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Military hossy's and declining interventions.

post #1 of 32
Thread Starter 
I'm asking this question for my sister who is due at the end of July. She is military and will be delivering in a military hospital in Georgia. She is taking child birthing classes through the military and is having some major reservations about the hospital. First her military midwife (I use that term loosely she is an OB wannabe) said she WILL be there for the birth, now she is finding out in the childbirth classes she only has a 10% chance of getting her midwife. In the begining they were also told that the hospital would bend over backwards to follow birth plans, now she's finding out that there are a bunch of stipulations on that. Such as they don't respect birth plans that are made without research cited, birth plans printed off the net are ignored (because ya know Mom didn't read and agree with the bp she just printed it out without reading it), etc....

The nurse giving the classes was asked questions about how are birth plans followed if you end up with a new doctor. Many questions were asked about declining routine interventions such as, refusing eye ointment, delaying cord clamping, declining episiotomy, no IV etc. The nurse pretty much said that it's up to the OB, if the OB doesn't want to delay the cord clamping then he won't and that this is what you get in a military hospital with a 'too bad so sad' attitude. When my sister brought up declining eye ointment the nurse said, "we don't do that here, it's state law and it's military hospital policy there is no way around it".

So is the nurse right? Can you decline these procedures in a military hospital or is it pretty much the same as a civilian hospital? To me if I say I don't want the cord cut and they do it anyway that is battery. I don't care what kind of hospital it is.

The nurse was getting very annoyed at all these questions and my sister is becoming scared she won't get her natural birth.

My sister never put money aside for a doula because her midwife told her "it would be overkill because you have a midwife for care provider and I'm into natural birthing" (this was in the begining before we knew otherwise) Money is very tight and she can't hire a doula. As of right now she has no one down there to be with her for the birth (her DH and other friends who were in her unit are deployed). I'm going to try to be down there for the birth but any suggestions for her going it by herself? (I already told her a doula would be worth double her weight in gold but I think she is very unable to pay for that atm).
post #2 of 32
I have heard horror stories about trying to have a natural birth in a military hospital. It sounds like this one is especially awful. If she has any way of switching providers, especially to a birth center or homebirth midwife, that might be an excellent choice.
Barring that, I would say she needs to get a doula in there if she wants to have any chance at a natural birth. There are some programs that provide free or low cost doulas. If you post in the finding your tribe area, you might be able to find one.
If she's there totally alone with no one to advocate for her, she's very likely to wind up with all the interventions. It's incredibly hard to advocate for yourself during labor.
I'm sorry. It's such a sucky situation.

ETA: You might contact the Georgia Birth Network and beg for help.
post #3 of 32
If her dh is deployed she can get a FREE doula through Operation Special Delivery.

http://operationspecialdelivery.com/
post #4 of 32
I am surprised to read the replies. I had my oldest four in military hospitals and had no issues. In fact, I have found that without the constant threat of malpractice looming overhead that they are MORE relaxed. I had no trouble finding a military OB who was happy for me to VBA2C etc etc. I loved delivering in military hospitals for the most part...
post #5 of 32
I was born at the Ft. Stewart GA base in the early 80s, my mom said back then you had no choice but to go all natural. If you wanted an epidural or induction you were told to suck it up and deal with it. Funny how things change!
post #6 of 32
Thread Starter 
You ladies are a LIFESAVER!!! OSD sounds perfect. I called my sister and she is very excited.

Actually it's the hospital on Ft. Stewart that my sister is delivering at. Winn Army Community Hospital if I remember right.

Dancindoula would a doula working for OSD be offended if I did end up being able to get down there in time for the birth? I live 14 hrs or so away and while I'm going to try VERY hard to get down there in time there's a very real possibility I may not.

