The Day I Offered to Leave Triage

Why you belong there

What happened when I overheard a nurse call me “a lot,” and what I’d do now.

What happened

I couldn’t feel my baby move. It happened over and over in my first pregnancy, and every time I was told to come in. My doctor’s written instructions said it plainly: “If you desire daily surveillance you can present to triage whenever you do not have an appointment.”

On one of those visits, I overheard a nurse describe me as my doctor’s patient who was “a lot,” a “low risk patient that keeps coming,” and say they were annoyed with me.

I walked over, terrified for my baby. I said I didn’t want to annoy anyone, that I was only there because I’d been advised to come, and that I could leave if needed.

“Oh hon, it’s fine. Don’t worry about that,” the nurse said, as though what I’d heard was nothing.

As a Black woman, it felt embarrassing but not surprising.

What it did to me

I keep thinking about how quickly my attention shifted. I was frightened for my baby, and I found myself trying to relieve the staff of the inconvenience of assessing us. Their annoyance became one more thing for me to manage.

After that, I had to steel myself to receive care in a place where I felt unwelcome. I kept going back, because I kept not feeling my baby move. And I still couldn’t bring myself to leave my doctor’s practice. I felt paralyzed. I was afraid.

I felt that they didn’t like me. I wasn’t a good patient to them, and they weren’t good doctors to me.

It left me with a fear I still carry: that the way you ask for care can become a bigger subject than the care you’re asking for.

I’m not the only one

In a video from Hear Her, the CDC’s campaign on urgent maternal warning signs, a mother describes going back to the hospital again and again with high blood pressure after giving birth. By her third return, comments from staff made her feel like a bother. Her account brought me right back to triage: the worry is still there, and now you also know people are tired of seeing you.

In a first-person essay in Elle, Serena Williams described asking for a scan after childbirth because she suspected a blood clot. She reported a dismissive first response before a doctor listened and the scan found clots. She knew her body and her history, and she had extraordinary public standing. None of that guaranteed she’d be heard the first time.

What triage is for

Triage is where labor and delivery assesses you when you come in between appointments. At one academic hospital, the steps are:

Check-in, with basic information. You may give a urine sample and change into a gown.
Vital signs: heart rate, temperature, breathing rate and blood pressure.
Monitoring of your baby’s heart rate and your contractions.
A review of why you came and your pregnancy history.
An evaluation by a resident or midwife, who confirms the plan with your provider. You may need blood work, an exam, an IV or more monitoring.

Wait times vary with how busy the unit is and who else needs care first. A wait doesn’t mean you shouldn’t be there.

Key points

If you were told to come in for a symptom, say so at the desk: “I was told to come in when this happens.” Triage sees patients “in order of medical priority,” not in order of arrival, so a wait doesn’t mean you shouldn’t be there.
In a 2023 CDC survey, 20.7% of people who held back questions or concerns did so because they thought their provider might think they were being difficult. Write down your symptom and when it started before you arrive, so you can say it in one sentence.
In the Giving Voice to Mothers study, a U.S. study of mistreatment during pregnancy and childbirth, being shouted at or scolded was the most common form of mistreatment, reported by 8.5%. Women of color reported mistreatment at 23.8%, against 14.1% of white women. If it happens, write down what was said, when and by whom, and report it to the hospital’s patient relations office.

What I’d do now

Say why I’m there in one sentence: “I was told to come in when I can’t feel my baby move. I haven’t felt movement since this morning.”
Bring the instruction. A screenshot of the portal message or the written instruction that told me to come in.
Ask before I leave: “What did the monitoring show, and what should I do if this happens again?” And ask for that in my discharge paperwork.
Ask for the charge nurse if something said in front of me makes me feel I should leave. The charge nurse runs the unit for that shift.
Write it down the same day, and send it to patient relations if I want it on record.
Stay for the assessment. I offered to leave because I felt unwelcome. I needed an assessment, and I should have been able to receive one without worrying that I was annoying the people caring for us.

Take this back

To discuss with your care team:

Which symptoms should bring me to triage, and which should I call about first?
Can you put that in writing, in my chart or my portal?
If I keep needing to come in for the same symptom, what’s the next step beyond monitoring?

To discuss with the people in your life: If I need to go in, can you come with me or stay on the phone? If someone makes me feel like a bother, will you help me stay? A line from the script I wrote for my husband: “She was told to come in for this. We’d like her assessed. Can we speak with the charge nurse?”

Don’t wait if

Go in right away for decreased or no movement, heavy bleeding, leaking fluid, a severe headache, vision changes, chest pain, trouble breathing or a blood pressure reading with a top number of 160 or higher or a bottom number of 110 or higher.

Next in the series: “Getting Ready for the Hospital”