We have been planning the second episode of our podcast, WCHAT. During this episode, we will discuss how sexual and reproductive health care providers can often fail patients by not communicating well with them. While we are often very caring and have the best of intentions, maybe we were in a bad mood, super busy and stressed, or just don’t know what to say.

The goal of Woman Centered Health is to help you navigate through these barriers so you can have stronger and more trusting relationship with your patients. The first step is always to recognize that we, as a collective of providers, may have issues communicating from time to time and to want to improve. In this post, Nicole and I share just eight of the over 70 stories women shared with us about times when they felt their provider’s communication led to bad patient care.

Communication issue: Dismissing Symptoms

“I was very embarrassed when my period symptoms started causing bowel issues, chronic pain, and pain with sex. I talked with my GYN several times about it but was always told that it’s not that bad and to just take the birth control pill. As my symptoms continued to get worse, I was told there was no way my period was causing my symptoms. I went to another doctor and after an exploratory laparoscopy, I was diagnosed with stage 4 endometriosis. My organs were wrapped and twisted around each other and I had significant scaring on my tubes and large cysts on both ovaries. I never went back to my first doctor.”

Communication issue: Lecturing

“Mostly when they criticize my weight and diet over and over again at check in. I weigh 180 pounds, but I train in 3 types of martial arts and walk 5 miles every weekday to commute, so I’m muscular not obese. Thus far I’ve been told to stop eating all carbs (which I need to have enough energy to commute/train), stop drinking milk and get my calcium from pills because milk “has too many calories” (I only drink milk, tea and water) and to limit my protein drastically (once again I need this to not feel like crud when I work out). Given the ample evidence that female athletes can weigh more and still be healthy, and the fact that I don’t even look fat (I have visible muscles everywhere and a 30 inch waist) it is ridiculous getting a canned lecture on my weight every time I go in.”

Communication issue: Not explaining medical issues or procedures

“The only male provider I’ve ever had made me feel dumb for asking simple questions before a LEEP procedure. It was before I worked in the health field and didn’t understand HPV. He told me I had a bunch of warts that he removed but didn’t explain everything and I was terrified. I walked out of the office bawling and thinking I had cancer. It was awful and I’ll never forget it.”

Communication issue: Not knowing your patient

“After 3-4 years of trying to conceive unsuccessfully, my OB/GYN referred my husband for some initial tests, they showed we would be unable to conceive naturally. She offered to discuss/pursue fertility options, which I declined and we started the adoption process. All of this was (or should have been) in my file. On at least 2 occasions during routine well-woman check-ups, the nurse who was taking my vitals and asking initial questions prior to seeing the doctor asked what kind of birth control I was on (none), then asked why I wasn’t on birth control (“are you trying to get pregnant?” “no, my husband and I are unable to conceive”). Although these are routine and innocent questions, the experience of infertility is painful and emotional and these simple questions asked in such a clinical and uninformed way had me immediately in tears at just a routine visit. A cursory review of my file should have revealed this information and the questions and check-in could have been done in a way that didn’t leave me in tears trying to explain why we weren’t pursuing fertility treatments to a nurse who already had my file.”

Communication issue: Treating patients like they are “difficult” or a “nuisance”

“While I was in labor with my first child, I had several issues with the nursing staff. The first was that while in active labor and already at my maximum pain threshold, a nurse was rude when I wouldn’t let a student do my IV because she was hurting me. The second was that I felt like through the revolving door of nursing staff I had, no one was listening to me when I asked for a smaller blood pressure cuff, for air because I felt like I was suffocating, for someone to look at my epidural because it was only working on one side and then when I had trouble nursing. Third issue was when I pooped while beginning to push. The nurse that was with me when it happened acted offended and wouldn’t clean it up until a new nurse came and told her to. It was humiliating. The entire labor and delivery experience (except my interactions with my OBGYN) left me feeling embarrassed and ashamed. I felt guilty asking for something I needed and even with my husband there, I kind of felt like I was on my own. The experience was so negative that I wrote a letter complaining. My second birthing experience was at the same hospital 3 years later and was COMPLETELY different from the first time around. They had had a complete overhaul of their women’s services and I had amazing care.”

Communication issue: Generally being insensitive

“At my first postpartum visit, I told my doctor that I was concerned that I have a rectocele (which I confirmed that I do). He said, “it’s really unfortunate what birth does to that part of the body.” I really love him as my gynecologist otherwise, but that was a pretty hurtful comment. It made me feel ashamed.”

“Seeing a new male provider, who wore a pin on his medical coat that read “fun-o-meter.” Just creepy with a male OBGYN wearing it. He proceeded to make comments about my “small feet.”

“When a doctor has said bluntly, “Well, just don’t stand there, take your clothes off.”

In Conclusion

What can you do to improve how you communicate with your patients? We have created a free guide “10 Ways to Make Your Communication Woman Centered” available at www.womancenteredhealth.com. In this guide, we provide more stories that we collected from women and recommend ways to prevent your patients from having similar experiences. We hope you enjoy it. Please let us know what you think! We’d love to hear from you.

Written by Stephanie Edmonds PhD, MPH, RN