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I'm going to participate in my local hospital's OB focus group - give me ideas  

post #1 of 40
Thread Starter 
NAK

My local hospital is in the process of expanding it's small OB/L&D dpt. I am going to attend a focus group about how to improve their services. There are 10,000 things I want to mention, but I don't want to miss something really important because it happened to be out of the scope of my experience. Tell me what you'd like to see. I plan to go in with notes & copies. I'm probably their worst nightmare. :LOL :LOL :LOL :LOL :LOL
post #2 of 40
what a great opportunity!

I would tell them that getting certified as a "Baby Friendly Hospital" would be very attractive to moms-to-be
http://www.cdc.gov/breastfeeding/com...riendlywho.htm

also that having water birth as an option can draw a lot of moms (especially since it is getting more popular)

I would also mention that I would like to see no one asking moms if they want to circ or trying to make it seem like "the norm" ("its time for his circ"...) a parent must REQUEST their child to be circed and if they don't it isn't done

also not automatically giving newborns Hep B shots or at least letting parents know they can be done later- they shouldn't make it seem like they are mandatory at birth- they can be done later at the pediatrician if the parent feels it is necessary (since this is an STD there really is not reason if the mom isn't positive)
post #3 of 40
Breastfeeding support, real circ info, waterbirth options, nurses trained in natural childbirth.

Oh what an opportunity
post #4 of 40
Thread Starter 
I've had 2 babies at this hospital. One was planned hospital birth with a CNM practice. My 2nd birth was a planned homebirth & I wound up in the hospital at 39.4 with my own health issues completley unrelated to pregnancy/labor. That's an interesting situation to be in let me tell you. They treated me like a nut ball till my midwife faxed in my records & they had "proof" I'd gotten "adequate" prenatal care. Good times. Anyway....

On my list was...

!!!!!!!!!!!!!!!!!!!!!!!!!DO VBACS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!

IBCLC lactation consultants avaliable (not the others - we've got SO many "bad" LC's near me - I'm regularly astounded at the misinformation moms get :Puke )

I know they won't care, but I'm gonna explain why giving a new mom a bag full of artificial milk is not a good idea (focusing on the health issues - it's a 7th day adventist hospital & they're exceptionaly interested in healthy things)& ask that they at the very least, include local LLL & IBCLC info (which, I, of course, will have on hand )

Actual info on circumcision. Real stats & the AAP statement at the very least. (I was not asked about circ - even this time with NO birth plan - & the ped that sees the newborns is not a circ proponent - I've discussed it with him. His stance is "there's no reason to do it" which is better than most)

I hadn't thought of waterbirth. That's a good one - keep em comming!!!!
post #5 of 40
Thread Starter 
I just clicked your link on the baby friendly hospitals.. I'll be using that one!!! By the time I actually go to this thing, I'm gonna need one of those huge rolly lawyer brief cases to carry all my info, aren't I? :LOL
post #6 of 40
I've always thought that hospitals should find a way to educate the partner or family about PPD.

It is helpful to give the info to the mother- but as she is the one that gets the ppd and is often overwhelmed, the partner/family, etc, needs to know about it.

Also, it would be great if they don't offer circumcisions- left it up to the parent to request, but as that is probably unrealistic- at least be educated in presenting unbiased information as per AAP and REQUIRE pain relief as recommended by AAP. Also, switch the question from "are you going to circumcise", to "are you leaving your son intact?"
Perhaps if you are in a diverse area you can incorporate cultural sensitivity into the arguement since it is only Americans that circ for non-religious reasons.

One final note that I would have liked would be for my hospital to try to limit intrusive visits- the morning tend to be quite buys. I was only there for 3 days and every morning I had so many people coming in and out. I remember crying because it was 11, I hadn't showered yet, and my breakfast had gone cold and gross because of all of the interruptions.

I remember feeling like I was a prisoner in my room- like I couldn't leave without anyone's permission. I was on semi-bedrest so it wasn't really clear what I was supposed to do. In retrospect, getting the heck**&& out of there would have been my best bet (-;

Good luck, that's awesome. Update us!

