Doctor and Hospital just not playing "nice."

[rachiem]

Hi everyone. After a hospital delivery (medicated) with my first child, I decided I wanted a birth center baby for this one (due in Feb.) Unfortunately, my insurance won't cover the BC and the price out of pocket is more than we can really pay right now, esp with the holidays.

So, I went back to my OB today and said how I didn't want it to be all medical and interventional in the hospital and basically she's like "Well, you're getting the IV and the monitor because that's hospital policy blah blah blah."

The BC wants their $ by my 36 week in 7.5 weeks so its really out of the question now. I feel like I"m stuck at the hospital. My insurance doesn't cover any midwives in my area, either.

I thought I had options. I thought I could go to the hospital and say no IV. I thought that these "hospital birthing centers" would "work with me" to make sure I was "happy" or something.

All they care about is policy and politics.

I feel like if I go to the hospital, I will be strapped down and want to ask for the epi. I don't feel comfortable with doing it at home (we live in a very small apartment.) And, we just don't have money to do it elsewhere.

Do I have options at the hospital? Don't I have a right as a "patient" to refuse what they want to make me do if I am considered low risk?

[earthmama369]

I don't know if there's a difference between states, but my understanding is that as a patient, you absolutely have the right to refuse procedures. If they say it's policy, ask to get a waiver -- usually they're happy if you remove their liability from the situation. But they often won't tell you about the existence of waivers or your right to refuse procedures.

nak

[lilsishomemade]

I see no reason why you shouldn't be able to refuse the IV. Or, if you'd be willing to compromise, get a saline lock, which is where they put something like a "port" into a vein, they have access, but you're not hooked up to it. Personally, I'm not getting either, but that would be something to throw at them.

Maybe it's your provider. Are you able to look for someone else at this point? OB's have been known to throw out scare tactics and the ol' "you have no choice" talk. You may also want to find out from the hospital what their policies truly are. I'm sorry your insurance is so limited!! I hope someone has some other really great ideas for you!

[lilyka]

march yourself up to the OBfloor and ask for a tour. Don't call for an apointment or anything. Just tell them you are considering birth options and are considering this hospital and would like a quick tour. Once you have had your tour and gotten a little chummy with the nures ask them which Dr.s let women push in alternative positions, off the bed, skip routien monitoring and what not. Also throw in some rabndom questions about will any of them do elective c-secs, will any of them induce for mothers comfort, how soon can I get the epidural. be positive nd up beat with al the questions and you are more likely to get honest answers. Who is best with forceps etc. ask how doulas are treated and where would be the best place for video camera

Ask to see a copy of said policies. tell them you always hear "its hospital policy" and what does that mean. is it a written policy, may you have a copy? read a copy? whatever.

if the information isn't suitible ask to speak to the head of the womens center. Specak to the OB/neonatal social worker. speak to the head of PR if you have to.

then

go to LLL and ask around who everyones Dr. was and who do you like and etc etc They are a good cource. is there a bradly teacher in town? some other independant child birth educator? Have you asked the midwives at the birth center? ask them, explain you can't afford them and get a recomendations. they know whose good and whose not.

and finally do not be scared or feel bad to get a new Dr. You odn't own an unsuitable Dr. an apology, an explination anything.

and in the end what exactly are they going to do to you if you take off the monitors? ask for a second opinion when they say you need a c-sec? squat on the floor and push.

[Noelia430]

I would try a different OB. Maybe you can find one that doesn't require the "routine" IV fluids.They can't make you do anything you don't want to do. If you don't give them your arm for the IV they can't stick you.

[Undercover Hippie]

You absolutely have a right to refuse anything. I am going to PM you a copy of the ACOG statement on Informed Refusal. Of course, some docs are going to fight you more than others so if there are any other docs you can see, check them out. And also, if you are truly stuck with that doc, pick which issues are most important and fight for those; compromise on the others that don't matter as much to you. Maybe you are willng to have a heplock but not to be monitored, etc.

[MamaChel]

Get a doula. Along with all the other advice, a doula will be an invaluable advocate for you when you are not in a position to advocate for yourself. More later,nak

[alegna]

Drs. and hospitals don't play nice. Personally I would find SOME way to have a homebirth. I had a homebirth with my dd and will never do it any other way. Perhaps you can find a midwife who will work with you.

good luck

-Angela

[mamaverdi]

You might want to read Birth as an American Rite of Passage if you still expect drs and hospitals to play nice.

AND, your apartment probably isn't any smaller than a birthing room at a birth center or hospital. Money is a reason people may not be able to have a homebirth---but some midwives will barter or take a payment plan.

AND Homebirth is the best present I have ever given myself or my babies.