And how can you 'buck policies'. I mean if she goes in there and she wants intermittent monitoring. Can't she just refuse constant monitoring, can't she just unhook herself from the monitor if they won't listen? I guess I just don't understand how just because they are military they have complete say over your body. What will happen if she does refuse a 'policy'?
post #7 of 32
So much depends on the hospital CO. There isn't a uniform maternity policy across the armed forces.
Here in SA the hospital with the highest VBAC rate is Wilford Hall (Lackland AFB). Two of the most beloved CNM's in town are both retired AF.
What one experiences in one military hospital won't necessarily be the same experience somewhere else-just like civvy hospitals. Some are natural friendly, some really aren't, unfortunately unlike civilians, she doesn't have the option to take her business elsewhere.
post #8 of 32
A woman in my parenting group had her oldest son circumcised without her consent when she gave birth in a military hospital. She had a normal vaginal delivery and a healthy baby, but was still separated from him for 6 hours after birth during which time they did the operation.
post #9 of 32
Hi- former military spouse and doula who has worked at a MTF here. I don't understand why civilian women in military hospitals believe the nonsense that military care providers tell them. She is not in the military, they can not tell her what to do anymore than a regular doc could. She did not sign away her rights to the military, her husband did and because he did they have to provide medical care for her. And they CANNOT do any sort of disciplinary action against her DH because SHE refuses treatment, no matter what they say, AND if someone were to threaten either of them with that c&#p, that person could get in a lot of trouble for it. (sorry, I've heard that one way too many times!)

She can decline anything she wants to in the military hospital, just as she could in a civilian hospital. If there are state laws about nb procedures there are usually just waivers to sign off on, the same as any hospital does (though you should be able to find more about GA state law for that on the Finding your tribe boards). She can actually sign those waivers before she gives birth and have them put in her file. Tell her to go down to Peds at the MTF, tell them she's giving birth there and she wants to decline certain nb procedures and wants to fill out the waiver now, though her MW should be able to get those for her. Just realize that in MTFs, there are many many births, the corpsman are on AUTO PILOT so if you don't want something done, remind them you are declining it WHEN they are messing with the nb after the birth because they will forget, though I think that's true of most CPs. The BEST way to avoid any thing being done to your nb is to not let her our your arms, all those nb assesments, with the exception of weight, can be done while baby is on mom, and they can weigh the baby when mom goes to pee! It's just a PIA for the staff, so they tell you the "can't" or "it'll just be a minute" which inevitably turns into 15. I think this is probably true of most hospitals, as well.

MW in MTFs can have "private patients" just like any other care provider. She should probe her midwife about it, ask her how the MW will know if she comes to the hospital in labor if the MW is at home, etc. The midwife would most likely give your sis her home # or put a note in her file specifically saying she wants to be called when your sis comes in, if she truly intends to be there.

Her OSD doula will be fine with having you there! An OSD doula is just a regular doula who has decided to waive her fee for a military family in need. She is still working for your sister.

And as for the person who had her baby circ'ed without permission unless SHE is active duty military (and honestly, because it was something done to the BABY, I'm not sure if that would even matter anyway) she can and should sue for that. A military doctor can be sued by a civilian patient and they are scared of it, because if you are a military doc who loses a suit like that, you don't just get a raise in your malpractice premiums-you get kicked out of the military.

HTH!
post #10 of 32
Thread Starter 
Quote:
Originally Posted by Banana731 View Post
Hi- former military spouse and doula who has worked at a MTF here. I don't understand why civilian women in military hospitals believe the nonsense that military care providers tell them. She is not in the military, they can not tell her what to do anymore than a regular doc could. She did not sign away her rights to the military, her husband did and because he did they have to provide medical care for her. And they CANNOT do any sort of disciplinary action against her DH because SHE refuses treatment, no matter what they say, AND if someone were to threaten either of them with that c&#p, that person could get in a lot of trouble for it. (sorry, I've heard that one way too many times!)


