Can I violate "hospital policy" on wearing a fetal monitor? - Page 3

[christifav]

Although I would suggest you find a HB MW (and yes, there are some out there who will take you at 36+ weeks) if the fact that you are 1 hour away from the hospital is really bugging you, how about getting the MW to meet you at a hotel nearby?

I had to move in with my parents during the last weeks of my pregnancy with ds and there was no way in hell my mom was letting me have my baby in her house. So, with my HB plans out the window, I asked my MW for options. She said she had caught babies in all kinds of places and would be willing to meet me in a hotel or anywhere I wanted. I ended up finding a birth center, but the point of this story is, perhaps being attended by a MW at a location close to a hospital will offer you the best of both worlds...freedom to labor/deliver as you choose, and peace of mind of being near the hospital in the event of a true emergency.

[redhen]

With my first birth I was made to get out of the whirlpool tub for hourly monitoring and then in the morning when my intended OB arrived he (sort of) cussed the nurses out because THEY KNEW they had waterproof wireless monitors... the new monitor showed up within about ten minutes and I was allowed to labor the rest of the time in the tub.

[studentmama]

Originally Posted by LaughinWillow

I haven't gotten a doula, because what I really really want - and what I wanted with my ds (the previous cesarean) is to be ALONE in labor. I know this sounds crazy, but I just have no desire to have anyone there at all. So adding another person into the mix just doesn't seem for me. I always wonder if I had just "braved" it and walked off into the field to have the baby last time if he wouldn't have gotten "stuck" at all. I just feel like a really private person, and with both my 13 year old and my son, in labor I felt like I just got really into my own head or something. With ds, I barely made a sound the whole time, and never wanted to talk to anyone or ask anyone for anything. I just wanted to sit in the tub and deal with my feelings myself. And I almost felt like I was "supposed" to be in more pain than I actually was experiencing because I had my husband and a friend and the midwife and the nurse all standing around focusing on me, and I really didn't like it. Does this sound insane? Seems like "most" women really want people there - I don't know...

Anyway, with ds, I was reading all these stories about women who had solitary labor and childbirth, but being an hour away from a hospital just was too scary for me. And still is, because there's really no way for me to be sure if the baby would have been ok if I had just done what I wanted, or to know that there won't be a very real problem with this one, because no one seems to be really clear on why ds got "stuck" - they say it may have been just a fluke, or it may have been a problem with his size - so if I have another baby of similar size, the same thing could happen.

I'm thinking at my next midwife appointment, I'm going to tell her that I'm willing to do the intermittent monitoring - or even do constant monitoring for the first hour I'm there and then take the monitor off and switch to intermittent if everything is normal. I feel like the more medicalized things get, the more it's all going to get into my head and psyche me out of a normal birth. Wish I lived closer to the hospital - I'd just go ahead and stay home!

I am definitely don't touch me kind of laborer, so I totally understand. If you are going to do a hospital birth and you do hire a doula you can explain that you really just want her there to be the liason between you and the hospital staff.

For my hbac, the only person who could even get near me was my m/w. Not her assitant, not my dh, not my mom. I just wanted to be left alone and she was so respectful of that.

I read later on what you were told about homebirth being illegal and I can totally relate. When I first approached my hcp about even thinking of a homebirth she gave me the same garbage. Oh it's illegal, no one would do it anyway. I was very lucky to have a close friend who had a hb and she told me what a crock I had been led to believe. Well, I started looking into midwives and lo and behold, the cnm at my hcp LIED. But then, hb midwives are in direct competition with cnm's at the hospitals. Every hb m/w I talked to said that most folks who come to see them are seeking a vbac. That's a lot of money that the hcp are losing if women birth at homes.

Does anyone know what a typical birth costs nowdays? I know that 8 yrs ago my c/s was over $30,000.

