[Tamera]

I went to an OB office for my very first appt with this pregnancy. I met with a woman I thought was a nurse practitioner (I found out by reading my chart she's a CNM). The appt was horrible, she told me that I needed to wean my 16 month old DD or risk miscarriage, she told me to sleep train my DD by letting her cry it out in a crib, she said the only way a baby doesn't sleep through the night after 6 months old is if they have "behavior problems". Needless to say, I never went back. Until tonight, I had been too lazy/scatterbrained to actually complain about her aside from mentioning it to the midwives I see at a different UCSD location.

Fast forward to tonight, I was looking through the copy of my chart I was given before our trip to London in April. I found her notes from my first appt:

Subjective:

Tamera is a new patient being seen today for her first obstetrical visit. She is at 13w1d by her LMP of 10/28/2010. This is her third pregnancy. The first was complicated by PROM @ 34 weeks. She was induced and had a healthy baby. The second was a term NSVD. Her husband just got out of the military and they just moved to San Diego. They are both students.

Pt is accompanied today by her husband and her 16 month old daughter, who is very restless. Pt states she is still breastfeeding. She was advised to wean her daughter ASAP. She states it is hard because her daughter still sleeps in bed with them and wakes up every 1-1 ½ hours and pt breastfeeds her to keep her quiet. I advised her to move her daughter to a crib ASAP. Pt states they plan to get a crib over the weekend.

They better be thanking their lucky starts that their office is closed right now and I can't go down there and slap her upside the head with some breastfeeding information. How the hell does she expect a 16 month old to act in a freaking doctors office? That's why I brought my husband to take care of her. I especially love the part where she says I only breastfeed my daughter at night to "keep her quiet" like I was co-sleeping and night nursing out of sheer laziness. I started writing a letter, maybe you ladies can give me some feedback:

To whom it may concern:

I had my first prenatal care visit at your office in January 2011. Based on my experience with Joan P. Laundy, I will never be returning. She is severely lacking knowledge about breastfeeding, especially during pregnancy. She also made rude and unnecessary comments about my daughter. You will see in the notes on my chart that she noted my daughter was restless during the appointment. She was acting in a way that was perfectly normal for a 16 month old toddler. Joan Laundy also took it upon herself to give me parenting advice based on her "time in pediatrics" and told me that the only reason my daughter would not be sleeping through the night is because she had behavior problems. I believe this is an ignorant and false assumption and had nothing to do with my prenatal appointment. She advised me to wean immediately and stated that I could miscarry my unborn baby if I continued to breastfeed. I'm genuinely concerned that her misinformation and bedside manner is a serious risk to women that come to her for care. I hope that you take my concerns seriously.

I really really want to find her and slap her right now! Ugh!

 

[lovingmommyhood]

Ohhh I'm so sorry! Honestly, I always request my medical records and my children's so I can have them on hand and you all wouldn't believe the crap they write in there. OP, I doubt your letter will change much as far as their minds go but I'm glad you gave them a piece of yours.

 

[Tamera]

I hope they take it at least a little bit seriously. What if she said crap like that to a mother with postpartum depression? Telling them they're causing behavior problems by nursing and cosleeping? That is really risky. She shouldn't be seeing patients.

 

[elove]

wow, I am sorry to hear that you need to go through this! I tend to get worked up in these situations (usually after the fact). I am told that it is best to put it in action (write a letter, make a phone call) and than let it go... if you can of course...

also, see if she has a "yelp" or a review page..you can leave a comment, something short and sweet like "unpleasant and unprofessional bedside manner". When some one is looking into picking her as their healthcare provider, this may be helpful.

I am not sure how far the letter will go, but I think it is a good thing to write it and send it in anyways. Perhaps some HR related person would be diligent enough to either talk to her or put it in her records, who knows. Sadly they may be more interested in loosing your business rather than specific issues w her, but that is healthcare these days.

