Department of Reproductive Health and Research (RHR), World Health Organization
Managing Complications in Pregnancy and Childbirth
A guide for midwives and doctors
Section 1 - Clinical Principles
Talking with women and their families
Pregnancy is typically a time of joy and anticipation. It can also be a time of anxiety and concern. Talking effectively with a woman and her family can help build the woman’s trust and confidence in her health care providers.
Women who develop complications may have difficulty talking to the provider and explaining their problem. It is the responsibility of the entire health care team to speak with the woman respectfully and put her at ease. Focusing on the woman means that the health care provider and staff:
It is understandable to disagree with a woman’s risky behaviour or a decision which has resulted in a delay in seeking care. It is not acceptable, however, to show disrespect for a woman or disregard for a medical condition that is a result of her behaviour. Provide corrective counselling after the complication has been dealt with, not before or during management of the problem.
Providers should be aware of the rights of women when receiving maternity care services:
When a provider talks to a woman about her pregnancy or a complication, s/he should use basic communication techniques. These techniques help the provider establish an honest, caring and trusting relationship with the woman. If a woman trusts the provider and feels that s/he has the best interests of the woman at heart, she will be more likely to return to the facility for delivery or come early if there is a complication.
Speak in a calm, quiet manner and assure the woman that the conversation is confidential. Be sensitive to any cultural or religious considerations and respect her views. In addition, providers should:
If a woman must undergo a surgical procedure, explain to her the nature of the procedure and its risks and help to reduce her anxiety. Women who are extremely anxious have a more difficult time during surgery and recovery.
Rapid initial assessment