[wombat]

To the OP - I can think of at least 2 HB MWs who will do HBACs in MD - I know they've travelled down to almost the DC border. Not sure how far down in VA you are though - and that's some dicey traffic to navigate in labor. There's a lot of info about HB MWs on the MD/DC/VA tribal forum. I couldn't find a birth center who would do a HBAC around here - they're mostly citing legal and insurance issues. Sometimes the problem with the MW doing HBACs is having 'approval' from their backup OB.

I think a lot of Drs and hospital MWs are clueless about homebirth. They may not be deliberately misleading you, they just might not know anything about it. When I was looking for a CNM to do a HBAC, the CNMs I called who worked at hospitals had limited knowledge.

Don't think it's too late to change providers.

[[e-mail]]

Originally Posted by Fyrestorm

I was not a VBAC, but I was a HB transfer. You can refuse anything you would like, however they can still force you into it. When I refused, they got a court order. I had no choice.

I'm so sorry to hear that this happened to you, and I wanted to come out of lurkdom to let people know their rights should they find themselves in a similar situation. I don't know when you underwent your court-ordered cesarean, but they've become much more rare in the aftermath of multiple appellate court rulings declaring them to be illegal.

The women who've appealed their court orders forcing them to undergo a cesarean have won. Of course, this does you know good when you're faced with one because the surgery is usually performed ASAP before the appeal process can be initiated. So in most cases, the appeal took place well after the violation occurred.

However, it is helpful for women to know this information. Hospital attorneys certainly do, and they also know that at least one hospital lost a multimillion-dollar lawsuit as well as the family’s appeal to the appellate court (whose rulings hold the force of law). So they're well aware that they're taking a gamble any time they pursue a court-ordered cesarean, and they're banking on the fact that laboring women are unaware of the case law on this issue.

Anyone who finds themselves in this situation can inform staff and the hospital attorneys that they will appeal the ruling, all the way to the Supreme Court if need be, and that the law is on their side. Not to mention ACOG's ethical guidelines on court-ordered cesareans, which state that they are "rarely, if ever" justified and that, in fact, there has yet to be a case in the US that could be considered ethically justifiable, not to mention legally sound. So you can always remind staff that in addition to the law, you also have ACOG on your side and that you'll be filing a complaint against your physician as well.

Katie Prown
Legislative Chair
Wisconsin Guild of Midwives

[rmzbm]

Originally Posted by [e-mail]

I'm so sorry to hear that this happened to you, and I wanted to come out of lurkdom to let people know their rights should they find themselves in a similar situation. I don't know when you underwent your court-ordered cesarean, but they've become much more rare in the aftermath of multiple appellate court rulings declaring them to be illegal.

The women who've appealed their court orders forcing them to undergo a cesarean have won. Of course, this does you know good when you're faced with one because the surgery is usually performed ASAP before the appeal process can be initiated. So in most cases, the appeal took place well after the violation occurred.

However, it is helpful for women to know this information. Hospital attorneys certainly do, and they also know that at least one hospital lost a multimillion-dollar lawsuit as well as the family’s appeal to the appellate court (whose rulings hold the force of law). So they're well aware that they're taking a gamble any time they pursue a court-ordered cesarean, and they're banking on the fact that laboring women are unaware of the case law on this issue.

Anyone who finds themselves in this situation can inform staff and the hospital attorneys that they will appeal the ruling, all the way to the Supreme Court if need be, and that the law is on their side. Not to mention ACOG's ethical guidelines on court-ordered cesareans, which state that they are "rarely, if ever" justified and that, in fact, there has yet to be a case in the US that could be considered ethically justifiable, not to mention legally sound. So you can always remind staff that in addition to the law, you also have ACOG on your side and that you'll be filing a complaint against your physician as well.

Katie Prown
Legislative Chair
Wisconsin Guild of Midwives

This entire post should be made into a sticky!

[Fyrestorm]

Originally Posted by [e-mail]

I'm so sorry to hear that this happened to you, and I wanted to come out of lurkdom to let people know their rights should they find themselves in a similar situation. I don't know when you underwent your court-ordered cesarean, but they've become much more rare in the aftermath of multiple appellate court rulings declaring them to be illegal.