 

[Italiamom]

Tamera, the wording in the letter is great. And big, big kudos for keeping it tempered. I would be seething... I would maybe try to highlight more that it was a prenatal appointment. Not a pediatric appointment. And that the advice was completely unsolicited. The clinic managers may not give two hoots about what kind of advice she gave you, but they'll sure as heck care about her giving advice outside of the scope of the appointment. In medicine, time is money. And when she wasted time, she wasted money.

I had a situation where I saw a pediatrician who laid into me about breastfeeding DS, who was then right about 18 months. I was MAD. Still am mad, actually. Thinking about that woman just makes my blood boil. I was fully, completely confident in my breastfeeding relationship with DS, which she didn't shake. Practitioners like that make me so mad though, because I know that the vast majority of women might actually listen. Like you said, what if some poor woman with PPD came in there, and heard that it was "her fault" that her child didn't do X,Y, or Z.

Again, my sympathies. It's a very common problem, sadly

 

[elevena true]

i, too, am so sorry you had to deal with such a hassle with a "care" provider full of misinformation and judgements.

i think writing a letter, even if it is overlooked by the addressees, can be quite theraputic, and is a great idea.

when i had my surrogate baby, it was supposed to be at the hospital with cnms, but for a variety of reasons baby ended up being born outside of the hospital...an "oops," if you will. the cnm on duty that day, when we went in and delivered baby (ha! not attempting a pun) to intended parents, etc, had to check me out (i guess. i was fine....not a tear, quick labor, etc.

). she told me she was going to feel my uterus (long story, but they aimed to steal my placenta, so i did not bring it in with me....it was safe in a friend's freezer.) she starts to manhandle my uterus "feeling" if any placenta was retained. i am screaming at her....louder then any labor noise, mind you.....to get her hands off me..."no, stop, please, no, stop..." which she continues to rough handle me through, until she is satisfied. i am literally pushing and kicking her away from my body. she deems that there is no retained placenta. no sh*t. it's at home in the freezer. there was such a rape dynamic in that moment there is little question as to why baby ended up not being born in that hospital, with those cnms. i shudder at the thought.

i guess i just got caught in a rant, but the point is that later on i did write a letter, to the office and hosipital as well as the larger hospital bureaucracy that surveys patient's experiences. i don't know that anything came from it, but it made me feel a lot better. maybe someone else will have an easier time because i spoke out? the same for you highlighting your crappy experience with said "care" provider.

 

[Inali]

I don't disagree with any of you and I don't know nearly as much about raising children or breastfeeding but I do work with a lot of doctors. And while I would probably be as pissed as you, Tamera, when it comes down to it I don't think she meant things as harshly as you precieve the. Of course I could be wrong, it really all depends on her tone when she actually spoke to you.

I would go so far as to say she was concered about your daughter because it is a stress to you. I don't think that there should be any ill will towards you or your daughter just a recognition that you have your hands full with an active, healthy young girl! Breastfeeding, again I don't know much about it, but I would assume also puts extra stress on your body when it is trying so hard, esp in the beginning to nourish your new little one. So instead of your body trying to feed 2 people, it is trying to feed 3. One of which is capable of getting her nutirition from whole foods. Now, I'm not saying you should stop breastfeeding her by any means, and I'm sure you havent if you feel that is what is right for your family. However, I do think that what she pointed out are valid concerns for your health and that of your baby. It doesn't have to mean there is anything wrong with your daughter at all!

I hope you are staring to feel better about everything over time and I'm sorry she didn't treat you the way you needed to be treated. I wouldn't go back either if a practitioner made me feel bad, and the other moms are right, it would be terrible to hear those things if you had PPD. I just hope that she meant them with the best intentions.

 

[jennyfah]

The "who is very restless" BURNS ME UP. Are you kidding me? That doctor obviously knows nothing about normal toddler behavior, and should NOT be giving parenting advice. She's also clearly and sadly ignorant about breastfeeding on several levels. It is sad that she's probably still dishing out all kinds of misinformation to vulnerable people (new parents).

I am

for you after reading what she wrote! But I think your letter is very well-worded. You go, girl!

