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Signing a baby out AMA....ILLEGAL???? - Page 2

post #21 of 60
Quote:
Originally Posted by Moon
I have found that it really is all in how you approach this subject with the family. If the ped or hospital social worker barge into a room and treat a family like they're a bunch of inconsiderate idiots, well, that's just asking for an outraged family. But if you gently explain that this is a mechanism that the hospital must engage to ensure the safety of babies and is in no an indictment of a parent's intent or ability to be a nurturing parent, most parents handle this little hiccup pretty well. I agree with an above poster that it's important to realize that a hospital has an obligation to ensure that a baby is safely discharged to the parents, and there are certain procedures that the hospital must adhere to legally...because there are, sadly, families that are not as thoughtful or as prepared as yours. I've seen some yucky stuff, and it's a shame that other families get lumped in with that.
No matter how gently it is explained, it is still an insult. Parents should be free to do as they wish UNLESS there are red flags, not restricted until cleared by an authority. As a society that values liberty, it should be horrifying to us that we routinely cast suspicion on innocent families in order to screen for the ones that will neglect or abuse their children.
post #22 of 60
I'm with Lady Lilya. Under this policy, you're considered guilty until proven innocent. Very unAmerican. I'm glad I'm not having any more kids, and that I never had a hospital birth. How screwed up this system is. Hospitals get to kidnap babies. I'd refuse to pay any bills for anything past the point of wanting to leave with my child, and I'd add that to every form I signed ahead of time.
post #23 of 60
Quote:
Originally Posted by Lady Lilya View Post
No matter how gently it is explained, it is still an insult. Parents should be free to do as they wish UNLESS there are red flags, not restricted until cleared by an authority. As a society that values liberty, it should be horrifying to us that we routinely cast suspicion on innocent families in order to screen for the ones that will neglect or abuse their children.

I couldn't agree with you more, and I find it very frustrating to be in situations where I am called to assist in these kinds of matters. It is an insult and it is horrifying at the core to know that most rules/laws are made because someone else truly screwed things up in the past and may have nothing to do with the current situation.

My only point is that a hospital is confined to the parameter's of a state's law. Just because the hospital is mandated by law to contact the dept of social services DOES NOT mean that it is okay to treat the family like crap in this matter. Because the social work that I practice does not routinely cast suspicion on innocent families. It is a crummy spot to be in, as a parent, and the very least that hospital staff could do is treat the family with respect and understanding while they adhere to their mandate...
post #24 of 60
Quote:
Originally Posted by lotusdebi View Post
I'm with Lady Lilya. Under this policy, you're considered guilty until proven innocent. Very unAmerican. I'm glad I'm not having any more kids, and that I never had a hospital birth. How screwed up this system is. Hospitals get to kidnap babies. I'd refuse to pay any bills for anything past the point of wanting to leave with my child, and I'd add that to every form I signed ahead of time.
Eeeeps, I suddenly find myself in a very awkward position of speaking for the hospital here, which is not how I expected to spend my first day posting on these boards.

The hospital is not kidnapping the baby, and that sounds like an inflammatory thought. The hospital is adhering to the state law. CPS and the court system are the entities responsible for determining when a change in custody must occur. The hospital is merely adhering to a state-established mandate. I get that hospitals have some VERY inane rules (as a social worker in one, and as a gal at 32 weeks who has been microscopically creating her own birth plan to counter some of the birthing obstacles a hospital-based birth presents), but in this sort of circumstance, it's not the hospital creating the rule or "kidnapping."

In my experience over the last decade in both roles (CPS and hospital social worker), I have NEVER seen a removal of custody based on this kind of circumstance--healthy, thoughtful, prepared parents without any kind of history. Not once.
post #25 of 60
Moon, I understand perfectly well that you are not a hospital. You just have inside info about how they work, and how they work with government agencies.
post #26 of 60


Whoever told you that is wrong. I live in CA and checked my son out and myself AMA when he was 6hours old from a hospital *he was born in 2006*. They just try and scare you about needing to do blood work that you can can come back the next day and do it.

post #27 of 60
i realize this was 10 years ago, but my aunt was a homebirth transfered to hospital for a c/s in california. she signed herself AND baby out of the hospital 2 hours post op. i know she never got CPS called. and it was TOTALLY AMA.
have you posted this on the tribe boards for cali? someone there may have somemore insight about how true this threat really is.
if it deems to be as serious as you fear, i would either try to find a ped and jsut play the hopital game or look into a homebirth.
post #28 of 60
Thread Starter 
Quote:
Originally Posted by Irishmommy View Post
So it's not actually ILLEGAL it's just against hospital policy?
Essentially the hospital and all of the ones in the area that I have spoken to say they will report it to CPS and refuse to "allow" you to leave with the baby.
post #29 of 60
Thread Starter 
Quote:
Originally Posted by elisheva View Post
What was it Navelgazing Midwife said a while back? "If you buy the hospital ticket, you go for the hospital ride."

