Bringing a child into the world can be a transformative experience. Usually, the hope is that the transformation that takes place will be joyful, for the new mother and for the family that welcomes the child. Sometimes, however, a difficult birth can lead to maternal injuries with serious complications that dim a new mother’s joy in her infant – she may be thrilled to meet her child, but unable to shake the feeling that something in her body is not healing well. For a variety of reasons, postpartum care for many women is a perfunctory affair, and when individuals who have recently gone through a difficult birth raise concerns about their recovery process, they are often dismissed and told that healing takes time. In many cases, getting a second opinion after a difficult birth can clarify whether there are underlying issues going unaddressed, as well as what the possible treatment options may be. To learn more about your rights as a patient, you can reach out to a medical injury attorney with Erin Marshall Law at 505-218-9949. Call us anywhere in the Albuquerque area to schedule a consultation.
What Is a “Difficult” Birth?
One of the many reasons why women may hesitate to seek a second opinion during the postpartum period is that often there is an uncertainty about what is “normal” and what constitutes a “difficult” birth experience. Adding to the problem is a cultural pressure many new mothers feel to act grateful and delighted about the arrival of a new baby, as opposed to overwhelmed, consumed with physical misery, and potentially devastated by the changes in their own bodies. Many fear incurring criticism for being “a bad mother” for paying attention to their own physical needs and experiences. Even worse, some suffer in silence, enduring shame on top of discomfort, convinced that they are bad mothers and that every woman who gives birth goes through what they are feeling, without complaint.
Signs of Labor Complications
A difficult birth may be any delivery experience that is complicated by any of the following:
- Early labor
- Emergency Caesarean section (C-section) to deliver the baby surgically
- Prolonged labor (sometimes called “failure to progress,” according to the Cleveland Clinic)
- Breech birth
- Excessive hemorrhaging
Numerous other, less common complications can also lead to difficult births.
When To Seek Medical Assessment
Unfortunately, even mothers who are proactive in getting a thorough medical evaluation for their children in the aftermath of delivery complications that present the potential for birth injuries may be hesitant to voice concerns about their own health to their physicians or other medical professionals. Requesting a second opinion, particularly if they have described their symptoms and been told “it just takes a while to heal” or “your body is different now” or exhorted to “get back in shape,” can be even more intimidating. At Erin Marshall Law, we see women regularly who have been persuaded – deliberately or not – into believing that devastating physical symptoms are a fully normal part of recovery from childbirth. All too often, these perceptions can lead to delays in getting much-needed evaluation and treatment.
Keep in mind that even genuinely dedicated medical professionals cannot know how your body feels from the inside. Two different patients may rate the same symptoms with completely different levels of severity. As important as it is to listen to medical advice, it is also critically necessary to advocate for yourself when your concerns are not being addressed. Consider seeking a second opinion after a difficult birth when any of the following apply:
- You are not healing according to the projected timeline (projected by your healthcare providers or by other authorities).
- You keep feeling that something is “off” but your healthcare providers have been unable to pinpoint an underlying cause.
- You healed well initially, but continue to experience issues in specific areas, such as your pelvic floor or abdominal wall.
- You are experiencing persistent sexual dysfunction several months after the birth.
While it may simply be the case that your healing proceeds a little slower than that of some other new mothers, any of these scenarios can also be a sign that some physical damage not recognized during the labor process is not mending on its own and needs treatment. Even if a second medical assessment yields results no different from the first, getting a thorough examination from more than one professional may give you peace of mind and help you establish realistic expectations for your own recovery timeline.
What Is the Meaning of a Second Opinion in Medicine?
In its most basic terms, a second opinion is exactly what it sounds like: an alternative or corroborating opinion from another source, after one person has already offered an assessment. In medical contexts, while this basic format holds true, the process of getting a second opinion is often formalized – partly because the billing rules of many health insurance policies will require explanations of why the initial opinion was not adequate (or, in other words, why the insurance should cover a second medical professional’s contributions). and partly because documentation of patient history, including diagnoses explored and the reasons for pursuing or not pursuing additional testing or treatment, tends to be a high priority in healthcare settings.
Do You Need a Referral To Get a Second Opinion?
