Question about refusing continuous EFM - Page 2

[phathui5]

Originally Posted by Kelly1101

That's what I'm wondering. Would they try to physically hold you down? That's crazy.

No. Generally, when you refuse to consent to something they want to do, they lecture you about how much safer it is for the baby. If you keep refusing, they surrender but keep occasionally asking throughout labor.

[mrsberman]

This may be a little off the original topic, but what about withholding the baby as "emotional blackmail." When my SIL gave birth, she wanted the placenta to come naturally and the dr said she couldn't hold my niece until it was out. So she caved and took the pitocin so she could hold the baby. I thought it was a little outrageous they could do this.

[Turquesa]

Originally Posted by mrsberman

This may be a little off the original topic, but what about withholding the baby as "emotional blackmail." When my SIL gave birth, she wanted the placenta to come naturally and the dr said she couldn't hold my niece until it was out. So she caved and took the pitocin so she could hold the baby. I thought it was a little outrageous they could do this.

I've heard of similar practices using your baby as blackmail. Why is it that only in a hospital setting, somebody can basically abduct your own child? Why is it that access to your baby--both a legal and fundamental right--is framed as a privilege instead of a right? Fortunately, with EFM, there's no baby yet, and therefore no blackmail leverage. Although I suppose that as a "difficult" patient (i.e. one who asserts her rights) you could be punished after the fact...

[peainthepod]

Two words: medical battery.

Throw that term around and they won't lay a single finger on you without your consent. It carries with it the pungent, distinctive odor of no-holds-barred lawsuits and possibly criminal charges if the offense is grievous enough. Patients rarely know about medical battery, so use that to your full advantage. Submit your birth plan in writing and if they violate it, depending on state law, they will rue the day they decided to tangle with you.

Virtually all states have recognized, either by express statute or common law, the right to receive information about one's medical condition, the treatment choices, risks associated with the treatments, and prognosis. The information must be in plain language terms that can readily be understood and in sufficient amounts such that a patient is able to make an "informed" decision about his or her health care. If the patient has received this information, any consent to treatment that is given will be presumed to be an "informed consent." A doctor who fails to obtain informed consent for non-emergency treatment may be charged with a civil and/or criminal offense, including a battery, for the unauthorized touching of the plaintiff's person.

More info here, here, and here.

No one can legally make you have EFM, continuous or otherwise, against your wishes. Have a good advocate and don't let them bully you into anything you're not comfortable with. (Easier said than done, I know.) Good luck, mama.

[HappyMommy2]

Ahhh, but the docs and nurses are craftier and more manipulative than this. They catch you at a weak moment, and make you think that your baby is dying. It is very difficult to stand up to that plus labor at the same time.

Preparing and knowing your rights is very important!

I once had a very honest midwife in a hospital setting tell me this. Oh yes, you can of course refuse anything you want. BUT ... there are so many tactics like fear, shame, power, etc. that multiple people will use to try and get you to do it. They will take your DH in the hall, and scare the crap out of him, in order to get him to try to convince you too.

[peainthepod]

Oh, definitely. That's why having a strong, no-nonsense advocate is so important.

[owlgirl]

Coming from the 'granola bulldog RN' perspective, funny I have never heard that. I think I'm rather a natural birth advocate assisting my fellow sisters on the fronline, none-the-less.....I would STRONGLY advise you not to play games. I think the best advice was to copy ACOGs standard of cEFM and show your OB. We here only do cEFM for high risk labors. Otherwise its every 30 minutes, I use a doppler and listen after a UC. I can do that in the shower, jacuzzi, on the toilet, anywhere. I also agree that generally it is the MD on call who calls the shots and writes the orders. I don't think having your OB sign your birth plan will do much. You can always not consent. Period on that one. And you should. Sometimes insurance will not pay if you do things AMA, I don't think this would apply to cEFm but I know it does apply in some situations.

Can you switch to a family practice doc? An OB for a low risk labor I don't like to begin with. I am sorry to hear of your situation. Keep us updated!

[birthjunkie27]

Thanks for all of the replies, everyone! I appreciate it.

Unfortunately my options for care providers are limited as I am on state aide for this pregnancy (which is the ONLY reason I'm even having a hospital birth... I can't afford to pay a midwife out of pocket and with my last homebirths I was on insurance that covered my homebirth friendly family practice).

[Pat899]

Originally Posted by MegBoz

I think you've gotten some great advice already - especially "find the granola bulldog" nurse.

call, whoever he is, won't be around much during your labor? So how will he evenThe only thing I wanted to add was that, isn't it pretty likely the OB on know? Seriously!

So as long as you have a birth plan, signed off on, that says "intermittent" & the nurse assigned to you is OK with that, I would think you'll be fine. (Now, during pushing phase, it's a different scenario, but I personally didn't mind continuous EFM during pushing - a nurse held it in place so I didn't have to wear the belt.)

You OB might very well have the EFM app on their Iphone. Many do. And they would know right away if your tracings stopped. Just be aware that even though they are not there many are electronically connected to what is happening.

[Kitten]

The whole "insurance won't pay if you AMA" is a myth. Someone posted a link a while back to a medical journal -!ournal of Emergency Medicine perhaps- that published a study which concluded that it is a myth. The authors said they weren't sure if medical personnel really believed this were true, or if it was emotional blackmail to get patients to do what they wanted them to do. Wish I'd kept the link. It really ought to be made a sticky.

[Sudonk]

Originally Posted by mrsberman

This may be a little off the original topic, but what about withholding the baby as "emotional blackmail." When my SIL gave birth, she wanted the placenta to come naturally and the dr said she couldn't hold my niece until it was out. So she caved and took the pitocin so she could hold the baby. I thought it was a little outrageous they could do this.

That is horrible. That actually happened to a friend of mine, but she has a major Mama Bear streak and actually laughed at the doctor who said it. She just looked at her husband and said, "Honey, please get our baby or call an attorney." The baby was on her chest seconds later. But it still angers me that she had to go there to hold her own kid who was still attached to her!

[owlgirl]

Originally Posted by Kitten

The whole "insurance won't pay if you AMA" is a myth. Someone posted a link a while back to a medical journal -!ournal of Emergency Medicine perhaps- that published a study which concluded that it is a myth. The authors said they weren't sure if medical personnel really believed this were true, or if it was emotional blackmail to get patients to do what they wanted them to do. Wish I'd kept the link. It really ought to be made a sticky.

If you find this please do make a posting of it. I am abhorred by some of the stories out there re:emotional blackmail, etc. I knew when I became a RN it'd be only very special places I could work at. They have been (as much as they can for a hospital). Just a note that floor staff is often, usually, very removed from the insurance piece of healthcare. I am not sure if the insurance not paying if you pull an AMA is a myth or not. I know I was told that where I work when a situation arose, that insurance wouldn't pay. There wasn't emo blackmail going on. Much consulting with the house sup and manager was needed to figure it out. I wonder if it is state by state? Either way I never thought of it being used in such a horrible way before, yikes!!

[mrsberman]

Originally Posted by Sudonk

"Honey, please get our baby or call an attorney."

LOVE it! I wish I had the guts to say something like that. I don't think I'll have to worry, as long as I'm able to go to the hospital I want.