Your voice in birth matters. A lot.

Or: How to write a letter of complaint to your OB, midwife or hospital…

Every birth matters, and YOU have a voice. Significant changes have been made in recent years in our local birth world – changes to policies, procedures and options. Many of these changes happen because you are a consumer of services and local providers and hospitals want to earn your business. Some happen because the voices of attorneys, insurance companies and administrators are louder than those of the women actually giving birth. It is important for you to share your experience with them, to give feedback, so that care providers can know what they did right and what they can do better.

This is not just a favor to them or the women who will follow you, it is often a significant part of the healing and recovery process for women. For some, writing is therapy, it comes naturally and their thoughts flow easily onto paper. For others, it may be daunting or difficult to translate those powerful emotions into words. It is never too late to send a letter about your maternity care. It doesn’t matter if you gave birth 3 months ago or 5 years ago. If it weighs on you, write it.

Of course, many times a letter or card will be to express gratitude for amazing care, a positive experience, care providers who went above and beyond to make a birthing woman and her partner feel safe and supported. Those letters of appreciation are equally important. It doesn’t need to be long. Positive feedback is received with gratitude and also helps shape the choices that birthing women after you will have. But this post will primarily address letters about situations that were not as positive as they should have been.

After a negative situation, it may seem easier to vent anger, frustration and grief by writing a scathing and anonymous review on some website and just hope someone reads it, but a written and personal letter addressed to the people in charge who really should be reading it to begin with is much more powerful and effective.

When something bad happens, you have three choices. You can let it define you, you can let it destroy you, or you can let it strengthen you.

In writing your story, remember to include some basic facts, such as:

  • names (of you, the patient, and your partner and baby)
  • names of the care providers – doctors, nurses and anyone involved in your care
  • dates of care, procedures, discharge or follow-up, as relevant
  • place where the procedure or birth took place
  • procedures performed

More importantly, address the reason for your letter, which may be an instance in which:

  • you felt your patient’s rights were violated
  • you felt you were unnecessarily rushed, bullied or harassed
  • you felt you were not given adequate information for informed consent
  • you felt information on risks or alternatives was withheld or misrepresented
  • you felt procedures were done without explanation or necessity
  • you felt a provider spoke or acted inappropriately
  • you felt a provider pushed his or her personal opinions on you
  • you felt your wishes and opinions were not honored and respected
  • you felt actions were taken that were not in the best interests of you or your child
  • how you felt about it
  • the consequences of any of the above actions that

Consequences of the action that led to your letter are important to include. Providers and nurses often do not consider the longer-term effects of a patient’s experience after their discharge from a unit. Their goal is often “healthy mom and healthy baby” and it sometimes seems that they essentially feel they have achieved that if you both leave the unit. Consequences of actions that prompt you to write a letter may include a change in the level of your trust in the staff, physical or emotional trauma, feelings of anger or depression or regret, difficulty bonding with baby, breastfeeding challenges, setbacks in your physical healing, experiencing the stages of grief, a trigger for postpartum depression and so on. In more extreme situations, it can even lead to a change in a couple’s plans for a family. I’ve seen this happen several times and it’s heartbreaking every single time.

It is OK to have a healthy baby and feel upset by your birth experience. People who say you should just be grateful you have a healthy baby are being dismissive of your feelings, to which you have every right, of being let down in some way during your birth experience.

Women’s strongest feelings [in terms of their birthings], positive and negative, focus on the way they were treated by their caregivers. ~ Annie Kennedy & Penny Simkin

Below are some prompts to help you get started writing a letter. Use as many or as few as you’d like. What matters is that you express yourself from the heart. 

  • I feel it is important for me to share my experience because…
  • I did not expect…
  • I was disappointed with….
  • I felt that….
  • One thing I was grateful for was…
  • What really would have helped me would have been….
  • A particularly helpful staff member was…
  • I felt I wasn’t being heard about….
  • A comment that really affected me was….
  • An action that really affected me was….
  • I felt my provider was not being entirely truthful when I was told…
  • I hope that future patients will…
  • What I would wish to be different next time is…
  • I believe it should have been handled differently when….
  • I was scared when….
  • I had really been looking forward to….
  • What caught me by surprise was….
  • My partner was particularly upset/disappointed/surprised when…
  • I feel an important part of my healing is…
  • What I hope to accomplish by writing this letter is…

My hope is that these prompts will help you to share your voice and your viewpoint in a constructive and empowering way. Ultimately, of course, birth has inherent risk. Not all outcomes will be positive. There will be some frightening situations, injuries, differences of opinion and those are normal and expected in an intense experience such as birth. Hopefully you chose your provider because you felt comfortable with and trusted him or her, and any complaint letter is based on a (perceived) violation of that relationship.

It may be wise to write the letter and let it simmer for a while. Let it rest, and check in on it after a few days or a week. What would you change? Is there anything you could reword?

Also, consider whether or not you desire or expect to receive a response. Are you looking for an explanation? An apology? A number of questions to be answered? A review of policies and procedures to prevent the same birth trauma from happening to another woman? Know that you may receive a response. You may not. Some people find that putting their thoughts down on paper is in itself a huge step in the healing process. Some fear that having their letter ignored would feel worse than receiving a defensive letter in reply. Think about these things to be prepared.

Every birth matters, and YOU have a voice. A strong and powerful voice that needs to be heard. I urge and encourage you to use that voice! It matters.


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