types of medications they had been on, went off. etc.

Otherwise I typically would not ask to know the medication by name, I do have a general open ended question on my postpartum intake form
"Please add anything else you feel is important for me to know regarding you and your family"
Women on medication typically write they are taking
"medication for ___", they write family problems or whatever they want us to know.

If they disclose they have "depression" i might ask how they are feeling, not necessarily if they are taking meds. I'm a postpartum doula and I am there safety net, so they usually are up front with this stuff..

PS Why are you asking these question, did you have an incident with a client?

 

[mysticmomma]

I always take a complete History including meds during our first appointment.

 

[MidwifeErika]

Quote:

Originally Posted by mysticmomma I always take a complete History including meds during our first appointment.

Do you feel this helps you? And if so, how? I am always curious about why others run things the way they do.

 

[TO Doula]

I don't ask. I'm not a medical professional. Most women will offer the information if they have serious health concerns, and then I can help them find out more information about how their health may impact their pregnancy or birth and help them talk to their hcp.

If a woman discloses about a mood disorder I would not ask about meds. Mild to moderate depression is often best treated without meds but is still a concern. I find that when women talk to me about a history of depression it's usually because they're worried about ppmd, so we have a conversation about that.

 

[mysticmomma]

A lot of times when arriving in labor and moms are asked hx questions they leave things out because their concentration is elsewhere. I have worked with mostly single moms, though who don't really have an advocate. I'm not your typical doula though, I also provide some clinical skills.

 

[98741]

If it was disclosed I would ask. I would want to know in the context of do I need to make a note to remind her to take it during labor before leaving the house or something? Should we make sure her inhaler is close by during labor? Are there signs of a seizure to watch for? If a seizure occurs, what should I do to help, if anything? Those sorts of questions as opposed to questioning their use during pregnancy or anything. As far a depression I would ask if they are treating it in some way and how they are feeling currently. If they aren't doing well I may recommend basic things like sun, walks, fish oil, excercise, basic non medicinal sorts of things and encourage them to talk with their health provided.

 

[Beccadoula]

I always ask about medications and medical issues. For instance, epilepsy medications are extremely bad for pregnancy...major deformations are fairly common...you need to be able to pass that on. Plus, they can't just quick cold turkey, they have to have a detailed plan with their doc...nothing small to mess with.

 

[Shell_Ell]

I have a few lines blank on the personal history form I have clients fill out where they can write down any medical issues and medications. I figure if they feel it's significant enough for me to know about, they write it down. I don't discuss it in detail or ask for dosages, I just like to have an idea.

 

[TO Doula]

Quote:

Originally Posted by gentlehandsdoula I always ask about medications and medical issues. For instance, epilepsy medications are extremely bad for pregnancy...major deformations are fairly common...you need to be able to pass that on. Plus, they can't just quick cold turkey, they have to have a detailed plan with their doc...nothing small to mess with.

Well, exactly. That's why I don't think it's really our role to deal with that - their doctor or midwife, in conjunction with any other specialist the mother is seeing, will be dealing with it. Few of us would have the knowledge to deal appropriately.

 

[BrooklynDoula]

I don't necessarily ask but if it comes up I would ask if they are being treated for it and what their midwife or OB said if it seemed important to know. With anxiety and depression I ask about this in relation to postpartum and I would ask about medications as part of talking about how they have handled their depression or anxiety in the past.

 

[dnr3301]

I ask, but in the same vein as asking if they have cats that need to be fed before we leave the house, it's something I can help them remember to do (take) at a time when they may not think of it.

I actually ask partners now as well, after having a dad who was diabetic freak out at a birth because his blood sugar did nutty stuff. It would have been nice to be able to remind him to step out and check his blood sugar and eat something.

 

[Surfacing]

Quote:

Originally Posted by BrooklynDoula I don't necessarily ask but if it comes up I would ask if they are being treated for it and what their midwife or OB said if it seemed important to know. With anxiety and depression I ask about this in relation to postpartum and I would ask about medications as part of talking about how they have handled their depression or anxiety in the past.

This. Yes I asked, as a back up when I was visiting, along with my trainer who was the primary. The client mentioned she had anxiety problems in the past and she was concerned about how she would handle the birth. I had asked her to know if it was a tool in her box, she had also done therapy in the past. I was thinking ahead to the postpartum, the possibility of PPD and PPA, and the spectrum of coping tools. To me it's no big deal, it's reality, let's talk about what we're dealing with, not sweep it under the rug. The primary was surprised that I had asked her. She discouraged it. I have some training in mental health issues, destigmatizing them, I have volunteered on a crisis line, etc. It's comfortable for me to ask about mood disorders and talk about them. And if a mama is struggling with mood problems I have some good resources to refer her to. I just want to bring pregnancy-related and postpartum related mood issues out of the closet. In my view it's so isolating if it's a big secret that you can't talk about. It's not like I harp on it or something, if the mama doesn't want to talk about it.

 

[Surfacing]

Quick update: under DONA guidelines it is not permitted. FYI
gotta run!

 

[1stimestar]

Quote:

Originally Posted by Surfacing Quick update: under DONA guidelines it is not permitted. FYI gotta run!

When you have more time, would you give us a source for this? It's not something I've ever heard addressed by DONA.