This isn't a battle I personally would fight. If having babe home soon is that important to you, can you look into a homebirth? Otherwise I think you need to make peace with their policies. On CPS' radar is *not* someplace you want to be.
I would love to have the baby at home but cannot afford it, so I don't have that option. With that being said i do not believe that should limit my "rights".
post #30 of 60
Have the baby at home. There are plenty of good midwives in CA. It is worth the extra $. Do not let the insurance companies decide where you will have your baby.

Somebody along time ago posted that a woman was able to sign herself and her baby out AMA after much back and forth rig-a-moro with the staff of a small hospital when the hospital presented the new mother with a special form; a Disposal Of Dead Infant Form to sign. In the story, the mother signed it and left.

When you are in the hospital, you are on their turf; much will depend on what hospital you are at, who your paediatrican is, and who is in charge of the ward at the time.

A hospital is an institution with rules that benefit it, not you.
post #31 of 60
Quote:
Originally Posted by elisheva View Post
What was it Navelgazing Midwife said a while back? "If you buy the hospital ticket, you go for the hospital ride."
That's awesome!
post #32 of 60
Quote:
Originally Posted by alicia9178 View Post
I would love to have the baby at home but cannot afford it, so I don't have that option. With that being said i do not believe that should limit my "rights".
You're right. It shouldn't, but it does. This is partially what comes from handing our country over to corporations (I'm an American living in Canada but speaking now as an American) - they make rules to benefit their bottom line and avoiding lawsuits is one of their biggest goals.

I don't know about CPS in CA but, honestly, the idea that they could take your baby or start to make trouble for your family would scare the crapola out of *me*. Guess I've been reading too many stories along these lines lately.
post #33 of 60
I was told the same thing. I found, though, that all I had to do was to tell them I WAS leaving at lunch time and I had to get the pedi in there by that time. It may not work for everyone, but I just kept on them and they finally gave in. The pedi gladly signed the discharge when I told him we were leaving. The only hesitation came from the OBs. But they finally gave in and signed me out, but noted that it was against their better judgement.
post #34 of 60
Quote:
Originally Posted by MoonHasBeams View Post
In the hospital where I work, it's pretty common that a mom and baby can be discharged after 24hrs after an uneventful vag delivery, pending no other subsequent baby issues

<snip>

There have been instances in which a mom wishes to discharge with her baby <24hrs, and the ped usually consults me to chat with the parents about their desire to leave in this "quick" timeframe (for hospital-based births). It's true, I am mandated by hospital policy to notify the dept of social services where the family lives.

<snip>
this is a mechanism that the hospital must engage to ensure the safety of babies
Ok, so am I understanding correctly that you do NOT have to have a "chat" with any family who does NOT wish to leave early?

If yes, so, in other words, families who keep their mouths shut & don't request to leave any sooner than normal aren't subjected to this mini "investigation." Right?

That has got to be one of the stupidest things I've ever heard.

It's like a "net" to catch potentially abusive/neglectful parents, but a net with such massive holes that you'll rarely catch anyone in it - if you're only screening parents who request to go home early! Shoot, if I were abusive or neglectful, I'd do my best to stay off the radar & would be LESS likely to request anything out of the ordinary, like early discharge!

I know such a 'chat' isn't a big deal. And I THINK we had a social worker chat with us too in the hospital as first time parents. But it was a standard thing for everyone and, at least in my perception, it was more to HELP us & answer any Qs we had about resources & assistance we might want/need, than it was to "check up on us" to make sure we wouldn't be abusive. It wasn't "checking us" to see if we were fit parents. BIG DIFFERENCE, IMO.

Just the IDEA that to request something so normal & what should be typical as discharge <24 hrs "requiring" a "check up" ticks me off. I"M NOT A CHILD! This is MY BABY & I shouldn't be "investigated" unless there is good cause. And I sure as shouldn't have to wait to "pass" - wait for "approval" before leaving with a healthy newborn in <24 hours.