Jessica
post #7 of 40
I would like to see more hospitals and physicians give truly well-rounded information to patients. That means covering as many of the options as possible and talking about the honest-to-goodness pros and cons of each one.

As an example - pain mangement: too often OBs only give out info saying that yes, you can get your epidural, and here's how. I'd rather see them provide a list of a bunch of different options, including non-medical options, and give the ways that each of them affect the mom and the baby.
post #8 of 40
Quote:
Originally Posted by jessjgh1
I've always thought that hospitals should find a way to educate the partner or family about PPD.

It is helpful to give the info to the mother- but as she is the one that gets the ppd and is often overwhelmed, the partner/family, etc, needs to know about it.

Also, it would be great if they don't offer circumcisions- left it up to the parent to request, but as that is probably unrealistic- at least be educated in presenting unbiased information as per AAP and REQUIRE pain relief as recommended by AAP. Also, switch the question from "are you going to circumcise", to "are you leaving your son intact?"
Perhaps if you are in a diverse area you can incorporate cultural sensitivity into the arguement since it is only Americans that circ for non-religious reasons.

One final note that I would have liked would be for my hospital to try to limit intrusive visits- the morning tend to be quite buys. I was only there for 3 days and every morning I had so many people coming in and out. I remember crying because it was 11, I hadn't showered yet, and my breakfast had gone cold and gross because of all of the interruptions.

I remember feeling like I was a prisoner in my room- like I couldn't leave without anyone's permission. I was on semi-bedrest so it wasn't really clear what I was supposed to do. In retrospect, getting the heck**&& out of there would have been my best bet (-;

Good luck, that's awesome. Update us!

Jessica

Jessica to another Jessica,

Same here with what you said about this. Would want this for all of my births, I'm pro hospital woman. Thank you.
post #9 of 40
My last two births ended in emergency cesareans. The first time I didn't get to see my baby for three hours. The last time I didn't get to see my baby for nine hours.
It seems like if the baby just came out of your body, then it is not going to give you an infection. All infections come from the hospital or hospital staff. Why can't your baby be in the recovery room with you? I would even have let them put them in one of those incubator things if it meant I could SEE them and KNOW they were okay, kwim?

There is a world of difference when you have the doctors and nurses telling you she is fine as compared to seeing with your own eyes.
It made my 'recovery' that much more difficult because I was crying because I wanted to see my baby. The stupid doctors thought I was crying from the surgery and it took me longer to realize that if I stopped crying then they would let me out.
post #10 of 40
Quote:
Originally Posted by MamaInTheBoonies
My last two births ended in emergency cesareans. The first time I didn't get to see my baby for three hours. The last time I didn't get to see my baby for nine hours.
It seems like if the baby just came out of your body, then it is not going to give you an infection. All infections come from the hospital or hospital staff. Why can't your baby be in the recovery room with you? I would even have let them put them in one of those incubator things if it meant I could SEE them and KNOW they were okay, kwim?

There is a world of difference when you have the doctors and nurses telling you she is fine as compared to seeing with your own eyes.
It made my 'recovery' that much more difficult because I was crying because I wanted to see my baby. The stupid doctors thought I was crying from the surgery and it took me longer to realize that if I stopped crying then they would let me out.

mommaintheboonies,

Oh my god, thats horrible they treated you and most likely other women in the same position as you. If I was you I would write letter to the hospital stating what you just said to us. Thank you.
post #11 of 40
How about talking to them about EVIDENCE BASED PRACTICE. It's what every other area of medicine does. For example, not pushing routine EFM on uncomplicated labors, allowing most moms to move around freely.

I like all the other ideas so far too.
post #12 of 40
Quote:
Originally Posted by mara
How about talking to them about EVIDENCE BASED PRACTICE. It's what every other area of medicine does. For example, not pushing routine EFM on uncomplicated labors, allowing most moms to move around freely.

I like all the other ideas so far too.
Kimberly,

Totally agree with what you just said. WOW quoting and then agreeing to alot of the respones in this thread.