My sister IS military. Both her and her husband are in the same unit. That unit is deployed atm, which is why neither her DH nor her friends can be there to help her out, they are all currently in Iraq. So now you have me wondering can they do some sort of disciplinary action against her or is it like a normal 'civilian' birth?
post #11 of 32
Quote:
Originally Posted by harli View Post
You ladies are a LIFESAVER!!! OSD sounds perfect. I called my sister and she is very excited.

Actually it's the hospital on Ft. Stewart that my sister is delivering at. Winn Army Community Hospital if I remember right.

Dancindoula would a doula working for OSD be offended if I did end up being able to get down there in time for the birth? I live 14 hrs or so away and while I'm going to try VERY hard to get down there in time there's a very real possibility I may not.

And how can you 'buck policies'. I mean if she goes in there and she wants intermittent monitoring. Can't she just refuse constant monitoring, can't she just unhook herself from the monitor if they won't listen? I guess I just don't understand how just because they are military they have complete say over your body. What will happen if she does refuse a 'policy'?
As to your first question, I can't imagine a doula being offended at your presence! I'm sure she would be delighted that you made it.

As to the second, I guess I worded that pretty poorly. I meant that it is difficult for even a willing midwife buck the policies governing her actions in a military hospital. Mind you, I can only speak from what I have witnessed and YMMV from base to base.
post #12 of 32
Quote:
Originally Posted by harli View Post
My sister IS military. Both her and her husband are in the same unit. That unit is deployed atm, which is why neither her DH nor her friends can be there to help her out, they are all currently in Iraq. So now you have me wondering can they do some sort of disciplinary action against her or is it like a normal 'civilian' birth?
No, she is still a patient when she is at the MTF giving birth. She still has most of the same rights as a civilian. She can't sue the military. She can't refuse Tx if it's mandated by the military for it's own operating purposes (like vaxes, or physicals-things that "affect the mission" so to say) but birth isn't the purview of the armed forces. If she went in for a sinus problem she wouldn't automatically have to take a certain drug or have sinus surgery, she would have a say in her treatment, as she does now. She should have her CP sign off on her birth plan, and make sure there is a copy in her file, and bring a signed copy with her. And the nurses may say it's up to the "OB" but realistically, in this day and age the things that your sis probably wants (intermittent monitoring, vag exams upon request, freedom to move around, delayed cord clamping) are not unreasonable or out of the ordinary. So the constant monitoring is a function of what the nurses want. I have been told as much by the officer who was the head of the nursing dept at my MTF. They are understaffed for nurses, just like most hospitals and it's easier for them to be able to be to have everyone on the monitor all the time. Again, pretty common anywhere.

Having a doula will be her best asset in this whole process. She should stay home as long as she possibly can, that will help her avoid many of the interventions that she's trying to. Even if OSD can't find a doula for her, there is bound to be someone around who is in need of births for certifying or even experience for a low cost.

I would remind her that she should not be intimidated by the hospital staff, that when she goes there to have her baby, she is not at work, she is a patient. And that the staff is essentially working for her, even if they outrank her. If the Army Medical Corps (it is Army, right?) is anything like the Naval Medical Corps then patient rights and customer service are a big deal there, and they place a pretty high priority on it.
post #13 of 32
Are there any military hospitals around where you live or other family members? If not it, could be a good thing. A family friend is in the Coast Guard and when she got close to her delivery time she went TAD to a unit near her hometown. She said there is some rule that allowed her leave so she could be near family when she gave birth. There were no MTFs nearby so she gave birth in a civilian hospital with a civilian doctor. DH is also in the Coast Guard and we also were able to go home for the birth of DD.
post #14 of 32
As far as refusing vaxes and whatnot...I thought that because the BABY isn't military that they can't force things like that on him. They can say, "We'll do XYZ to you" but not to the child...
post #15 of 32
I have a friend down in GA at the moment and the general area where she is giving birth needs to be looked at.

1) Homebirth midwives are illegal there. Many practice under the radar, but it is illegal.
2) there is very very little natural birthing, almost no birth centers, very little breastfeeding and other "crunchy" things that go on in public eye down there.