(Sorry, Moon, I know you are just the messenger - I'm expressing outrage at the State's policies, not you personally. I'm sure lots of families are lucky to have your assistance!)

Quote:
Originally Posted by Lady Lilya View Post
Parents should be free to do as they wish UNLESS there are red flags, not restricted until cleared by an authority.
Exactly! Well said! You expressed how I felt in a much more succinct & eloquent manner. Yeah -> that!

All this being said, I was GBS+ with my DS & didn't have time for antibiotics, so standard is to stay 48 hours. (Which is stupid & not evidence-based since early-onset-GBS infection shows symptoms within 24 hours in 90-some% of cases, whereas LATE-onset-GBS infection can not show up for 3 weeks. So, 24 hours should be the limit, but, ya know, whatever, to heck with science & stats. )

I decided not to fight it.

It wasn't that bad. Really wasn't. Nurses were awesome, room was HUGE & plenty of seating for my many visitors. They even had the paperwork ready to go so we could walk out the door at 48 hours on the dot. Yeah, the food was bad, but DH brought me stuff. It was nice having help cleaning meconium diapers. & as a FTM, having someone show me again how to swaddle.

Again, I was in the hospital for 48 hours & it really wasn't that bad.

There were other tiny perks too - like a free massage! Having the birth cert & social security paperwork taken care of is another bonus & chores I'm not looking forward to with my upcoming HB. So, overall, I'd try not to sweat it too much if you're stuck a bit. You got some fantastic ideas from MoonHasBeams on how to make it happen, but if you're still encountering problems or just decide it's not worth the hassle, then really, I don't think being stuck is all THAT bad if it's a decent hospital.
post #35 of 60
The thing is when your requesting to leave early with so many "risk" factors that could affect baby then it does appear to potentially be abusive or neglectful to hospital staff and social workers.

If your GBS positive and you refuse treatement no Pediatrician will discharge early because they want to watch for a possible GBS infection. 48 hours being CDC guildelines for this, plus labwork. IF a pediatrician were to sign a baby out willingly BEFORE the 48 hours and your baby dies of a GBS infection... it will be aweful for you, but that doc will also face large ramifications from the early discharge. They will face not only a lawsuit from you potentially, as well as potential loss of their license, as well as could face criminal charges for doing something that isn't considered a safe standard of care. So, yes if you sign out AMA you protect hospital and doctor from liability but doesn't mean that it doesn't appear neglectful if your kid could have an issue. Now if it was for JUST GBS and baby was over 37 weeks, and you recieved BOTH doses of antibiotics then you may be able to get a ped to sign an early release. But adding in the GD and your history of prematurity (if baby is born at 36 weeks) I'm not thinking you'd find a ped willing to do an early release and maybe not one before 48 hours if you have ALL of that going on. (Not sure on protocols reguarding GD or prematurity).

Heck we cannot afford a homebirth either but will be making it happen somehow. In my hospital twins are mandated to be delivered in OR, they just automatically will do a breech extraction for 2nd twin, require epidural, etc. Or OB's won't attempt a vaginal delivery. They also mandate ALL twins go to the NICU for observation... even if they are born full term, good weights and doing well. Just because there was two of them. So we're choosing to have a homebirth and toughing out the money situation so we can hopefully have the care that we feel is acceptable reguardless of how many babies are in there.

If you still decide for the hospital birth and stay the 24 hours, enjoy it. You get fully cooked and prepared meals served to you, and cleaned up after. You can refuse any checks on yourself and require any newborn stuff done with you present. I had two hospital births and both the stays after were great. I also made sure my nurse was very strict with visiting hours lol so we didn't get too many people coming to see us at once. If I felt I could get the best care in our hospital I would most certainly go there, but I refuse to fight like that in labor as well as for my babies who won't need NICU care at full term just because there was two of them in my belly at once.

Good luck in figuring out what your going to do.
post #36 of 60
Quote:
Originally Posted by turnquia View Post
If you still decide for the hospital birth and stay the 24 hours, enjoy it. You get fully cooked and prepared meals served to you, and cleaned up after.
I wish this were true. I was in the hospital for three meal times. I only got one, after my mom went looking for it, and only ten minutes from me walking out the door. Not to mention that it was only a wrapped sandwhich.