Thank you.
post #13 of 40
I was gonna call you and tell you about the Baby Friendly hospitals. Glad you got that info.

So let's see....
1. Baby Friendly certification
2. Water birth option
3. No asking about circ
4. No formula samples
5. Supportive breastfeeding information and assistance
6. VBAC support

Those are the big issues. I can think of little ones like being able to wear your own clothing during labor, nice gourmet style meal after birth, visit from a massage therapist after birth, MORE PILLOWS for mom and how about some boppies for nursing. I know UCH use to do the gourmet meal and massage therapist for a while but stopped before I had Alex.
post #14 of 40
Thread Starter 
Gourmet meal & massage?!?!?!?!? Wow. I sent my dad to KFC cuz I was craving greenbeans. haha Can you imagine if they offered that at our little hospital!!! :LOL Lots of good ideas. I'l surely include the PPD info. They never mentioned that to me at all. There are only 2 baby friendly hospitals in FL & both are pretty far from here (Clearwater & I think Orlando)
post #15 of 40
Take heart and try to focus on a few things at a time-- Also realize that it is mostly a search for the most marketable changes that would have the least to do with changes in actual practice. like birthing rooms -- you are going to get the bed spreads and and epidural ......

so things that would be nice and keep a woman from being straped down if she isn't on an epidural would be wireless monitors. and the ability to use tubs---
post #16 of 40
Thread Starter 
Oh, I understand what their goal is. I'm just not the mom that's gonna talk about decorating. I know that they want simple things that can make money, and in what I have to offer are a coupple of those, and maybe they'll help - who knows. But, I just can't ignore the broader issues. And, as of yesterday, only me & one other mom said they were comming, so it looks like I'll have time. haha

I'm the mom that got treated pretty poorly as a midwife client because the hospital was assuming I had no prenatal care (that is what they thought midwifery care was - nothing). I'm the one that had to argue with a nurse, the OB & a pediatritian (not even my own) about how "I was putting my baby in danger" by refusing eye ointment. I'm the one that had to sign waiver after waiver about Vit K & Hep B. I had to answer "Can we break your water now - it'll really move things along?" 47 times (no mention by them of the cord prolapse they were so worried about when I told them I was having a home birth). I had to remind everyone in the room exactly what they couldn't do (again) before I felt comfortable enough to push out the baby. AND I still think I had a "good" hospital birth experience for the area. That's just sad. It's sad that women have to feel like they're gearing up for battle to walk through the doors of a medical treatment center. It's sad that when I started that pregnancy & was planning a hospital birth, I was working on hiring a doula who I thout was "vigilant" enough about natural birth. I was working on an extreemley detailed birth plan before I started picking out names. It's even sadder that many women don't even have the option of a hospital birth because (in most cases) they've already been supremely screwed over BY the same system who gave them the "failure to wait" C-Section in the first place, so now their choice is homebirth or dangerous, unwarranted repeat CS. It's sad that I have to hear women asking questions of me, THEIR HAIRDRESSER, about why the things that happened to them did, because I'm the only person they know who knows anything about all of this & will give them a straight answer (No, honey. 12 hours isn't too long to labor for your first baby. I'd have had a party if mine had come in 24. I know you feel cheated, and the fact that you & the baby were ultimatley ok isn't the end of it. The way you could have known that your baby was getting enough milk was.... If you saw fluid leaking from your heavy hard breasts, your milk came in.) I pass out about 10 LaLeche League & ICAN.org cards a week. There's a serious gap here in women's healthcare. So, while they'll pour over the bedspread fabric swatches, and the type of wood for the armiores that hold the monitors for at least a week, I figure I have about 45 minutes to bring up a bunch of things that they'd like to keep swept under the (new, home like) rug. I'm not expecting them to embrace homebirth, the anti-vax stand, CD all infants (but, God, how freaking cute would THAT be? ) and abandon artificial milk distribution, but I DO expect some kind of meaningfull improvement.

