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Do I legally have the right to refuse constant fetal monitoring during labor?

post #1 of 12
Thread Starter 
I live in Maryland, if it matters....

I am planning a hospital VBAC. When I was there yesterday for a NST I had to be on the monitors for almost an hour and was extremely uncomfortable (and not even laboring). I had to lay on my back and when I shifted or tried to get up, the monitors would slip a bit or the baby would move.

After that I know there is NO WAY I am going to be able to keep those things on through labor. I am not going to refuse any monitoring, just constant. I really want to know what my rights are in this case b/c it seems like the staff is going to fight me about it.
post #2 of 12
Of course. You *legally* have the right to refuse anything and everything. They're going to give you one heck of a hard time though.

Have you considered homebirth?

-Angela
post #3 of 12
Technically? YES.

In actuality....you'll likely be in for a heck of a fight, threats and possibly even courty/social worker involvement, depending on how ugly the doc wants to be about it. Of course, if you can find a doc who is willing to support you in that choice, that will all be moot.
post #4 of 12
You absolutely have the right to refuse any and all routine proceedures that you choose not to have. My suggestion would be, since you're this far along, to get a copy of their patient rights and responsibilities paperwork. Also, I would familiarize yourself with the EMTALA (Emergency Medical Treatment and Active Labor Act) which basically says that they are required to take care of you if you come in during active labor, and if you choose to refuse any treatment, they still have to treat you for the labor/delivery but cannot force you to do the exam or treatment you refuse. It also suggests the hospital "take all reasonable steps to secure written informed consent". It also covers the penalties that ensue if they break that. I was expecting a fight at my hospital, and so I put a copy of all of this stuff in my birth bag (although in the end I did not go so this is just what was reccomended to me by a VBAC friendly lawyer and friends I met through ICAN).
http://www.medlaw.com/healthlaw/EMTA...-treatme.shtml

Do you have a support person that will be going with you? If so I would reccomend having a chat with them about what kinds of interventions you are or are not comfortable with having so they can support you if staff decides to get pushy. Also put all of it in writing. Get a birth plan together. If your only requirement is not having constant monitoring, then that would not be necessary, but if you're questioning constant monitoring, I would imagine you're questioning other interventions as well.

As far as the monitoring itself, there is no proof that constant monitoring is better for mom and baby than intermittent monitoring. In fact, it removes the human element in many hospitals, because they can see all of these things from their front desk, and therefor do not have to stop in and check on you every 15 minutes, and miss out on any visual or verbal cues they would get by seeing you for themselves.
post #5 of 12
I live in uk and got transferred with my first dc, I uc'ed my 2nd and 3rd dc, had enough of being controlled and fighting for my rights. But I refused to be monitored and wasn't on a bed, laboured on floor with a beanbag, they monitored with one of those ear trumpet thingies but the midwife was not dressed appropriately for the extra movement involved like bending down instead of me being at their height for convenience, her uniform was practically bursting at the seams, I think it was too tight anyway, I'll always remember that cos she seemed a bit put out tho she did say 'I love these natural births' lol You deffo could ask for this and just insist on your own wishes, politely but firmly, ad nauseum. oh and when she did the heartbeat checks she said the heartbeat wasn't exactly what she wanted it to be and that she would have to call the doctor soon if it didn't settle down, I felt perfectly fine, just looked straight at her and said, really? She then quickly changed her tune and said it was fine now, I think they just play you with all that monitoring stuff, there was no way I was taking the bait and feel I would have some idea if things were going awry.
post #6 of 12
I really cannot imagine a social worker being involved because you want intermittent monitoring instead of constant monitoring. (intermittent would be a hand held doppler every 15 min or so, and is not anything like the discomfort of the belly band monitor) They would have no leg to stand on, just because you were disagreeing with them over a single intervention, and I would be suprised if a social worker would stop what they were doing and run to your bedside over it. You could check with others, but IMO there is simply no way it would be a legal battle (and I've done quite a bit of research on this, as I was planning to fight for a VBAC when my doctors and hospital all insisted that I MUST have a cesarean because my records were missing from the surgery).

