Why do hospitals feel so strongly about the hospital gown?

[msmiranda]

I'm genuinely curious about this.  My first birth was in a hospital with CNMs and although I had "wear own clothes" on the birth plan they had all seen and no one said boo about it, once I actually got there they gently talked me into wearing the hospital gown.  I don't remember the reason(s) they gave, as I was well into laborland, and I ultimately didn't find it a big deal to wear the gown, but it always struck me as odd.

Then I took the hospital tour for the hospital I will be birthing at this time, and the part where the nurse/tour guide said, "you will wear a hospital gown" was worded and delivered in a pretty insistent tone.  The reason she gave is that "birth is a messy process." 

I am just nonplussed by this insistence on the gown.  I don't see why it should be so important to them.  Does anyone have any insights as to why this might be?

[philomom]

Maybe because a woman might wear something special and the blood doesn't come out? I don't know. I had a CNM that I loved. I wore my own gown for a while but it was too hot. The hospital gown was icky to touch. I mostly ended up naked and the nurse piled up a gown or two around me once things got serious. For modesty, maybe?

[Comtessa]

OP, good question!  I've been thinking about this a lot lately, ever since the topic came up on another thread a few days ago. 

IMO, If they were really concerned about modesty, I don't think they'd insist on the gowns!  I feel much more comfortable in my own skin than half-covered by one of those ridiculous things.  But people (especially in this culture) are funny about other people's nakedness (just think of all the stories you hear about new moms being harassed for NIP), and I think the nurses sometimes feel that if they're uncomfortable with it, you must also be uncomfortable. 

I remember that in labor with my first, at some point during pushing I realized that it would be hard to nurse the baby immediately while I was wearing a bra.  So I took off the bra and pulled it out from under my shirt.  It got caught up in my IV, though, and was just hanging there next to my bed.  I couldn't have cared less, but the nurse got all clucky and said, "oh, we don't want that flapping in the breeze!"  and went to a great deal of trouble to whisk it away.  I just looked at her like, "are you serious???  I'm lying flat on my back on a bed, bared to the waist, with bodily fluids everywhere, and I'm supposed to feel embarassed because somebody might see my bra lying around???"  *Shrug*  So who knows what that's all about, really? 

Honestly, I suspect it has to do with all the "what-ifs" that are always front-and-center in hospital staff thinking -- they're worried about having some crazy emergency where they have to cut your clothes off to get access to some odd part of your anatomy, and they don't want any complaints from people later about them destroying clothing to get there.  That also seems silly to me, but I wonder if that's part of it.

Of course, "Birth is a messy process" is certainly true -- if you wear a hospital gown and it gets messy, they can just toss it in the bin and get you a new one -- they don't have to keep track of what you were wearing and set it aside for you for later.  And if it has blood or something on it, it's probably considered a biohazard, and they probably have all sorts of weird rules about handling it.  So they want you to wear a gown because it ends up being less work for them. 

And then, there's always the symbolic meaning of having a laboring woman dressed as a "patient."  There's a fascinating article here: http://www.terrylarimore.com/BirthRites.html that has quite a bit more on the topic. 

I never wore a hospital gown, personally, and I don't intend to this time, either.

[nia82]

The hospital for DS's birth didn't care, they just said they have to cut my stuff open in case of an emergency and that is totally ok. I wore old men t-shirts from Costco which I threw away afterwards, but at least t-shirts are comfy and cover you. I wore a hospital gown once when admitted for preterm labor (went home 2 hours later) and those things are huge. I'm not tall and skinny, the gown hung off of me terribly, it didn't cover nor warm anything.  DD was born out of the hospital, so a non-issue (I ended up naked, never thought I would, but it felt best).

OP, your hospital sounds very strict on everything, can you consider hospital shopping? First they give you grief for declining eye ointment and now that? Sounds way strict. As mentioned, the hospital in CA where I had DS didn't care whatever I wore, didn't bat an eye for declining eye goop, vitamin K or baths.

[Lisoula]

As a hospital L&D nurse, I think it's for a couple of reasons. 

First, as a PP said, for emergency reasons.  Should something happen, it's easy to unsnap the top and have access to your chest (for the EKG leads should you need surgery.) 

Second, because if a gown should get bloody, we can toss it easily into the hospital laundry.  We obviously can't do that with your own clothes....but in a hurry, I can see someone's personal clothing accidently being put with hospital laundry, and then that becomes an issue in itself. 

