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Natural Birth
Hospital "Policies"
If something is technically a hospital "policy", can you still refuse it? I honestly had no clue what the policies were at my hospital where I delivered DS (and plan to also deliver this one). I imagine if I asked my midwife what their policies were, she would be able to tell me but I'm wondering if it's a "policy", does that mean it's mandatory... you absolutely HAVE to have it?
Things I did have last time were a hep lock (which is something I want to request I not have this time) and intermittent fetal monitoring (which was okay with me since I wasn't changing anything I was doing to have the bands on my belly - I made the nurse strap them around me while I was laboring in a rocking chair, heh). Does anyone know if these are determined by care provider or the hospital itself... typically?
My best friend, my husband, my everything
Matthew Kevin
7/31/83-7/20/11
Met 1/8/00
Engaged 4/21/06
Married 9/29/07
Two beautiful legacies: Noah Matthew (2 yrs) and Chloe Marcella (8 mos)
Day Three
Matthew Kevin
7/31/83-7/20/11
Met 1/8/00
Engaged 4/21/06
Married 9/29/07
Two beautiful legacies: Noah Matthew (2 yrs) and Chloe Marcella (8 mos)
Day Three
This discussion has been closed.
Re: Hospital "Policies"
Usually it comes from the hospital. It's generally legality centered and is what the hospital lawyers have determined will cover them the best. That said, there are also doctors who work on establishing policy and those who will look the other way. There are also areas in which your mw will have a lot of say. No hospital is going to have a policy saying that you have to have an episiotomy, but they may have a policy about how long you labor without medical intervention... For instance there is a "don't ask, don't tell" policy regarding eating and drinking during labor with my mw. Which is good to know, cause it means I need to bring in my own little cooler!
hth
There were some things that I could not refuse and that my doctor had no say about.
1) Continuous Fetal monitoring once in active labor or after rupture of membranes. This wasn't an issue for me, I showed up in active labor, my membranes broke while I was in triage.
2) Some type of IV access, so you could decline the iv drip (if you were not getting iv pain meds or an epi), but you had to have a hep or saline lock in place. The hospital required this in case of emergency, like a general anesthesia C-Section or pit to stop bleeding (if you are bleeding out your blood volume will be much lower and it is really hard to find a vein).
3) No showers or use of the tub once the membranes were broken or in active labor. Had to get out every hour for at least 15 minutes of monitoring.
4) No getting out of bed with an epi. The hospital had recently had some patients fall, it was a liability issue. I was aware of this well before labor when I talked over pain relief options with my doctor. I fell a few hours after DS was born because my legs were still too numb, I was very fortunate to not get hurt.
5) Patient and the patient's support person will be separated during the triage process for a short time. The nurses need to ask questions that they cannot ask the patient with another person present (questions about drug use, medical history, sexual history, & abuse). If you come in about to push, they will ask the questions later, but they will ask them privately and ask your partner to leave the room if they are there while asking those questions.
For my hospital, food was never an issue. I had trays of clear liquids brought to me in labor & delivery, so I had broth & juice & jello throughout my labor. I was also able to drink water (encouraged to while I was laboring without the iv drip). They even brought a tray to me while I was pushing since I was pushing since it was lunch time.
I would talk to your care provider about what you want and take the tour of your facility. Asking my care provider about things life refusing an iv and other issues helped to cut down on the issues we had with the hospital staff. It also allowed me to tell the nurses to call my care provider to ask if he had ok'ed all the different things we were doing (which he had, so the nurses were fine with it).
Thomas ~ 07/07/2008 ~ 8 lbs, 5 oz
What's in my camera bag: Nikon D5000, Kit Lens 18-55mm, 55-200mm, 35mm 1.8G, 50mm 1.8G, 85mm 1.8G, Tamron 28-75mm, SB 600 Speedlight
Global Developmental Delay consisting of a receptive language delay and self help skills delay
Ugh, I had this happen when I briefly was hospitalized for preterm labor. It annoyed the crap out of me. I won't let it happen when I go in to have my kid...they can ask the questions later, they can ask them in front of my husband, or they can give me a form to fill out and I will hand it back to them.
This is a good question. I know my MW said that if I choose to go 2 weeks past my due date I would have to sign a waiver (I never planned to do this, she just mentioned it). Obviously a hospital isn't going to tie you down and force a fetal monitor on you, maybe you would just have to sign a waiver, but if you did it might cause problems with your health insurance. I'm merely speculating here though, I really don't know.
To answer your second question I would say that at least in relation to my hospital, some things were out of the MWs hands and determined by the hospital. My hospital was pretty flexible, but I did have to do 20 minutes of continuous monitoring when I got to the hospital and intermittent monitoring thereafter. I was fine with the intermittent monitoring, but would have refused the continuous monitoring if I could have.
you can refuse ANYTHING in a hospital.
anything.
they all have legal AMA forms for it all. you just have to know what your asking for.