For wahtever reason its just a region of the US that is still very much not "crunchy".

It drvies my friend batty. She is the only person she has ever seen breastfeeding. Everyone formula feeds.

So when she is down there asking for things like limited fetal monitoring, vag exams, delayed cord clamping etc she is asking for things that in their eyes are very foreign.

I'm not saying its right, and change has to start somewhere but that she will need to put up a fight to get what she wants. Even ebing in the military she has rights. Its not like she's refusing care, she is just askig them to change it provided things are going smoothly.

Tell her to hang in there, stay home as long as she can in labor and be prepared to stand her ground.

Now also I thought as of recently when a military family has children the member who is going to primarily take care of the kid has to leave the military. Tht they are trying to prevent children from having both parents being gone? I know they will not allow both parents to join the military if they already have kids... how does it work when having your first?
post #16 of 32
Quote:
Originally Posted by turnquia View Post
Now also I thought as of recently when a military family has children the member who is going to primarily take care of the kid has to leave the military. Tht they are trying to prevent children from having both parents being gone? I know they will not allow both parents to join the military if they already have kids... how does it work when having your first?
No, they don't require that one parent leave the military with the birth of a child. They just have to have a detailed care plan in place in case both members get deployed at the same time.

Again, since your sis is military and an unlicensed person attending birth in the capacity of midwife is illegal according to state law, your sister CANNOT use one of the underground midwives. If she does and is caught, she can be charged with "conspiracy to commit a crime" under the UCMJ. I have this cousel from an Air Force JAG officer.

I agree, staying home as long as possible is the best thing your sister can do, followed by having an advocate there (doula, etc) who is familiar with military hospitals, if possible. It is sucky, I know. And there is a thin line between patient "rights" as a military person and being required to follow orders in the medical care she receives because she is property of the US government. A woman I met who was in the military was ordered to have a cesarean performed, although the circumstances surrounding it were not cut and dry. She had no choice, under the UCMJ she has to follow orders.

I don't know whether it would be best to stay as low profile as possible and not raise the possibility that some military doc would take upon himself to make sure that she stays in line, or to go in actively advocating on her own behalf for the birth she wants. One thing is certain though - after the birth, the baby is NOT a military member but a dependent. As such, the doctors CANNOT require your sister to perform any newborn procedures that she doesn't want. What they do to your sister's body is a little less clear in terms of can and can't.

Good luck to your sister!
post #17 of 32
PM'd you, harli, with one more detail.
post #18 of 32
I also wanted to add... could she cross the line to florida and just birth there? Its legal there I'm not sure on where she lives and how close to state lines or is she required to go to the military hospital? Because maybe she could look into TN or Florida for birth options. Since midwifery/homebirths are legal there.
post #19 of 32
Or she could see if she can Tricare to change her provider to the the birth center in Savannah. 40 miles away according to google maps. Not sure if they would have to comply though, since she already has access to a "midwife" at their hospital. If she pushed her right to choose the location (birth center), they might transfer her.
post #20 of 32
This was five years ago and in SanDiego's MTF but I gave birth with just my doula while DH was deployed.It was a coerced induction and even though I had a birth plan( one page and several copies) signed off by my OB, and I had written on my admission forms what I agreed to it was thrown aside.My doula did help unhook me from some of the monitors so that I could use the restroom like a normal person.The nurse was not pleased that she had to come in and adjust the monitors because my labor was going so fast.my baby was given shots and bathed within minutes of being born and then the nurse said oops when he realized that was not supposed to be done.The whole hospital stay was awful and yes I filed complaints and nothing was done.I had a healthy baby.
I now know to make sure I have someone with me for the labor and someone to watch my baby and it's what I strongly encourage any mama to do especially at an MTF.I have also noticed that service members are treated kind of roughly compared to civilians.
If she can even just get a couple of mama friends one to watch her and advocate for her and one to watch the baby it would be great.
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