The hardest thing for me is to remember that this is for a hospital. I can't do anything about what the OB's do. Well, that turned into a vent, didn't it? I feel better now. Maybe I'll print this entire thread & read it to them. haha
post #17 of 40
Quote:
Originally Posted by AmandaBL
Oh, I understand what their goal is. I'm just not the mom that's gonna talk about decorating. I know that they want simple things that can make money, and in what I have to offer are a coupple of those, and maybe they'll help - who knows. But, I just can't ignore the broader issues. And, as of yesterday, only me & one other mom said they were comming, so it looks like I'll have time. haha

I'm the mom that got treated pretty poorly as a midwife client because the hospital was assuming I had no prenatal care (that is what they thought midwifery care was - nothing). I'm the one that had to argue with a nurse, the OB & a pediatritian (not even my own) about how "I was putting my baby in danger" by refusing eye ointment. I'm the one that had to sign waiver after waiver about Vit K & Hep B. I had to answer "Can we break your water now - it'll really move things along?" 47 times (no mention by them of the cord prolapse they were so worried about when I told them I was having a home birth). I had to remind everyone in the room exactly what they couldn't do (again) before I felt comfortable enough to push out the baby. AND I still think I had a "good" hospital birth experience for the area. That's just sad. It's sad that women have to feel like they're gearing up for battle to walk through the doors of a medical treatment center. It's sad that when I started that pregnancy & was planning a hospital birth, I was working on hiring a doula who I thout was "vigilant" enough about natural birth. I was working on an extreemley detailed birth plan before I started picking out names. It's even sadder that many women don't even have the option of a hospital birth because (in most cases) they've already been supremely screwed over BY the same system who gave them the "failure to wait" C-Section in the first place, so now their choice is homebirth or dangerous, unwarranted repeat CS. It's sad that I have to hear women asking questions of me, THEIR HAIRDRESSER, about why the things that happened to them did, because I'm the only person they know who knows anything about all of this & will give them a straight answer (No, honey. 12 hours isn't too long to labor for your first baby. I'd have had a party if mine had come in 24. I know you feel cheated, and the fact that you & the baby were ultimatley ok isn't the end of it. The way you could have known that your baby was getting enough milk was.... If you saw fluid leaking from your heavy hard breasts, your milk came in.) I pass out about 10 LaLeche League & ICAN.org cards a week. There's a serious gap here in women's healthcare. So, while they'll pour over the bedspread fabric swatches, and the type of wood for the armiores that hold the monitors for at least a week, I figure I have about 45 minutes to bring up a bunch of things that they'd like to keep swept under the (new, home like) rug. I'm not expecting them to embrace homebirth, the anti-vax stand, CD all infants (but, God, how freaking cute would THAT be? ) and abandon artificial milk distribution, but I DO expect some kind of meaningfull improvement.

The hardest thing for me is to remember that this is for a hospital. I can't do anything about what the OB's do. Well, that turned into a vent, didn't it? I feel better now. Maybe I'll print this entire thread & read it to them. haha

amandabl,

WOW about what you just wrote. Totally agree with you that the system has gotten way out of hand. Wish OBs would see what midwifes see, now after so many years of bad care by OBs. Thank you.
post #18 of 40
Also, don't forget about the "childbirth ed" classes that the hospital offers. If they're revamping everything, maybe they'll go to a more pro-woman format rather than a "here's how to be a good patient in our hospital" format.

I went to mine last weekend, and here's how the breastfeeding discussion went:

Instructor: "Is anyone here planning to breastfeed?"
(half class raises hands)
Instructor silently passes out "The Essential Guide to Breastfeeding" to those of us with our hands up.

...and goes on to the rest of the material. Spends no time discussing anything.

I was so disappointed. Missed such a great opportunity!!

So, don't forget about suggestions for the childbirth classes!


BTW, good good good for you. I'm so glad you're doing this -- on behalf of women who will follow you into that hospital:
post #19 of 40
Jen,

Thank you for the link to this Baby Friendly Hospitals and really all US hospitals should be doing it like other countries adapted to Baby Friendly Hospitals. Wish the doctors/nurses/administration/management/patients/other areas that I forgot here.
post #20 of 40
What a great opportunity!
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