However, you must also know that they can also refuse to treat you, call child services and in general make your life hell.
i always preach: pick your battles wisely and your care provider even more so
I was in triage several times for preterm labor. Each and every time they separated the person I came in with from me. When I was in labor I knew this would happen, so it didn't phase me. They brought DH back to me quickly so it wasn't an issue. I was worried that it would be, but we were apart for like maybe 5 minutes when I was in labor, the nurses asked the questions while they helped me put my gown and slippers on.
For my hospital this is just standard practice. I had back surgery there a few months ago and I when I went in, DH and I were separated to ask all my health history questions.
I should note that I go to a an urban hospital that sees a lot of drug use and abuse situations. Often women are brought in by their abusers (partners), and dealers (partners), my hospital has programs to help these women, but these women may be frightened to say anything in the presence of that person. Also may of their patient's can not read, so they ask all questions verbally, many nurses speak spanish, or have memorized the questions in spanish.
Thomas ~ 07/07/2008 ~ 8 lbs, 5 oz
What's in my camera bag: Nikon D5000, Kit Lens 18-55mm, 55-200mm, 35mm 1.8G, 50mm 1.8G, 85mm 1.8G, Tamron 28-75mm, SB 600 Speedlight
Global Developmental Delay consisting of a receptive language delay and self help skills delay
So, the thing that I always wonder about is if you do sign the AMA form, then your insurance company isn't obligated to pay the bill anymore, right? And is everything considered AMA, or just big things, like refusing a c-section, or checking back out after they want you to stay?
DS2 - Oct 2010 (my VBAC baby!)
This is the question I am always wondering about, too! I wish I could get someone to answer it!
My guess would be that IN PRACTICE, the insurance company will usually the bill anyway, but IN THEORY they could refuse to...and I am not sure I am comfortable with taking that chance!
yea - thats another douzie - they too can make it a pain. from what i understand ~ its like a domino effect.
they have generic forms for things like a heplock and more independent ones for c-secs and stuff like that. but if you refuse one thing it would stand to fault that you had to 'endure' higher costs of further implications due to your initial refusal.
Jeeze, sounds like I better get myself a lawyer before I go in and refuse a hep lock, haha! Just kidding... I can tolerate it but I'd prefer not to have one. If they're going to get their panties in a twist over it then whatever.
Matthew Kevin
7/31/83-7/20/11
Met 1/8/00
Engaged 4/21/06
Married 9/29/07
Two beautiful legacies: Noah Matthew (2 yrs) and Chloe Marcella (8 mos)
Day Three
I just delivered naturally with a midwife at a hospital about 2 weeks ago. I also had a doula and my husband on board with all of my decisions. From day one of seeing my midwives I talked openly about my wishes for a natural birth. Thankfully my hospital is very natural childbirth friendly but I also knew that there would be some policies and I did decide to pick my battles wisely. One of the things I decided not to complain about was having a hep lock inserted "just in case"....... I honestly didn't even realize it was there (and I even labored in a birthing tub). They did monitor the baby for a few minutes every hour or so and used a hand held monitor while I was in the tub. Again I did not mind having this done......my midwife and L&D nurse were very respectful and the monitoring seemed non intrusive to my laboring. After I delivered my nurse did put a little pitocin in my heplock to help with bleeding but to be honest I didn't even realize that she had done it....... I was on that "natural high" you get after natural birth.
I had a wonderful hospital experience so you never know..... once you speak with your practitioner you may see that your hospital will work with your wishes.
When I was considering a hospital birth, the procedures AFTER the birth where what really got my goat. I would have had to sign a release for everything I didn't want to happen to Lily- to delay the clamping of the cord, to decline the Hep B and eye goop, etc. You should also consider what you want here and try to get all of those releases signed ahead of time.
Also, watch out for blanket consent forms. You don't want to be handed one of those while you are in labor and unable to read it in depth.
GL
This makes me laugh because, usually, when someone is signing something... they have to be "of sound mind". You would think that someone in transition wouldn't be considered "of sound mind" and the contract would be nullified anyway. Sue those bastards, hah! Just kidding... but really, that is why it's important to have someone there to speak for you but would you have to grant them some kind of special rights to represent you? Might be worth it, lol. I'm incapacitated during labor - I cannot be talked to.
Matthew Kevin
7/31/83-7/20/11
Met 1/8/00
Engaged 4/21/06
Married 9/29/07
Two beautiful legacies: Noah Matthew (2 yrs) and Chloe Marcella (8 mos)
Day Three
why would they need to know about abuse...
what the hell does that have to do with labor?