Third, is like someone said about IV tubing.  It's not exactly easy to feed IV tubing in and out of normal clothes, and as we all know, things can happen very quickly in labor and us nurses sometimes don't have time to fiddle around with things like that...lol.

I really think nurses aren't trying to be mean, or not being considerate of patient's wishes when it comes to gowns.  I hope that's not what you felt, OP.

[JamieCatheryn]

Uniforms dictate attitudes. Awkward hospital gown means you are the patient and you're stuck there. Helps make their jobs easier. Also they make them easy to get out of the way for emergency procedures.

[Marissamom]

I think it's probably the "every birth is a potential c-section" attitude. though I did opt to wear the hospital gown, I had a particularly messy labor, birth, and post-partum period. (low platelets will do that to you, so much blood everywhere)

[msmiranda]

Originally Posted by nia82 

OP, your hospital sounds very strict on everything, can you consider hospital shopping? First they give you grief for declining eye ointment and now that? Sounds way strict. As mentioned, the hospital in CA where I had DS didn't care whatever I wore, didn't bat an eye for declining eye goop, vitamin K or baths.

I know I must be giving that impression, but it really isn't!  This is a hospital that is known to be supportive of natural birth and breastfeeding out of all the hospitals in my area.  Of course, it is still a hospital, but they: (1) have a pretty unrestrictive policy on intermittent monitoring (10 min out of the hour, and they let it be known that in practice it is often done less than that) and the nurses will work with you to not be in bed while on the monitor; (2) don't do a lot of vaginal exams -- in fact, she said that you could basically go through a whole labor there with none at all until you felt you were ready to push, and then they would just want to check to make sure you were completely dilated (after hearing so many stories of women being bugged to have one every hour, I was impressed!); (3) bend over backwards to minimize mother/baby separation -- there is no mandatory observation period or anything, baby goes right on mom after birth, etc.  The only thing that bugs me is that they don't do any newborn procedures/exams in the postpartum rooms, which my last hospital did ... but I think it is because their postpartum rooms are TINY and not that well lit, parents are welcome to accompany baby of course; (4) seem to respond to evidence and change protocols accordingly -- for example, the nurse I was talking to thought that the low blood sugar cutoff was 50 and that they tested babies of GD moms every 4 hours for the first 24 hours of life, but when she stopped a nurse who currently works up there, she said no, the cutoff is 30, and they check it an hour after birth and then once 2 hours later and if both were fine they don't check again .. they had changed their protocols in response to the most recent evidence; (5) are known as a hospital that has a number of nurses who like to assist NCB moms. 

Also, the tour guide nurse told me that my physician group (Kaiser) has a much lower c-section rate than all the other practices who have privileges there, and that the reason for this was that when a Kaiser doc is on call, that is all they are doing that day, so they are more willing to be patient and wait things out than private practice doctors who are trying to get back to their offices.  So essentially she was telling me that a lot of unnecessary c-sections are done for physicians' time management reasons (and she clearly disapproved of this) ... which I already knew, but I was surprised she was so honest about it.  And, during the L&D room part of the tour, the first thing she said was, if you're managing your labor naturally, then [here are all the ways we can help you with that -- shower, jacuzzi tub, birth ball, etc.].  Then she addressed epidurals for those who might want that.  A small thing, but I think it makes a big difference in normalizing it to mention NCB first and then talk about pain meds second.   

So really it was just the eye ointment and the gown that were the only negative things.  And who knows, the nurses who are currently working L&D may not care about the eye ointment or the gown, maybe it was just her.  :)
 

[happysmileylady]

I am sure there's a functionality aspect-docs and nurses know how their stuff works.  If you have a big flowy shirt on with snaps and stuff, they don't know what pulls up and what unsnaps and what twists this way and that.  Or worse, if someone has something tight on, it could be hard to move it where it needs to go when stuff goes down. 

Plus the whole ruining of the clothes...Not just blood, but if they have to get to an arm for an iv or whatever quickly and they rip something by mistake, that could really irk off some folks, having nurses rip their clothes by mistake. 

As others have mentioned, there's the emergency c-section aspect too.

I am pretty sure that nurse are not thinking or trained to get people to wear gowns just make people into compliant little patients.  Seriously, that's a pretty big conspiracy power trip, to get everyone, all the docs and all the nurses, in on that sort of attitude.