My section itself was not court ordered. The threat was made that if I didn't comply, they would get a court order and I would lose custody as soon as the baby was born because I put her in danger. The threat was enough.

The women who've appealed their court orders forcing them to undergo a cesarean have won. Of course, this does you know good when you're faced with one because the surgery is usually performed ASAP before the appeal process can be initiated. So in most cases, the appeal took place well after the violation occurred.

My case was won on the basis that I was coerced with threats in a situation where all the medical signs showed no danger. I was lied to and fortunately could prove it in court. There were court orders in my case for procedures preformed on DD after she was born that we had refused. We won on those as well since they were also proven to be medically unnecessary.

However, it is helpful for women to know this information. Hospital attorneys certainly do, and they also know that at least one hospital lost a multimillion-dollar lawsuit as well as the family’s appeal to the appellate court (whose rulings hold the force of law). So they're well aware that they're taking a gamble any time they pursue a court-ordered cesarean, and they're banking on the fact that laboring women are unaware of the case law on this issue.

Good luck getting anything thing accomplished with hospital lawyers in the middle of the night while in labor...the medical staff will just run you down and let the lawyers sort it out later. As I stated..in my case, they were careful to raise the threat level to high by threatening to take my DD away through CPS. This way they can avoid the pit falls of having to fight a court ordered section later. I think they believe they are safe this way since technically I consented.

Anyone who finds themselves in this situation can inform staff and the hospital attorneys that they will appeal the ruling, all the way to the Supreme Court if need be, and that the law is on their side. Not to mention ACOG's ethical guidelines on court-ordered cesareans, which state that they are "rarely, if ever" justified and that, in fact, there has yet to be a case in the US that could be considered ethically justifiable, not to mention legally sound. So you can always remind staff that in addition to the law, you also have ACOG on your side and that you'll be filing a complaint against your physician as well.

Katie Prown
Legislative Chair
Wisconsin Guild of Midwives

I did all this LOUDLY!!!! It made no difference...they just increased the threats until I consented. They can and do have the power to do anything they want, whenever they want to. It does not matter how informed you are. Unless you have an atty standing right at bedside during labor and delivery..you really have no choices.

[rmzbm]

Fyrestorm,
Can I ask what prevented you from walking out? I mean, if they didn't have the order already? Was it hard labor? That would be understandable. I'm not in any way being accusatory, I hope it doesn't sound that way, I am SO sorry you went through that. I am trying to get a picture of/understanding of what went on. That is so scary! I just wondered: did you try to leave & were prevented in some way? I understand the fear of losing your baby. I'm so sorry!

ETA~ I think I'm asking because getting "trapped" in a hospital is a huge fear of mine.

[Fyrestorm]

Originally Posted by rmzbm

Fyrestorm,
Can I ask what prevented you from walking out? I mean, if they didn't have the order already? Was it hard labor? That would be understandable. I'm not in any way being accusatory, I hope it doesn't sound that way, I am SO sorry you went through that. I am trying to get a picture of/understanding of what went on. That is so scary! I just wondered: did you try to leave & were prevented in some way? I understand the fear of losing your baby. I'm so sorry!

ETA~ I think I'm asking because getting "trapped" in a hospital is a huge fear of mine.

I was pretty trapped...they had already gotten the court order for internal monitoring..I had been having premature pushing contractions that I had been fighting for about 12 hours at home before I agreed to transfer to the hospital. I was completely exhausted. MY HB midwife explained later that with the rolling contractions I had been having all night, it was like I had been in transition for about 6 hours. Leaving was not really an option at that point. I did think about it...I just didn't know how I could. I also don't think they would have let me out at that point based on what they later did with DD. They called security as well as the police when we tried to get out of there.

Check out DD's story in my link for a more comprehensive time line.