You may very well be in for a fight with the hospital staff (the doctors are not even there for most of labor generally so I would expect it would be the nurses that you'd be arguing with and they are just following their normal routine and generally detest changes in routine - its more work for them if you refuse it) IMO though its worth fighting for a good birth.
post #7 of 12
Another good source for information on your rights as a pregnant woman - www.advocatesforpregnantwomen.org
post #8 of 12
YES!!! YES!!! YES!!! You have every right to refuse the belts. I did this when in labour with my 4th, a VBAC baby. In order for labour to progress right you need to move. The machine for the belts restricts your movement a lot. Yes the midwives, doctors, ob's and anyone else who cares to be there will all jump up and down and flap their arms and foam at the mouth and taunt you and bully you about risks and internal rupture and everything else under the sun that they think will go wrong. This is fear talking not rational human ability. Your uterus will be (should be) completely fine. If nothing has happened during the expanding 9 (10) months then labour isn't going to cause any issues. You will know anyway.

I had the belts on for 10 minutes and couldn't stand it. I ripped the belts off and they stayed off. The midwife had to use the plastice trumpet shaped thingy and listen every 5/10/15 minutes (sorry, that bit I can't remember her timing). But in the finish she backed down and assisted me in delivering my 10lb 4oz boy by VBAC and I had no tears or stitches.
post #9 of 12
I had this same question for my doula about the hospital in my town. She told me that I could always refuse the fetal monitor, but that they would give me a VERY hard time about it. I asked her if they could kick me out and she said "absolutely not". However, I don't want a bunch of negative energy around me when I give birth. This brings a lot of problems into the open. So, I have decided that I will have a hospital birth with a home labor. I am staying at home as long as humanly possible before going to the hospital. That way I won't have to abide by their rules for very long at all. That is the goal anyway
post #10 of 12
Haven't read all the replies, but wanted to add my 2 cents.

Yes, you can refuse anything you don't feel is necessary. For my last birth, I refused continous monitoring. I did agree to intermittent monitoring since I had been in labor for 54 hours when I did get to the hospital. I labored at the hospital for another 6 hours. During that time, every 1.5 - 2 hours I would do the EFM for 15 minutes (while the doula and my DH held it on my belly). Once they got their reading and everything looked good, I took off the EFM and continued to labor as I wished. And yes, trying to labor while hooked to that thing was much harder, especially if they weren't holding it on my belly. So perhaps you can come to a similar agreement because you will most likely have to fight for your right to labor off of EFM. It gives them the feeling of doing what they are suppose to be doing and you the freedom of being in charge while knowing everything is perfectly fine. However, if you get stressed, it could show some fetal distress also. My dr was verbally abusive during my labor... so the EFM did pick up some late decels when he was yelling me. Once I calmed down, so did my baby and we continued to labor off of EFM.
post #11 of 12
http://www.ican-online.org/resources...egalprimer.pdf

http://www.advocatesforpregnantwomen...interventions/

not everything in these links pertains directly to fetal monitoring but they give a good overview legally of your right to refuse various treatments

oh and heres a sample refusal of service form from medlaw.com

http://www.medlaw.com/healthlaw/bm~d...of-service.pdf

hth
post #12 of 12
You sort of have the right, but they have all sorts of ways of taking it away from you. Courts, CPS etc can be used. They can declare you temporarily unable to make your own decisions and so on. It will depend largely on whatever nurse you happen to get, and if she likes you or not.

Now, you can take showers, if you aren't hooked up to a lot of machines, and short walks, and all that. If you don't make a lot of fuss about the monitors, but frequently ask to have them off for a little while, then hope they forget about you for a little while, you can sometimes get away with more than if you use direct confrontation. Things can sometimes escalate to a power struggle if you try to put your foot down, and the next thing you know you are strapped down for your "own good." I've been down that road before. That's why I wont' have any more babies in the hospital. I birth at home where I call the shots.

In the hospital I know I'll end with a c/s every time. At home, I can VBAC. My births take too long for the hospital, they just won't let it happen, and all the monitoring etc slows me down even more. Home is the only option for me, home or c/s.

Kiley
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