 

[Italiamom]

Quote:

Originally Posted by Inali

Breastfeeding, again I don't know much about it, but I would assume also puts extra stress on your body when it is trying so hard, esp in the beginning to nourish your new little one. So instead of your body trying to feed 2 people, it is trying to feed 3. One of which is capable of getting her nutirition from whole foods. Now, I'm not saying you should stop breastfeeding her by any means, and I'm sure you havent if you feel that is what is right for your family. However, I do think that what she pointed out are valid concerns for your health and that of your baby. It doesn't have to mean there is anything wrong with your daughter at all!

Unless Tamera has a history of pre-term labor, or extreme nutritional issues, nursing during pregnancy is not a valid health concern. Period. Nursing during pregnancy can be very uncomfortable, and very inconvenient, yes. But there are VERY FEW medical reasons to discontinue nursing during pregnancy. A lot of mamas don't have that information to arm themselves with. And because nursing past early infancy is so sadly uncommon, a lot of health care practitioners don't have the appropriate information either. Which is a damn shame.

Unless there is a real (and uncommon) medical indication to discontinue nursing, doctors should be adamantly supporting extended breastfeeding practices in families who choose to do so.

 

[Tamera]

I can see your point Inali but even her tone was very condescending when she spoke to me. I think some of her comments show that, like saying I only breastfed my daughter at night to "keep her quiet". It's also completely false that breastfeeding during pregnancy will cause a miscarriage. She said that during the appointment, but didn't write it in the notes.

 

[Aka mommy]

Quote:

Originally Posted by Inali

I don't disagree with any of you and I don't know nearly as much about raising children or breastfeeding but I do work with a lot of doctors. And while I would probably be as pissed as you, Tamera, when it comes down to it I don't think she meant things as harshly as you precieve the. Of course I could be wrong, it really all depends on her tone when she actually spoke to you.

I would go so far as to say she was concered about your daughter because it is a stress to you. I don't think that there should be any ill will towards you or your daughter just a recognition that you have your hands full with an active, healthy young girl! Breastfeeding, again I don't know much about it, but I would assume also puts extra stress on your body when it is trying so hard, esp in the beginning to nourish your new little one. So instead of your body trying to feed 2 people, it is trying to feed 3. One of which is capable of getting her nutirition from whole foods. Now, I'm not saying you should stop breastfeeding her by any means, and I'm sure you havent if you feel that is what is right for your family. However, I do think that what she pointed out are valid concerns for your health and that of your baby. It doesn't have to mean there is anything wrong with your daughter at all!

I hope you are staring to feel better about everything over time and I'm sorry she didn't treat you the way you needed to be treated. I wouldn't go back either if a practitioner made me feel bad, and the other moms are right, it would be terrible to hear those things if you had PPD. I just hope that she meant them with the best intentions.

From what i've researched even the Mayo Clinic is torn about this misinformation and many doctors under their services acknowledge that a child breastfeeding during pregnancy will not harm the mom or the baby being carried as the nutrients needed to sustain a pregnancy come from the body (think of hyperemsis pregnancies where the mom can sustain nothing and births an 8 lb baby) and a child breastfeeding come from the mom's diet. A mom who is on a proper and healthy diet has no issues doing both. Also the risks of breastfeeding causing preterm labor or contractions is only a risk to pregnant women who are high risk or have a history of preterm labor. These are the same contractions that sex cause and you don't hear many care providers forbidding expecting mothers from having sexual relations with their partners (unless this is a high risk pregnancy or complications arise). And lastly, there are no known studies or data to support the theory that breastfeeding during pregnancy directly results in a miscarriage or preterm labor. My OB happens to agree with this and does not forbid her patients from doing so as she believes its best for the babe to continue.

http://www.kellymom.com/nutrition/vitamins/mom-vitamins.html

http://www.kellymom.com/nursingtwo/excerpts/02miscarriage.html

The major concern of breastfeeding during pregnancy is that it can leach your calcium. Babies (nursing and in utero) will take what they need, but you may be left with needing more, so the best thing to do is to up your calcium intake (and this can't cause a miscarriage). Really, aside from that there is no data to support what this CNM told her. There are more studies done on drugs and interactions while breastfeeding or pregnancy than pregnancy and breastfeeding.