[rmzbm]

Originally Posted by Fyrestorm

I was pretty trapped...they had already gotten the court order for internal monitoring..I had been having premature pushing contractions that I had been fighting for about 12 hours at home before I agreed to transfer to the hospital. I was completely exhausted. MY HB midwife explained later that with the rolling contractions I had been having all night, it was like I had been in transition for about 6 hours. Leaving was not really an option at that point. I did think about it...I just didn't know how I could. I also don't think they would have let me out at that point based on what they later did with DD. They called security as well as the police when we tried to get out of there.

Check out DD's story in my link for a more comprehensive time line.

OMG! You must be very traumatized! I would feel raped, well, you really WERE. I'm so sorry. That's a huge fear of mine...no matter what anyone says, they OWN that baby until you are discharged, they really do. I'm going to go read your story...

[Fyrestorm]

Originally Posted by rmzbm

OMG! You must be very traumatized! I would feel raped, well, you really WERE. I'm so sorry. That's a huge fear of mine...no matter what anyone says, they OWN that baby until you are discharged, they really do. I'm going to go read your story...

I think cases like mine were the reason the term 'birthrape' was coined.

[rmzbm]

Originally Posted by Fyrestorm

I think cases like mine were the reason the term 'birthrape' was coined.

HOLY CRAP! I just read it...are they also paying for a lifetime of therapy?! : I would never trust anyone in a white coat ever again. You are one strong woman!

[grumpyshoegirl]

Originally Posted by rmzbm

HOLY CRAP! I just read it...are they also paying for a lifetime of therapy?! : I would never trust anyone in a white coat ever again. You are one strong woman!

I just read it too. I have to thank you from the bottom of my heart for standing up for ALL OF OUR rights. I am so, so, so sorry for everything you went through. I am so glad they're paying for this. It will never undo the damage but maybe it will make them think twice before they treat anyone like this again.

[[e-mail]]

Originally Posted by Fyrestorm

My case was won on the basis that I was coerced with threats in a situation where all the medical signs showed no danger. I was lied to and fortunately could prove it in court. There were court orders in my case for procedures preformed on DD after she was born that we had refused. We won on those as well since they were also proven to be medically unnecessary.

I know you can't talk about the settlement, but can you explain more about the charges you filed against the hospital, staff and police? I think many women can learn from and be inspired by your story. Physicians still love to spread the myth that the only cesarean you get sued for is the one you didn't do. Looks like you proved them wrong. And I'm so very sorry you and your family suffered so much for it. What happened to you was indeed a crime, and I really admire you for making sure people were held accountable for it.

I'm curious to know, too, whether the suit against the hospital was for malpractice--was it a civil suit? And then you also filed criminal charges against the CNM and other staff? Was anyone convicted of criminal charges? I'm assuming you also filed complaints with licensing boards--is that how the CNM lost her license? Or was it the result of criminal charges? Also, how were you able to prove that you were lied to? That would be very helpful information for other women to have.

Sorry for so many questions! But I do think other women can learn more from your experience about how they can see to it that some form of justice done in the aftermath of the type of abuse that you endured.

Also, if you don't mind PM-ing me the name of your attorney, I would really appreciate it (please note that my user name isn't my actual email address--using the PM feature here will work though).

I'd like to get in touch with him/her because I'm working with a group of attorneys who are developing a continuing education program for lawyers where they can get CEUs for learning about the patient rights abuses that birthing women endure and legal strategies (such as yours) for remedying them. We have a physician, too, who will teach a workshop educating malpractice attorneys about the medical misinformation that expert witnesses use in malpractice cases. Another attorney who won a malpractice case for an unnecessary cesarean will be leading a workshop, and I know he would be interested in networking with attorneys who have been involved with similar cases.

Thank you for sharing your story with us.

Katie Prown
Legislative Chair
Wisconsin Guild of Midwives

[Fyrestorm]

I would be happy to answer any questions that I can...but would you mind bringing this over to the birthstory thread in my siggie as I think this thread had been hijacked long enough...