[Jane]

I wish they were not as scratchy.

[Momsteader]

I always wore my own clothes and never had anyone take issue with it. Lots of times, I'd wear a hospital gown backwards as a 'robe' but no one said boo about my wanting to wear my own clothes. I usually was just wearing like a tank top or swim top and slip on short skirt so maybe they just saw it as easy off/on and didn't say anything.

[lifeguard]

I think this is very much an individual hospital thing. I wore my own clothes through my whole birth with ds. They gave me a gown but dh & I couldn't figure out how it all went together & gave up.

[lovebeingamomma]

Last time I just said no thanks I brought my own gown, they were like, whatever!  Didn't care.  But if they did care, I'm still not wearing it.  I was naked when pushing, and the nurse kept putting a sheet or something over my boobs.  Like I cared about modesty at that point.  I didn't.  Maybe it made her uncomfortable?  I dunno. 

[happysmileylady]

Originally Posted by lovebeingamomma 

Last time I just said no thanks I brought my own gown, they were like, whatever!  Didn't care.  But if they did care, I'm still not wearing it.  I was naked when pushing, and the nurse kept putting a sheet or something over my boobs.  Like I cared about modesty at that point.  I didn't.  Maybe it made her uncomfortable?  I dunno. 

Or it could have been so that once baby came out, they weren't putting a slippery wet gooy baby on you, requiring two people to be cleaned up.  With a sheet, they can then use that to clean up baby and keep you clean at the same time. 
 

[Adaline'sMama]

I agree with the concept that uniform dictates attitude. Its really hard to be condifent and get exactly what you want out of your birth experience if your rear is hanging out the back of your gown and you have to do a dance to keep folks from seeing it. To me, letting them put the gown on me would have just been the beginning of a long list of interventions they would have tried afterwards. I stayed in my own clothes (big hippy skirt that I just wore up around my chest like a dress) and I felt much more in control just because I wasnt showing my as* to everyone who popped in the room.

[Italiamom]

Originally Posted by Comtessa 

And if it has blood or something on it, it's probably considered a biohazard, and they probably have all sorts of weird rules about handling it.  So they want you to wear a gown because it ends up being less work for them.

Anything with blood on it is technically considered a medical biohazard in hospital land.  A hospital isn't going to do your laundry for you once you're done with the birth, so it makes sense to me that hospitals would want you to use them.  In high volume hospitals especially, can you imagine trying to keep track of the clothes of 20 different women, while still treating those clothes as a biohazard, vs. just tossing a gown into a laundry chute?

This is one of my reasons I'm excited about a homebirth.  Our midwife will do a couple loads of birth laundry before she goes

[Comtessa]

I haven't the foggiest idea what happened to the clothes I birthed in; presumably that's exactly what happened to them.  I'm sure they got thrown in a bin somewhere and forgotten.  I don't remember ever feeling too broken up about the whole thing!  I think as long as you know, going in, that you might lose the shirt off your back (pun intended), it shouldn't be that big of an issue to wear your own clothes. 

[lovebeingamomma]

nope I like my ooey gooey babies they both went right on my bare chest.  Although honestly both of them were not that messy I don't even remember taking a shower right away.  I really think she just thought it would make me more comfortable.
 

Originally Posted by happysmileylady 

Or it could have been so that once baby came out, they weren't putting a slippery wet gooy baby on you, requiring two people to be cleaned up.  With a sheet, they can then use that to clean up baby and keep you clean at the same time. 
 

[Magali]

Being a hospital birth sceptic, and having given birth in 2 different hospitals, I have to say that i don't think hospitals "make" you wear the gown to promote their authority and make you feel like a "patient".  I think the reasons are more practical than anything.  For instance, my first birth I wanted an epidural.  I was wearing my own nightgown and the nurse apologetically told me that I would need to take off my gown and put on one of theirs...makes sense cause my nightgown didn't open up in the back.  And with my second hospy birth I was so bleedy, sweaty, nasty, that I glady wore their gowns so that I could change often, seeing as I only brought 2 gowns of my own and wanted to keep them fresh for after the birth.  I think it would be wrong for them to insist upon wearing a hospital gown, but I do not think there is a sinister purpose for them.

[camprunner]

I refused the gown at the hospital. They were about to have a fit until I made it clear that I couldn't wait to get out of the dress I was wearing and wear nothing.  They were totally cool with me wearing nothing! My husband was completely embarrassed by it.