Quote:

Originally Posted by Tamera

I can see your point Inali but even her tone was very condescending when she spoke to me. I think some of her comments show that, like saying I only breastfed my daughter at night to "keep her quiet". It's also completely false that breastfeeding during pregnancy will cause a miscarriage. She said that during the appointment, but didn't write it in the notes.

Quite frankly, i'd send a letter with info that supports your stance and let it be known that you don't appreciate a health care provider inserting her personal opinions which are neither scientifically or statistically supported. Good luck and enjoy your pregnancy!

 

[Italiamom]

Quote:

Originally Posted by Aka mommy

Also the risks of breastfeeding causing preterm labor or contractions is only a risk to pregnant women who are high risk or have a history of preterm labor. These are the same contractions that sex cause and you don't hear many care providers forbidding expecting mothers from having sexual relations with their partners (unless this is a high risk pregnancy or complications arise).

AKA mommy, I LOVE this comparison. I've been asked to explain my continued nursing over and over again during my pregnancy... Maybe this comparison might bang it in to peoples' heads!

 

[Aka mommy]

Quote:

Originally Posted by Italiamom

AKA mommy, I LOVE this comparison. I've been asked to explain my continued nursing over and over again during my pregnancy... Maybe this comparison might bang it in to peoples' heads!

I can't take credit for it lol. I happened upon it when i was looking for research while nursing my dd#1 and pregnant with number 2. And then i believe the kellymom site also has it quoted by one of the specialist who studies causes of miscarriage. It's very helpful as it is the same contractions and very informative! A lot of people responded with 'I never thought about that'.

 

[cat13]

Quote:

Originally Posted by Italiamom

AKA mommy, I LOVE this comparison. I've been asked to explain my continued nursing over and over again during my pregnancy... Maybe this comparison might bang it in to peoples' heads!

Sorry, but my mind is in the gutter!

 

[Italiamom]

Quote:

Originally Posted by cat13

Sorry, but my mind is in the gutter!

Ya perv

 

[Valkyrie89]

Quote:

Originally Posted by Italiamom

Tamera, the wording in the letter is great. And big, big kudos for keeping it tempered. I would be seething... I would maybe try to highlight more that it was a prenatal appointment. Not a pediatric appointment. And that the advice was completely unsolicited. The clinic managers may not give two hoots about what kind of advice she gave you, but they'll sure as heck care about her giving advice outside of the scope of the appointment. In medicine, time is money. And when she wasted time, she wasted money.

I had a situation where I saw a pediatrician who laid into me about breastfeeding DS, who was then right about 18 months. I was MAD. Still am mad, actually. Thinking about that woman just makes my blood boil. I was fully, completely confident in my breastfeeding relationship with DS, which she didn't shake. Practitioners like that make me so mad though, because I know that the vast majority of women might actually listen. Like you said, what if some poor woman with PPD came in there, and heard that it was "her fault" that her child didn't do X,Y, or Z.

Again, my sympathies. It's a very common problem, sadly

 

[Inali]

If any health care provider speaks to any patient in a condescending manner then there are problems with their care. As many questions as we may ask as patients everyone still deserves to be treated fairly (given they are treating the provider in the same manor, there are some genuinely obnoxious patients out there who are simply rude). But no one should leave feeling like you did! And I can see where she may think she is trying to give good advice, whether it is true or not (like I said I haven't done the research so I wont speak to it), but if she is rude when she says it that's enough reason to discontinue her service. You wouldn't go back to a hotel that treated you poorly! And these people are being PAID to insure the well being of you and your family. So, if you feel it's necessary to write and send the letter, go for it. Whether it makes a difference behind the scenes or not you have done your part to alert them to your concerns, attempted to do a service to those who will come after you and applied some great therapy to yourself free of cost! All I wanted to try and say was that there are two sides to every story. But that being said, you wouldn't stay with a partner who did things that accidentally hurt your feelings every single day just because he didn't mean it! You'd move on or go crazy!

I think you should send your letter too so... Good luck! And I hope you find your perfect fit!