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Natural Birth
ReeseM
member
Can they "make" you
ReeseM
member
do ANYTHING that you don't want to, at the hospital? I mean, I know they have regulations, like monitoring at whatever intervals, Hep lock, etc. (Depending on the hospital).
I am just wondering to what level can any nurse/dr, etc make you do anything? Not trying to be that patient, but what if I go in, and simply refuse to lay down on the bed and get a hep lock put in? What are they really going to do?
I don't want like, a huge scene or anything, I am just really wondering to what lengths they can go to to make you follow regulations.
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Re: Can they "make" you
Basically, no. They can't make you do anything. However, be very careful what forms you sign and what they say. Most hospital admission forms are blanket consents for IVs, pit, episiotomies, sometimes even sections depending on the hospital.
Get a copy of the intake forms before you go into labor so you can take time to read it really carefully. You are well within your rights to change it, cross things out, add things, and refuse to sign it until you feel that your wishes are understood and will be respected.
As for the other things, unless you are a danger to yourself or the staff, they can't physically restrain you in any way (i.e. making you get in bed). Be prepared for them to march in an army of people to try to convince you to do things though. Some hospitals will trot out nurses, peris, pedis, OBs, anesthesiologists, case managers, etc to "explain" their policies and get you to follow them.
I don't mean to sound alarmist, I really don't. But, my mom is a senior administrator at a hospital and I've heard her talk about using all of these techniques to get patients to "comply". Not necessarily obstetrics patients, but they same rules apply no matter what you're there for. Just be educated about your hospital and their policies so you can be prepared to refuse things you don't want.
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There are three ways they can legally make you do what they want: 1) You are unconscious or in a state of emergency where you cannot make decisions for yourself - they are then legally obligated to treat you the way they feel is best, even if you have previously instructed them not to do certain procedures. A "birth plan" is not legally binding enough to stop them from doing things if you are unconscious -- only something like a living will that has been notified would do. This is an example of a c/s if you start to bleed out and lose consciousness -- or a hysterectomy if you've already had the baby and other methods to control the bleeding have failed.
2) You are deemed to be making a choice that will cause imminent danger of death or severe injury to yourself, your baby, or another person. They would need to be able to prove in a court of law that your actions would have caused something this severe. So it's not going to apply to something as mundane as refusing to stay in bed or refusing an IV.
3) The state has declared a state of emergency or public health epidemic. Think the movie "Outbreak" - if there is a large scale emergency crisis (like an earthquake that kills thousands and injurs millions), they have the right to triage and fully manage your care the way they see fit -- again, this isn't going to happen in routine labor.
They can refuse to treat you if you refuse to sign their contract/consent to services, or if you make changes to it that they don't agree with as long as they can prove that failing to treat you will not result in imminent danger to you (ie. if you are in early labor, they can refuse to admit if you won't play by hospital procedures - though this is unlikely). They can also forcibly transfer you to another hospital if you won't follow procedure. Again, only if the transfer can be done without harm to you or the baby - and you will be fully responsible for the cost of the transfer.
These are unlikely situations, but just to let you know that they legally could do these things if they chose to. Most likely they will pressure you and give you a hard time, and possibily be rude to you, but that will be the extent of it.
In my experience with surgery consent forms, I have crossed out sections and added verbiage, such as "I do not consent to company reps being present in the OR" (this was for foot surgery). I always point out any additions or deletions I've made to the standard forms.
When in labor it can be hard to think clearly if forms are shoved in your face. Be sure your birth partner is fully aware of your wants, so s/he can be your advocate and point out wording in a consent form that you wouldn't want.
And I fully agree with the poster above who said if you're told you "have to" do/have something due to "hospital policy," just ask to see it in writing.
It seems to depend entirely on the hospital. I would say tour as many hospitals in your area as possible and bring a list of questions to ask. On my tour last night, I was very encouraged because the guide flat out said, "The hospital won't MAKE you submit to any procedure that you don't want. It's not standard policy to do IV, continuous monitoring, etc. And you can always say no."
I wrote that down on my notes and circled it "You can always say no." Also, it helps to find a nurse that supports your plan. Our guide recommended that when we you check in, to let people know that we are planning a birth with as few interventions as possible, and we'd like to be matched with a nurse who shares our philosophy. The nurse will ultimately spend more time with you than the Dr., and in many cases is your primary link to the Dr.
Hope that helps.
This is great advice. I never thought of doing that with my first. Of course, it was my first time so I didn't know the ropes yet but I'm definitely going to get the papers that I had to sign upon admission (luckily, it was a scheduled induction so I wasn't in the throes of labor while trying to fill out paperwork) at the hospital tour this time around. Then I can take my time to read every word, call the hospital with questions beforehand and then bring a signed copy to the hospital with me.
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)
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