Patient Experience Week: Care and Understanding throughout Two Pregnancies

Our fourth guest post for Patient Experience Week is from Danica Longair, a PVN Patient Partner who experienced exceptional care through two pregnancies.

When it comes to health, we all require the best medicine. However, even the very best medicine can be of little use to you without honesty, time and empathy as well as genuine warmth and caring from the person providing it. Dr. Nancy Mitenko, my obstetrician, is at the centre of the best and worst experiences of my life, but was always the best herself.

In the fall of 2014, during my first pregnancy, she opened my first appointment with honesty: she might not be the doctor to deliver, but she trusted her team at St. Paul’s Hospital to do so. It made me feel secure and prepared. Throughout that pregnancy I bled periodically, sometimes heavily. At the end of week seventeen, Dr. Mitenko discovered I was to miscarry. We were devastated. She presented us with honest, experienced options and advice. She ensured that I delivered my daughter’s body on the maternity ward at St. Paul’s, where her team took amazing care of me, as she promised they would. She has always been exceptionally honest about what happened: science does not yet know why we lost our daughter. There’s a confident humility in saying, “I don’t know.” She never gave us false, empty platitudes like “it wasn’t meant to be,” nor did she come up with unproven hypotheses to placate us. We understood the limits of medical knowledge, and appreciated her respect for us in being truthful.

When Dr. Mitenko discovered that I was to miscarry, she spent all the time with us that we needed and checked on me the next day. Time is precious in health care and yet Dr. Mitenko always gave it. She never rushed, apologized if she was late and always took time to answer every question. In 2016, I became pregnant again. Returning to her, she greeted us with warmth and seriousness. She had a plan. For most of the pregnancy, every two weeks I saw her for check-ups and had ultrasounds at St. Paul’s. I was scared, but Dr. Mitenko instilled confidence. Once, I had mild cramping and came into the maternity ward. She happened to be on the ward that day. Two nurses sat separately with their hands on my belly, feeling for contractions. Dr. Mitenko took the time to feel for contractions as well. When she had determined that I was likely dehydrated, she asked if she could get me a drink, and personally brought me a juice, again taking the time. On my due date, I delivered a healthy baby. Dr. Mitenko checked on me each morning in the hospital, never giving me the sense that she was in a rush.

In the final weeks of my second pregnancy, Dr. Mitenko detected a slight blood pressure elevation. She sent me for weekly fetal monitoring. It was November of 2016 and current events were causing me anxiety which also elevated my BP. When I mentioned the reason for the anxiety to some, they laughed it off. But when I mentioned it to Dr. Mitenko, she understood. She had always been empathetic, sharing personal experiences from her own pregnancies and early motherhood, again with the confident humility of honesty. She showed interest in my life and family and expressed concern for my sleep and mental well-being. She always made me feel heard and respected, never patronizing or pressuring me. When I asked about birth plans, again she was honest and empathetic saying while her patients are welcome to create one, birth often does not go as planned. During my six week post-partum appointment, she cooed over my baby son, sympathized with my struggle to breastfeed, and assured me that if I was unable to, we would be just fine.

I have typed much of this with the beautiful, bright baby son Dr. Mitenko helped bring into this world asleep on my chest. I don’t think any of what I have described was special treatment. I get the sense that the caring, warm way Dr. Mitenko treated me is her standard practice for all her patients.

Dr. Mitenko always showed love of her job: joy at seeing the ultrasounds (she likes the 12 week ones best), warmth at seeing my husband and me, and, most of all, genuine delight at meeting my son. Her receptionist and nurse were always warm and inviting. In the end, she wasn’t the one to deliver either of my children; Dr. Valerie Rychel and Dr. Jennifer Oakes were the OBs who delivered my daughter and son respectively. Both were amazing doctors, just as Dr. Mitenko promised me they would be. While I’m sad that Dr. Mitenko wasn’t the OB on the ward for either of those deliveries, I credit her with feeling so well cared for during the worst and best days of my life.