If you are paying out of pocket for your own health care, you may not need a referral to see a second physician to discuss your concerns after a difficult birth. However, some specialists may prefer to see referrals because the referral process can help to ensure that the patients who come to their offices for consultations are individuals whose health concerns fall within their scope of practice. Much as lawyers tend to be cautious not to present themselves as legal authorities in states where they are not licensed, or in types of law they have never practiced, for ethical and compliance reasons as well as for practical considerations physicians generally try to limit themselves to seeing patients for health problems their own training and board certifications or registrations put them in position to evaluate and treat responsibly.
Some physicians’ offices are more proactive in vetting potential patients than others, so if you do not need a referral to satisfy health insurance filing requirements and you feel uncomfortable asking your current healthcare provider for a referral to get a second opinion, you can try to make an appointment with an appropriate professional on your own.
Requesting a Referral for a Second Opinion
If, as is common, you have health insurance that will cover a second opinion consultation only with the benefit of a referral from your current healthcare provider, the good news is that most doctors do not typically take offense at this type of request. There can always be exceptions to the norm, but as a general rule, second opinions are so widely accepted and valued in medical settings that a refusal to refer you can itself sometimes be a concerning sign, particularly if there are other indications that the healthcare professional overseeing your care is not taking your concerns seriously. For the most part, if you are feeling unwell and your physician or other healthcare provider has not been able to pinpoint the cause and treat it effectively, they will usually be open to referring you to a trusted colleague – often someone practicing in a more specialized area of medicine, but sometimes a peer they know to have previous experience with cases similar to yours.
Asking for a Second Opinion in Medicine Is Normal
From outside the medical community, it can be easy to worry that asking for a second opinion may suggest a lack of confidence in the attending physician’s judgment – but it may be reassuring to know that in medicine, as in law and academia, there tends to be widespread understanding that no one person can be a leading expert in every single aspect of their field, and that collaboration often leads to insights that any individual working alone might easily overlook. Even within the same area of practice, an individual physician’s unique history of patient encounters and research experience will lead to a perspective that, while usually similar to those of others in the field, is never exactly duplicated.
What Is the Etiquette for a Second Opinion?
If you have an otherwise strong relationship with your physician or other healthcare professional, and you wish to avoid unintentionally giving offense – but still ensure your concerns are addressed – you may consider opening the referral conversation by asking if he or she knows a colleague who has significant experience in dealing with cases similar to yours. You can take the opportunity to emphasize that you are asking for a recommendation because you feel more confident seeking additional insights from someone your current healthcare provider knows and considers to be a good fit for your particular situation. Often, the answer may be a specialist in a related field; sometimes, your healthcare provider may instead suggest seeing a colleague in the same area of medicine who has an especially strong background in diagnosing and treating symptoms like yours after a difficult birth. Rarely will a physician refuse to put you in contact with a more experienced or specialized medical professional.
Second Opinions and Medical Liability
Beyond professional humility and collegial respect (both important qualities worth looking for in your healthcare team), another reason why physicians tend to be relatively open to referring patients for second opinions is that many healthcare providers have liability concerns. Many working in the medical profession feel it is to their advantage to establish a clear “paper trail” (these days, usually digital) showing that when a patient expressed concerns, the healthcare professional did not dismiss them, but instead took steps to make sure the patient had access to a second opinion from another healthcare provider with appropriate expertise. Although such documentation is not an absolute guarantee against liability for medical malpractice under the New Mexico Medical Malpractice Act (MMA), it is often understood to serve as evidence that the attending physician was not willfully or capriciously denying care.
Many physicians, of course, are deeply invested in patient outcomes and do not need the fear of legal repercussions as a motivation. For those who might consider protecting themselves against potential liability to be a further incentive, however, the reality is that either the second opinion will concur with their own assessment – lending additional weight to the medical professional’s credibility – or the second opinion will differ, in which case the referring physician can be seen to have acted responsibly in facilitating a second opinion.
“Better Safe Than Sorry” After a Difficult Birth
Many women recover without additional complications, even after very difficult births. Others may experience postpartum problems, despite a relatively uneventful delivery. In either case, it is crucial to listen to your own body and seek follow-up care if and when it whispers (or shouts) that something is wrong. Most medical professionals will respond promptly to a request for a referral for a second opinion, and may facilitate an introduction to a peer or a specialist, depending on the circumstances. If your healthcare provider does not offer to send in a referral on your behalf, do not hesitate to take matters into your own hands. If you feel your concerns are being dismissed or neglected, you may also wish to seek legal advice, as well as a medical evaluation. Reach out to an experienced maternal injury lawyer with Erin Marshall Law by calling our Albuquerque office at 505-218-9949 today.
