Is your care fragmented? Does it matter?

If your computer slows, may have been advised to “defragment the disc,” which puts all parts of a file together in the same place on the drive, enabling it to run faster and more efficiently. In much the same way, your pregnancy, birth and postnatal care needs to be defragmented. For most people, care is extremely fragmented, creating errors, delaying care and increasing frustration. Even for healthy women, the burden of keeping even two or three different midwives or doctors apprised of what you’re experiencing is typically on you. No one else is doing it. You will find you need to repeat yourself to several people, several times. "Oh, your file is too big. I haven't had a moment to read it. What are your main concerns?" "Oh yes, there is note here from ... hmmm .... I can't read who wrote it. It says something about ... oh, I can't read that either. Do you know what that might have been about?" Such conversations are not uncommon when you're dealing with the general hospital system.

You have to be the central communicator. Unfortunately, that role requires a fairly high level of knowledge about pregnancy and birth, and the ability to pry written information from one midwife or obstetrician so you can deliver it to another. You might be thinking this is not your role: you have a midwife or obstetrician so that they can coordinate your care, not you. And you'd be correct.

However, the more complicated your problems, the more fragmented your care will be. The average woman sees at least 30 care providers: midwives and obstetricians - from the first pregnancy visit until discharge from hospital with a baby.

What can you do?

Choose private care wherever possible. This can be a private midwife or a private obstetrician. Private midwifery delivers better continuity than does private obstetrics, because with a private midwife you will have that same person from your very first pregnancy visit until your baby is 6 weeks old, whereas with a private obstetrician, although they will provide all of your pregnancy care, you will have unfamiliar midwives in labour and shifts of midwives when you stay in hospital after your baby is born.

Be the hub of the wheel. Of everyone involved in your health care, you’re the one with the most at stake.

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