That said...

do midwives in your area have licensing? If so, they may have back up OBs. CAll around and find out who backs up the midwives. Call the BC and ask the same thing. And I agree about contacting the LLLL in your area....good resource.

[sweetpeasmom]

You have the right to refuse any treatment in the hospital. I had nurses whispering that in my ear while I had several stays and kept reminding me if I didn't like something, i could refuse. Of course they never said this around the doctors.

I think a doula would be a great option to go. Good luck to you!

[Guest*]

Your other options include:

1) A homebirth. Most midwives will work with you if cost is a big issue. You can work out some sort of plan.

2) If homebirth is not for you and hospital is you only option, then take Bradley classes, stay at home as long as possible before going to the hospital, and have your husband get refusal forms/waivers for everything you do not want (he'll have to be pretty forceful because you won't be in any condition to fight for your rights).

I'm sorry you have to deal with this. It should be criminal that insurance dicatates how and where women in this country give birth. It's your body, your choice and cost shouldn't have to be such a big factor.

[Metasequoia]

rachiem, I am having the same dilema as you. Both of my Dd's were hospital births with a midwife. My m/w didn't get there in time for Dd#2 so it was me, fully dilated, arguing with the nurses while Dp parked the truck. I refused the IV & they said it was policy so I just didn't give them my arm - I said that my m/w & I had discussed this already. As I got into my LDR room, I was having a HUGE contraction in the chair & they told me to get on the bed - what were they thinking?? Walk during a 10cm contraction?? So I said I needed a minute & they said, "you don't always get what you want." My m/w arrived about 5-10 minutes after Dd2 was born & she flipped on the nurses! She told them they should have let me stay in the chair if I wanted to. It was really funny, she came back in & said, "I hear you gave the nurses a really hard time," with a twinkle in her eye.
So now I'm supposed to go to a different hospital & I'm seeing a new OBGYN - eeks! I've had to fight for everything so far this pg, no PAP, etc.
I would like TBC too, but it's like 45 minutes away, up to 1-2 hours during rush hour & we just wouldn't make it in time. I know a HB M/W but she charges $3500 & she has offered to barter. I might still try to talk Dp into that scenario, at least I wouldn't have to leave my Dd's. Oh, & we live with my parents - how's that for sticky when it comes to HB?

[Wugmama]

I think a number of hospitals have a patients right group, sometimes called omsbudman. Call the info line of the hospital and ask if they have anything like that, then talk to them BEFORE hand. Mostly people talk to them after the fact when they've had a problem, but they could help you understand your rights as a patient, which in turn will help you feel more comfortable in asserting them.

You mention money it tight, but if possible hire a doula to attend your birth with you. In MN, they run from $300 to $500 I think. You can also sometimes find ones that have completed their training but haven't gotten their ceritifications because they haven't attended the requisite number of births yet. You can often times get these for very cheap, if not free. Try to find one that will be a strong advocate for you in the hospital.

www.doula.org can be a good place to start.

Best wishes,
Tracy

[amygoforth]

If a homebirth is out of the question, TRY TO GET A DOULA! I wish I'd have had one with DS to help DH and I speak up when we weren't able to speak up. Doulas in training often will help you free of or for reduced cost.

If you have to be in the hospital -- and I know this may be hard -- but be very nice to the nurses if you can. Take a private tour (personally, I found that a scheduled tour is best; play by the rules while you and your baby aren't on the line). Ask questions about the natural birth-friendly practices of the hospital. There will be some nurses comfy with it, and some who are not. Take a copy of your birth plan with you and discuss any sticky points ahead of time so you know -- straight from the horse's mouth -- what you're in for. I know my OB thought some things were "policy" that were, in fact, negotiable.

In both your birth plan and your attitude, I suggest trying to sound like you are ready to work with them so that you can have a safe and joyous birth experience, but that it is very important to you to be able to have a med-free, vaginal, natural birth. Even if you are seething on the inside, try not to be militant. Yes, it totally sucks, but if the nurses stick a label (uncooperative, hippie, kooky, bitchy, etc.) on you, you won't have any of them on your side.

Also, the poster who mentioned a Bradley class is right on. In ours, we learned techniques to get over-attentive nurses to leave us alone (such as hiding in the bathroom), and learning relaxation exercises in a less than peaceful atmosphere, such as a hospital room.

I absolutely hate writing a post like this. I can't believe how much work and politicking we as women have to do to just get them (the medicalized birth establishment) to simply LEAVE OUR BODIES ALONE! My gut reaction is to stand up and stomp and yell to get what I want from them. But, when it came down to it, I wanted to be as cooperative as possible (without compromising my needs and wants) so that I could try to get them on my side.