So sorry to the OP..

Can we bring this back to the OP question?

Originally Posted by LaughinWillow

Hey there - trying to figure out what my rights are, going into trying to have a vbac in August...

My midwife informed me at my last appointment that it's "hospital policy" that anyone attempting vbac has to be on constant fetal monitoring. I don't feel like this is necessary, especially because my previous cesarean was due to the baby's positioning. I don't object to periodic monitoring, but the midwife says that I won't be permitted to use the whirlpool tub because of the constant fetal monitoring required. I want to have the tub option - with ds it helped immensely with labor (I was fully dilated without meds before I had the cesarean). I suppose if there is no other option and it's the safest thing to do, I'll go along with the monitoring, but am I really required to? And will it really make things much safer than just checking the baby every 30 minutes or so? My midwife for ds had me sit up in the tub every 30 minutes to check the baby, and it didn't seem like a huge problem or anything...

Anyway, opinions?

[peapiebaby]

Don't we all wish we lived near the Farm? I bet many of us may not be here trying to VBAC now....

You can have a telemetry unit and bathe w/ it.

I was supposed to but when they did AROM and saw how much meconium came w/ it, they slapped an internal monitor on (which I had refused, refused, refused) without asking. Sigh. :

[kltroy]

...going back to the original poster's question about violating "hospital policy" - and related to Fyrestorm's absolutely horrible birth story (I'm so sorry that happened!)

let's all be realistic here for a minute. I think that a lot more can be accomplished re: getting hospital staff to cooperate with you and having a good hospital birth experience if you go into it with a good attitude. Getting the L&D nurses on your side, being a pleasant person etc goes a long way towards letting them bend the rules for you a bit. If you really have a serious problem with a known policy, consider going somewhere else or birthing at home. Hospitals generally require continuous EFM for VBAC because it's what the ACOG guidelines suggest. If they have a telemetered system it's annoying but at least you're not tied to the bed. And if they don't, keep "having to pee" and/or negotiate with the nurses and your doc/MW.

I think walking in the door pissed off and with a bone to pick, as much as we want TO MAKE A STATEMENT and to have OUR BIRTH to be the way we envision, is generally counterproductive and can create obstacles. Do what YOU need to to have the best birth experience that YOU can have, but remember that at the end of the day your top priority is that you and your baby are healthy. Best case: you have a great experience AND a healthy baby. But, as all of us mamas who have had c/s know, sometimes you have to "take one for the team" whether you want to or not, and whether you think it is for a good reason or not. And whether we like it or not, we are stuck with the medical system that exists in this country - best, then, to do what you can to make sure you get the best experience you can when dealing with it, flawed though it is.

So please, politely refuse or negotiate (it will get you farther than copping an attitude usually), but make sure you can live with the hospital policy before you go there. Making sure that you MW has a good relationship with her backup doctors and hospital is a good precaution, too - in case things go south.

[rmzbm]

What on EARTH are you talking about? I don't EVER need to "take one for the team!" :

[MilkTrance]

Regarding the OP, I don't know. I wish I knew, and I am going to research the legalities (in BC, Canada) before my next. I was basically confined to the bed, in a lying position, with an IV and an internal monitor, and only allowed to get up to go to the bathroom. ALL I WANTED was a nice, hot shower on my back.

My baby was posterior.

Had tea at a friend's house a few weeks after delivery. She told me that one way her delivery nurse coaxes the babe to turn during delivery is through a nice, hot shower.

I cried when I heard that!

Fyrestorm -- thanks for telling your story.

[wifeandmom]

Originally Posted by rmzbm

What on EARTH are you talking about? I don't EVER need to "take one for the team!" :

I'd take whatever I had to if it meant the life of one of my children. Perhaps that's what she meant by 'take one for the team'? It doesn't mean I'd like it, it doesn't mean I wouldn't try to do things different next time, but in the moment, if it was absolutely necessary, you bet your ass I'd 'take one for the team'. Wouldn't we all? :