Should I worry about signing an AMA?

[mrsdocmartin]

My midwife is being very cool about us not taking the abx for strep b, but said that if we get to the hospital in time to have abx (I'm hoping we don't!!), then we'll have to sign an AMA saying we refuse treatment. Should I be concerned about this??

[MegBoz]

I don't think you should be. You might have to sign such things to refuse other typical interventions, like Hep B fax & eye goop, that make perfect sense to refuse. I don't think it's a big deal.

But what you do have to worry about is that when you're GBS+ and get no ABTs, they want to keep the baby 48 hours for observation. This is a pretty standard recommendation from (I forget, some big pedi org), so I didn't think it was worth fighting. It's pretty stupid since early-onset-GBS shows signs in baby within 24 hours like 90-some% of the time (whereas late-onset-GBS can not show up for weeks)! But, ya know, whatever, not like we ought to be expecting evidence-based medicine anymore!

So just something to think about with arranging with your pedi for discharge of baby.

[nia82]

Depending on the hospital they might want you to sign a waiver, similar to the vitamin K shot and eye goop waivers. The peds that are on call might bug you, but just be prepared.
I did have the GBS test and it was negative, but by the time I arrived at the hospital they didn't have the results back and wanted to hook up IV abx right away, which I refused. We made them get our results. Anyways, they were somewhat pushy about it, but after saying no get the results they left it alone.

[mrsdocmartin]

Originally Posted by MegBoz

I don't think you should be. You might have to sign such things to refuse other typical interventions, like Hep B fax & eye goop, that make perfect sense to refuse. I don't think it's a big deal.

But what you do have to worry about is that when you're GBS+ and get no ABTs, they want to keep the baby 48 hours for observation. This is a pretty standard recommendation from (I forget, some big pedi org), so I didn't think it was worth fighting. It's pretty stupid since early-onset-GBS shows signs in baby within 24 hours like 90-some% of the time (whereas late-onset-GBS can not show up for weeks)! But, ya know, whatever, not like we ought to be expecting evidence-based medicine anymore!

So just something to think about with arranging with your pedi for discharge of baby.

The neonatalogist at our hospital clears babies after 36 hours if the cord blood is clear. When you say observation, that just means we both stay that long though, right?