No, my hospital birth didn't turn out exactly as I had planned (AROM at 9cm, epi [to prepare for a threatened c-sec] and vacuum delivery). I attribute this to not having a doula there to speak up for us when we were exhausted and vulnerable and not able to speak up for ourselves. The OB was the one who started calling the shots at the end, and took advantage of our vulnerability (which is why I'm having a homebirth this time 'round). The nurses who were with us throughout the longest part of labor were very accommodating. They all had read our birth plan, and respected what we wanted and pretty much left us alone. We were lucky in that regard (if you can call it "lucky" just to be left alone).

Sorry to ramble. I sincerely hope you can get the birth you want regardless of the location of your physical self.

[lilyka]

if you can't afford a doula ask for someone who has to attend a minimum number of births. A study showed that interventions decreased when the doula just sat in the corner of the room and didn't even interact. Go figure.

Also if you come in in transition/pushing there isn't many itnerventions they can fit in

[sapphire_chan]

I'd get the waivers/refusal forms now, fill them out except for the signatures and dates. I'd imagine that paperwork would be pretty hindering to a relaxed birthing state.

[mlec]

Hey, mama. Sorry you have this stress for you and your baby.

I had a BC birth w/ my first b/c we live in a small 1 br apt. and I just wasn't comfy w/ the idea of a homebirth. I totally regret it now. I was so comfortable laboring in my own home, when I got to the b/c I was like, why am I here?!

Also, a friend of mine just had a baby (her first) in a small apt. and it went GREAT. It's way more private than the hospital and that makes more of a diff than you might suspect. She was considering a birthcenter birth but had no insurance so opted for the HB. It cost her $1800 w/ a very exp. mw....and the mw said they could pay for it over a year instead of up front.

You don't need the stress of fighting for every inch w/ this doc (only to have her maybe pull the rug out from under you in the end, anyhow). I hope you reconsider a homebirth. I've had several not-very-crunchy friends make the switch and they all say they'll never go back. Find a mw w/ a sliding scale/payment plan and enjoy your birth at your own home.

[LoveChild421]

I feel like all of us who want a natural birth eventually hit this wall- no hospitals don't play nice- they play cover their you-know-whats so you can't sue. They take women who are in a vulnerable position and start the whole "if you don't stay strapped to this monitor your baby might die and you don't want to have to live with that do you?" and then ask you mid-contraction if you want an epidural and finally when you're at that "get this baby OUT" stage they say "i'm gonna cut an episiotomy ok?" and if you even hear them you say "whatever just get this baby OUT!" so they do it, even though you don't need it. They don't play fair because they think their way is better and all of us who want a natural, non-interventive birth are nuts. at least that is how it goes the majority of the time. (yes there are probably a couple of hospitals/ OB's who aren't like that)

so really, you're options are: find a different group of OB's/ CNMs who will support a more non-interventive birth/use a different hospital, birth at home, or just give in (which I sense from you're post that you're heart is not leading you in the "give up" direction).

I think that by all means, you need to birth where you feel comfortable- so you have to ask yourself, when I'm in labor am I going to feel more safe and supported at home or at this hospital? try to imagine each scenario. I gave birth to my son at home in a teeny 1 bedroom apartment and it was beautiful (even if the birth tub barely fit in the bedroom ). also homebirth midwives will usually work with you regarding payment.

take some time to search your heart and decide which option is best for you.

[hunnybumm]

I haven't read all the posts but thought I would respond. I know how it feels to want a HB but when it just isn't a possibility. I couldn't convience my DH to agree with a HB, it would have costed us $2000+ compared to a competely free birth with a BC or hospital. I finally ended up getting the BC covered by applying for Medicaid for Pregnant woman. It is easier to get than medicaid, so you don't have to be dirt pour. My DH is active duty military (E4 in the air force) and we qualify. My military Ins pays for 50% of the BC, and the medicaid covers the rest. I may end up with a $300 cost share but I am ok with that, it's more than worth it.

Also, I know here that the things that are 'hospital policy' actually depend on the OB. If your OB agrees that you don't have to have an IV or be monitered constantly, or that you can walk and move during labor, then the nurses will go along with that. It's ALL up to the OB, but even then like pps have mentioned there are waivers you can get, it's your body but sadly you have to fight for your rights.

[JBaxter]

When I went into the hospital w/ my 3rd DS ( for induction) they were great. The nurse asked if I would like an IV started now or wait. She did inform me that I would have to have a bag of IV fluid on board before they would do an epidural. I chose to wait and see how labor progressed. It wasnt until later in the evening I did get an IV. All the monitoring was done with the belt for 20 min at a time and I was sitting in the rocking chair for part of those. I did get the epidural after about 16hrs ( pit sucks) but we delivered 7hrs later. You do have the right to refuse procedures. They cant "make" you have one esp if there is no need.