What's happening right now?
I think this is an emergency
I'm being dismissed by my provider
I don't know if this is serious
I need to know my rights
Call 911 now.
1
Call 911. Tell them you are pregnant or recently gave birth. This triggers obstetric protocols in most EMS systems.
2
Say out loud: "I need an ambulance. I am [X weeks pregnant / X weeks postpartum] and I have [symptoms]."
3
If someone is with you, send them to meet the ambulance while you stay on the line.
4
In the ER, repeat: "I am pregnant/postpartum. I need to be seen now." Do not leave triage without being evaluated.
Signs that always warrant 911
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Seizure, convulsion, or loss of consciousness
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Sudden vision loss or severe headache that doesn't respond to Tylenol
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Chest pain, inability to breathe, or lips turning blue
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Fever with confusion, mottled skin, or no urination
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Severe abdominal pain (especially upper right) or heavy bleeding
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No fetal movement after kick counts (see your kick count log)
You are not overreacting.
1
State your concern directly and specifically. Don't say "I don't feel right." Say: "I am concerned about [specific symptom]. I want this documented in my chart and I want to know what we're ruling out."
2
Ask for the test by name. "I want my blood pressure checked." "I want a bile acid test." "I want a Doppler ultrasound of my leg." Providers respond differently to specific requests than to general distress.
3
If still dismissed: "I need this in my chart that I came in with these symptoms and was sent home. Can you document that?" Most providers respond very differently to this request.
4
If you are at a hospital and still being dismissed, ask for the patient advocate or charge nurse. Say: "I would like to speak to the patient advocate."
5
If symptoms are serious and you remain dismissed, go to the ER or call 911. You do not need your provider's permission to seek emergency care.
Scripts to use
To your provider
"I understand you may not be concerned, but I am. I'd like this documented in my chart and I'd like to know what specifically we are ruling out."
To a nurse if provider dismisses you
"I'd like to speak with the charge nurse or patient advocate, please."
Know these warning signs
When you're not sure, act.
1
Your instinct exists for a reason. You don't need a clear diagnosis to call your provider. You can call and say: "I don't know if this is serious, but something doesn't feel right."
2
Use the warning signs guides to see if any of your symptoms match a specific condition, that gives you language to use on the phone.
3
Log your symptoms with time and description. Even if this turns out to be nothing, a written log helps your provider understand patterns, and protects you if you're dismissed.
4
If you have any of the emergency symptoms below, don't wait, call 911 or go to the ER now.
Check the warning signs guides
Preeclampsia & HELLP
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Headache, vision, BP, right-side pain, swelling
Sepsis & Infection
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Fever, chills, wound changes, foul discharge
Blood Clots, DVT & PE
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Leg swelling, chest pain, shortness of breath
Postpartum Cardiomyopathy
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Breathlessness, swelling, racing heart after birth
Cholestasis
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Intense palm/sole itching, especially at night
Log what you're experiencing
Your rights as a patient
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You have the right to refuse any procedure, including vaginal exams, induction, C-section, and episiotomy. Consent must be informed and voluntary.
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You have the right to ask questions and get answers before agreeing to anything. "What happens if I wait?" is always a valid question.
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You have the right to a second opinion. At any time. Even in labor. Even in the hospital.
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You have the right to see your medical records, within 30 days under HIPAA, often sooner. Request them in writing.
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You have the right to a support person with you during labor and delivery. Hospitals cannot remove them without documented clinical reason.
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You have the right to leave the hospital against medical advice (AMA). This carries risk, understand what you're leaving before you go.
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You have the right to file a complaint with the hospital's patient relations department, your state health department, and The Joint Commission (if applicable).
If a procedure is being pressured
"I'd like to understand this before I agree. What are the risks and benefits? What happens if I wait 30 minutes to decide?"