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Dear Medical/Mental Health Provider…

“So…I guess we should just pretend you are the real mom…”

I sat there with my 18 month old and my brand new baby girl as those words washed over me. For a minute, my sleep deprived ears thought I must have misheard her.

“Pretend…real mom…”

This was my pediatrician, the woman who was there when Josiah was born and walked through the adoption process with Selah. The context of this conversation was that we were filling out forms for the insurance company and it was asking for health background of the parents.  I understood the confusion. Did they want to know health information about her birth mother or me? But her words…they cut like a scalpel.

Fast forward almost nine years and a third child, if that happened to me today I wouldn’t slink away and cry in my car. And it has happened- more times that I’d like to count. It’s always been amazing to me that medical professionals, even mental health professionals, have said some of the most insensitive things regarding adoption (not that medical professionals can’t be human and make mistakes, but when you are responsible for someone’s well being, I expect a level of education and sensitivity). So let’s grab some blog coffee and talk…

Tips for Medical Professionals when working with Adoptive families

Don’t assume a domestic adoption=no issues

We have been dismissed multiple times because we didn’t adopt our children out of foster care or from another country (except for our youngest). Of course, this doesn’t mean that all children who were adopted will struggle with developmental or learning issues, but it also doesn’t mean that adopting a child at birth will magically protect them from it either. Being educated on attachment theory will not only help you spot problems earlier with children, but will help you become a good resource for attachment problems with parents and thus become part of the solution to preventing disrupted adoptions. After we left our first pediatrician, we found a new one and I can’t express how grateful I am that she has taken our concerns seriously. We know that we were able to get help much earlier than many parents and most of that is because she listened to us, even when many doctors said “Selah will grow out of this”- because of this, I also listen when she tells me that I DON’T need to worry, because she has already proven that I can trust her.

Educate your staff

As a parent, my first impression of a new doctor or therapist is the office staff. If a parent is consistently having to field insensitive statements or questions, it can discourage them from coming back, even if they love the doctor. A bad encounter with office staff can also create unneeded anxiety for a child that gets projected onto the doctor. We visited a doctor once and the nurse got irritated with Selah for squirming while taking her blood pressure. I tried to explain that she was extremely sensitive to tight clothing (her Sensory Processing Disorder dx was in her chart), but she ignored me and continued to scold Selah (she was four years old). By the time the doctor came into the room, I was completely frazzled and Selah was  shaking and hiding under the table. Please also make sure your staff is aware of the legalities of adoption. When Josiah was a year old, he had to have ear tubes put in. The night before the surgery, a nurse called and asked about medical history. When I told her that he was adopted, she told me that she wasn’t sure I was allowed to authorize surgery and she would need to talk to whoever had custody of him. Needless to say, this was not comforting to a nervous mama!

Realize that for many adoptive parents, parenting choices are built upon attachment theory

When you are thinking about typical parenting issues, it is easy to begin with an assumption that a child and parent are firmly and lovingly attached to each other. However, for adoptive families, we don’t get to have that assumption (even when adopting a newborn!) when making parenting choices. Please don’t assume a parent is “weak” or “spoiling” their child if they feed them a separate Ethiopian meal for six months instead of making them eat what the rest of the family is eating. Please don’t criticize that mom for letting her newly adopted two year old use a bottle and pacifier. Please remember that above all else parents are trying to build trust with their child, and that may require allowing that child to do things that *appear* permissive or even coddling.

Look around your office

Does everyone look just like you? If you work in an office of all white doctors, nurses, and staff, it’s a problem. It’s also a problem if they are all male. As a mother of a black child, I tend to want to make sure that he sees people that look like him, especially in places that are designed to help him. I am much more likely to ask a black doctor or nurse for advice on the best lotion for his skin. At some point, my daughter became a little less comfortable with the male partners in her pediatrician’s office. When you work in an all white, all male environment, you miss a world of perspective and cultural difference and those differences not only make you a better provider, but they also expand the scope of your practice. To be blunt, I don’t trust practices that aren’t diverse. As a parent, it makes me wonder if I’m going to get cookie cutter advice.

Be a part of the team, not just the expert

Let me tell you the thing I am most grateful for with our pediatrician (and there are many things!). Over the last ten years with all my children, I have approached her with many different ideas and theories. Some of them have been medication oriented and some of them have been straight up voodoo. She has always patiently listened to my ideas, given me the science behind my questions, and encouraged me to try whatever my husband and I felt was best. She has told me when an idea didn’t have good research behind it, she has warned me about those who take advantage of hurting parents, but in the end, she has been willing to look into different options to help our kids. I don’t ever walk away from her feeling belittled or spoken down to. I feel like she is a part of our team. And in truth, that relationship (it works both ways, I am sure she has to trust us as well!) goes much further than her degree does in convincing us to go one way or another. Look, parents are bulldogs. Mamas especially. We will fight and research and try and ask around for solutions. We will hound other parents for ideas. We will spend hours reading the internet. And there are a thousand charlatans out there, just waiting for a hurting mom to pounce on to sell her some product or theory to fix her child’s problem. And the reason we fall for it is because love and worry trump reason. When we don’t feel like we are being listened to or that our child’s provider doesn’t really care about our child, we feel forced to find our own solutions.

Come back on Monday to hear my friend, Dr. Justin Smith, speak about what doctors need from adoptive parents.  Dr. Smith is a pediatrician in Lewisville, TX and a father through adoption as well.

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One response »

  1. I would add that they need community connections. We left a good pediatrician because he didn’t know who to connect us with. Our new pediatrician knows where to find the best pediatric opthamologist that takes foster care medicaid. she knows the differences between the two main local therapy providers and why we should pick one over the other. I could go on and on.



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