Is Anti-Spouse Bias the Reason for Bad Health Care?

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Why are babies born at military hospitals more than twice as likely to be injured during delivery than civilian babies? Why are new mothers at a military hospital more more likely to hemorrhage after childbirth than if they delivered at a civilian hospital?

Is there something about military wives that make us more vulnerable during pregnancy?

We don’t really know. This week the New York Times reported about the lack of mandated follow-up investigations and “persistent lapses in protecting patients” in military hospitals -- particularly when it comes to maternity.

“The reasons, military doctors and nurses said, are rooted in a compartmentalized system of leadership, a culture of interservice secrecy and an overall failure to make patient safety a top priority.”

As a sociologist, I’m wondering if one of the factors leading to this “overall failure” is the persistent stereotype that labels military spouses as complaining, powerless, entitled, weak, over dramatic and needy.

Does that stereotype make it more likely for military spouses to be dismissed and thus more at risk when seen in a military hospital? Especially when pregnant? No wonder some spouses are upset about possibly being pushed back into military hospitals for care.

Most of my own dealings with military hospitals have been good since childhood. I usually opt for military medicine when it is available in my area. And I know military medical staffs are full of people who work hard and do their best often in trying circumstances.

But sometimes it is the underlying, unconscious, unseen beliefs we hold that alter our behaviors. Few of us are free of that kind of bias.

And that bias against spouses exists even among other spouses. So often on SpouseBuzz we hear our own readers distancing themselves from other military spouses, “I am nothing like them.” Or “I am not the average military wife.”

But when I was delivering our youngest child while my husband was deployed, I was “them” to a T. Pregnant. Isolated. Stressed. Over committed. I was doing the best I could and faking the rest.

I had also struggled with nausea during the entire nine months of the pregnancy -- which probably read as “drama” to others. It read as exhaustion and emptiness to me.

So when the nurse kept complaining about the heart monitor for my baby and how it “never works right,” I didn’t say a thing. Neither did my girlfriend, a fellow military wife.

I probably should have insisted on a different monitor. But I was in labor. I was worn down. My husband was 6,000 miles away, which was nothing unusual in that ward. So I should have stood up for my own care.

Because it turned out there was nothing wrong with that monitor. It really was showing my son was in distress. He had moved into a breech position since my visit with my obstetrician a few days before. When the doctor came to check me, he found a foot where the head should be. There was hissing in the hallway between members of the staff. Murmurings about the monitor. Significant looks.

Moments later my son was delivered by emergency C-section. He was fine. I was fine. But the air of a near miss was all around that delivery. The next day a different doctor and two administrators came to quiz me about the delivery.

I didn’t care.

I had my baby. He was fine.

Months later when my husband came home from sea and we went over the blow by blow of the delivery. “Dodged that bullet,” my husband said.

Yes. I guess. There is some risk in pregnancy. Yet part of the problem that day was that I was just another pregnant military wife with a deployed husband complaining about being sick. Would they have caught the breech earlier if my husband had been with me? Would it have been any different if I delivered in a civilian hospital?

The thing is, I don’t want military wives dodging bullets when they are pregnant. I don’t want them fighting to be taken seriously because of an unacceptable bias against military spouses especially during deployment.

That isn’t a cause to dismiss a woman’s concerns. Military life is an added layer of complexity, one that often hides a real problem. It is a cause to be a little more gentle, a little kinder, a little more curious about what could be going on.

Not every military hospital has increased risk for pregnant wives. More needs to be done to examine what they are doing right and pass that along to every hospital that deals with military wives in the most vulnerable part of their lives.

Note from managing editor Amy: I, too, experienced questionable maternity care at a military treatment facility. After a urine protein test was charted incorrectly as a 24 hour test instead of the 12 hour test it actually was, my PA insisted that I be induced a few days before my due date. But I didn't care -- my husband was deploying in a month and I wanted that baby OUT.

What is your military hospital experience?

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