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Optimizing Your Visit with the Midwife
By Deb Gowen, CNM

For most of you, there is a wait time before you finally get to your first prenatal visit, repeat visits, or annual gyn visits, for that matter.  You may not know what to expect during the visit, or what’s expected of you.  In fact, when I listen to my friends talk about their visits, there are common themes.  One is “the visit was too quick”; another is “I waited too long.”  Often they say they did not get enough information offered to them, or they had no time to ask their own questions.  Very often they forgot their questions entirely until they got home.

In general, if you are someone who wants lots of information, it can be had.  The first piece may be to ask how long an appointment you will have when you make the appointment.  This will give you an estimate, not an absolute, of two things: first, how long you can expect to take out of your own schedule, and second, how long you have to give and get info. In general, appointment times vary from 10 minutes to one hour, depending on the nature of the perceived problem. A first OB visit can be between 30-60 minutes, repeat OB visits are 10-20 minutes, and gyn visits run 10-30 minutes, depending on the office. 

The actual physical part of the prenatal visit is weight, blood pressure, urine sample, uterus check, and fetal heart check depending on the stage of pregnancy, and takes about 5 minutes. A first prenatal visit includes a full medical history and may also include a complete physical exam, pelvic exam, Pap test and blood work, which explains why these visits are longer. Annual gyn visits have at least breast and pelvic exams, and may include a full physical, which will be determined by you and your midwife.  For any type of visit, once these basics are done, the rest of the time is yours for giving and getting information.


6 WAYS TO OPTIMIZE YOUR VISIT:

1.  Tell the medical assistant who brings you into the exam room about any problems you think will require an exam of a body part usually covered by clothing.   A common problem in this category is vaginal itching.  If you have already removed your clothing from the waist down when the midwife comes in, the necessary exam/testing for infection is easy for her to do without interrupting the flow of the visit.

2.  Tell your midwife early into the visit whether you like lots of detailed info, or just the basics.  For example, do you want an explanation of why anemia is common in pregnancy and all the potential complications, or do you just need to know that the midwife recommends you take additional iron daily, and the amount?

3.  Tell the midwife when you have a list of questions, so she can leave adequate time for them.

4.  Write your questions down before the visit and bring them with you.

5.  Know what the expected time frame is, and if on a particular visit, you know you have a long list of questions, let the reception staff know in advance, because they may be able to allow more time that day. If not, prioritize your questions and save some for the next visit. Some providers can call you back later, or use email. Ask about communication options.

6.  Bring something to do while you wait.  Many times, you’re asked to be at the appointment early enough to fill out paperwork, and doing this enhances your visit experience. In an OB office, however, the providers are seeing unscheduled clients who think they might be in labor, have decreased fetal movement, bleeding, or any number of other matters that require same day attention. This means that despite your early arrival, you might still end up waiting longer than you expect.  If you have a book, magazine, your knitting or laptop, you can use the waiting time productively.  This will keep you calmer and, when your visit time comes, focused on getting your needs met.

A final word:  As frustrating as long waits can be, please bear in mind that none of the office staff caused or can correct the provider running late. No one chooses this kind of day.  What we choose is to provide the best care we can, and some days unexpected client needs override the schedule.  If you cannot wait due to other commitments, please alert the staff and everything possible will be done to reschedule you for the next available opening. Be nice. If the day is so busy that you are feeling the tension, you can be sure they are feeling it as well.