No wonderfully hot meals for me. Part of why I was so "uncooperative", I was starving! And a lot of why I will never willingly do a hospital birth again.
post #37 of 60
Quote:
Originally Posted by Kidzaplenty View Post
I wish this were true. I was in the hospital for three meal times. I only got one, after my mom went looking for it, and only ten minutes from me walking out the door. Not to mention that it was only a wrapped sandwhich.

No wonderfully hot meals for me. Part of why I was so "uncooperative", I was starving! And a lot of why I will never willingly do a hospital birth again.
Awww that's so sad! I hope you complained once you were discharged! Our hospital has meal service that you call for your food when ready and can order off a pretty big menu...so it was definately a perk for me having a hospital birth.
post #38 of 60
I think the whole situation sounds ridiculous. A homebirth would be better but if it's not a good option for you maybe you can find ways to make the hospital birth better. I had my first 2 in the hospital and am still debating what to do this time. With DD I had no idea what I was doing and went entirely mainstream. Doc said this test needs to be done OMG okay! Epidural is best. Gotcha! Give here. Give baby bottle. Well are you sure? Umm okay. I hated it. I did my research and learned a little before DS. I planned for a homebirth but with minor pregnancy complications early DH wanted to use docs so we did just in case. I spoke up though and it wasn't as bad. DS was exclusively bf asap after birth no bottles, no pacis, etc. I told nurses what I wanted and they agreed. It wasn't so bad. The room was nice. I was mostly left alone during labor and the 48 hr stay was peaceful. Baby stayed with me and we BF. That was pretty much it.

If I was in your position and felt I had to go the hospital route I'd start talking. Talk to the hospital and see what options are available. Talk to the obs and peds. Find out your options. I'm sure you can find a way to make this more bareable. I wouldn't want to deal with the possibility of dealing with CPS.
post #39 of 60
Quote:
Originally Posted by MegBoz View Post
Ok, so am I understanding correctly that you do NOT have to have a "chat" with any family who does NOT wish to leave early?

If yes, so, in other words, families who keep their mouths shut & don't request to leave any sooner than normal aren't subjected to this mini "investigation." Right?
I'm consulted for LOADS of other reasons besides a family wanting to leave in a quicker timeframe. That really falls into the minority of what I do. (Mostly I deal with adoptions, substance-exposed newborns, incarcerated moms, teen moms, NICU micropreemies who need to be connected with community resources, lack of family support system, etc. And these things are much more concerning and involved that a mama who wants to take her baby home!) Just a rough guess, but in my 2 years as a hospital social worker, I have maybe been consulted less than 5 times for something akin to this. (And in those circumstances there was an intermix of issues, not just the early discharge request.) I imagine that there are an abundance of other moms who do leave earlier than typical, but they have had an open dialogue with their care providers and this smooths the way for their individualized birth plan. Everyone communicated appropriately, and there was no need for me to be involved.

If you *think* a social worker spoke with you, my thought is that s/he did it the right way--in a way that respected your new role as a parent, that empowered your ability to meet your baby's needs, and that prepared you in some way for some of the odds and ends for life after discharge.

I get it, I do. At the outset it all does seem ridiculous. I'm just trying to share a view through a slightly different lens. I've fought my own professional battles and I've made diligent efforts to educate the nursing staff about particular social issues. While I may not have the final say in any of these matters, I make sure that I do my job to be an advocate for the patient.

I start to feel a little snarly when I feel like all hospitals (or hospital social workers fulfilling a job duty) are painted with such an inflammatory brush. While I know there are lots like that, I also know that there are lots who aren't.

Bottom line: if you're planning a hospital birth, be diligent and prepared and openly communicative and persistent. I think it's great that the original poster is starting this dialogue here, as I think it can only serve to get her where she wants to be for her birthing.
post #40 of 60
Quote:
Originally Posted by ~Amy~ View Post
Sounds like a big empty threat to me, personally. They may call, but I suspect CPS has bigger problems to deal with than a competent, responsible mother wanting to take a perfectly healthy newborn home a little early.
NO NO NO!!! They are not "bluffing" They absolutely will, and CPS will jump at the chance to get involved. You wouldn't think it could happen, you would seriously think not in our country, but it is true unfortunately. They can even call cps and take your baby from you if you do not agree to what they want for you during your birth. It has happened.
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