Encouraging Client Nutrition

fearlessbirth · 10-21-2005, 01:52 PM

What do you do when your client (in this case, she's also a good friend) isn't taking the best care of themselves, despite knowing better...and isn't being completely truthful with the midwife about previous miscarriages or health concerns? This is very odd since she's hellbent on an all natural childbirth and I have advised her that honesty is the best policy, especially with your health care provider. I know she has some issues with her midwife and I wonder if she's not just being stubborn because the midwife advised her to do this or that and she's just being ornery.

Sorry for the rambling...and advice? Knowing her, if anything went 'wrong' in the labor or delivery or was wrong with the child she would feel great guilt forever about it. Is there a proper way of saying 'to minimize the regret factor, do the best you can NOW'?

Thanks for any input.

tlcdoula · 10-21-2005, 02:41 PM

Is this a very, very close friend? If it is I would just sit her down and tell her that you care about her deeply and care about her baby, and then go from there.

I have a very good friend who smokes, and while pregnant with her children she also smoked. It concerned me terribly so I sat her down one day and told her I was concerned. We talked about it and then she decided to still continue smoking and I left it alone after that. I was able to say what was on my mind, she respected me for saying what I had to say and then she chose to do whatever she wanted, but at least I felt I did my part.

fearlessbirth · 10-21-2005, 03:24 PM

That makes sense. She has decided that Oct 31st will be her 'quit smoking' date. I think after that, if she's still doing it, I will have a heart to heart with her. Arm her with the information and then let the choice be hers.

FYI...Prior to her being pregnant we were just friendly aquaintances who had mutual friends. We have gotten closer, of course, since she asked me to be her doula. I just wasn't sure how far was too far to go when encouraging mom to eat well, drink her preg tea or take her vitamins, exercise, quit smoking, etc.

Thanks for the input.

Babies_Bellies_Boobies · 10-22-2005, 02:34 PM

as for exercise, maybe you can be her walking buddy?

i agree with michelle.

1stimestar · 10-22-2005, 03:16 PM

Really, it depends (to me) what it is we are talking about. If you are concerned that she is smoking in pregnancy, she KNOWS it is not optimum so you telling her it isn't wont make much of a difference. Pregnancy teas and vitimins? If she has an adequate diet, then these are not totally neccessary and can be problematic. Smoking pot? Do your research very well here and see what you find. Crystal Meth? There are programs that can help her that she might not know about. Once again, do your research and offer her local options. Really, though it is hard, it is not your place to put your moral judgments on her (not saying you are and not wanting to sound harsh here) but to offer her information and options and support her. Good luck.

fearlessbirth · 10-24-2005, 10:27 AM

The issues (in addition to smoking) are not-the-best-diet..hence the vitamin or tea recommendation from the midwife...no drugs. As far as exercise goes I visit her 3 or 4 times a week for that very reason but she never feels like doing anything. I am going to the library to look for some prenatal yoga books.

During our most recent visit she stated that she's just not attached to the baby yet. Maybe this is normal? (She's 20 wks along). Maybe once the baby is moving more and her belly gets bigger she will be motivated to take better self of herself and her baby.

Thank you so much for the advice. It is hard to not 'judge'. Even though I'm not doing it on purpose, I just want to say 'this isn't best for your baby!'. Lol

1stimestar · 10-24-2005, 11:38 AM

Yep this is one of the hardest parts of our job sometimes. But you also want to support her. She wont let you if you drive a wedge between you. Mention to her different ways to get 80 grams of protien a day. Help her cut back by one cigarette a day, allowing herself to platou (sp?) on the weekends in a holding pattern. Get her out of the house with bribery if you have to (walk downtown for an ice cream) lol. Sometimes it works. Good luck.

fearlessbirth · 10-24-2005, 12:48 PM

Those are really great ideas...thank you. I think I just realized why I am having such issues with this. Lol This may sound silly but I think the midwife will think poorly on ME if when we go for her next check up she's still doing all the unhealthy things. Wow! How ridiculous! Lol I KNOW she won't. And I"m sure she's dealt with far worse and much more stubborn women. Lol Wow. I feel 100xs better now that I"ve realized that's probably where all that anxiety was coming from (of course, after wanting baby and mom to be A-OK).

1stimestar · 10-25-2005, 01:33 AM

Awesome that you learned something about yourself. It happens often with good doulas! We must always question ourselves about our feelings and how they affect how we treat our clients. I supported one mom who was not planning on breastfeeding. It was extremely difficult for me. It just felt weird, not right, and sad. I realized that it was the closeness and other special feelings *I* had that I knew she would miss that was making me feel so weird. That and not really knowing how to behave afterwards when I normally would be helping her latch on lol. So I just told her that the nurse would have to show us how to use the premixed formula as I didn't really know as I hadn't ever done it before. She didn't blink an eye and I don't think that it made her uncomfortable. Which is a good thing. Making her feel guilty or alienated from me would not have made her switch to breastfeeding at the last minute. I did ask her once the baby was born if she wanted to try it anyway even if she had planned on not. She said nope.