My patients ask me for advice every day. What type of contraception should they choose? How can they best prepare their body for a healthy pregnancy? Should they start hormone replacement therapy at menopause?
Those are a few examples of discussions that are fairly straightforward. I discuss risks and benefits and provide as much information as possible for my patients to make informed decisions.
Controversial, highly personal topics are often more difficult to discuss, especially if the provider has strong personal opinions on the topic. Abortion, circumcision, vaccination and even prenatal testing are among those that many of us find difficult to discuss objectively.
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One of the most challenging parts of practicing medicine is remaining neutral and giving factual, evidence based information, despite any personal bias. This is not always easy to do, since your opinions can come through even in subtle ways, like body language and word choice.
During a discussion in midwifery school, a classmate of mine commented that only uneducated people would still circumcise their sons. This was offensive to me, as my husband and I had made the decision to have our boys circumcised. I mentioned this and also pointed out that circumcision is considered a commandment from God for those of Jewish faith. But my classmate’s comments and nonverbal cues, made me feel like a pariah.
Even topics that seem straightforward and are clearly support by evidence can be controversial. Some of my patients have told me that previous health-care providers made them feel ashamed for bottle-feeding their baby. Although the benefits of breastfeeding are clear, and I feel strongly that we should educate, encourage and support new moms who want to breastfeed, alienating mothers who do not or cannot breastfeed is wrong.
As health-care providers, we must remember that it is not our job to sway our patients to think the same as us, or make the choices that we ourselves would make. Our patients look to us, not only for the best care, but also for sound, nonbiased, evidence-based health information.
Robyn Carlisle, MSN, CNM, WHNP, works as a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.
