Uninvited staff audience at hospital birth - Page 2

[woodchick]

Originally Posted by gcgirl

I totally understand your frustration. I had the opposite reaction, however, to the gaggle of hospital staff that crowded in the doorway to watch. So what if I was naked; it might be the only unmedicated birth they ever see. And I wasn't howling in pain, and I was friendly and cracking jokes right after. That has to be a positive influence.

But yeah, they should have asked in advance. Even if it was a teaching hospital.

:

Your wishes should have been top priority, but it doesn't seem like you had the opportunity to make them known.

I had an unmedicated vaginal birth that was 5 minutes away from a c-section. The room was full of nurses and neonatologists who were expecting surgery. Two weeks later in the NICU my DH kept pointing out new people who had been in the delivery room- I had no idea who they were or how many there had been!

I just hope that the experience gave them a look at natural birth and opened their eyes to other options than surgery.

[ollineeba]

Originally Posted by not now

I always introduced myself to my patients "Hi, I'm not now. I'll be your student nurse today is that ok?" I was never refused but the male students were refused often (on all floors) and I remember one female student being refused.

I know.. I can't believe I've never seen that happen. I heard that occasionally it will happen when there is a male student on L&D, though.
We were told just to say "Hi, I'm so-and-so, I'm a student nurse and I'll be taking care of you today along with Nurse so-and-so."
But by the time we've gotten to that point, we've already had that pt's info for like 24 hours and have been researching all their meds, etc (I'm sure you remember all that fun stuff ). But L&D is, of course, different.
I remember on my first day of school asking if they get permission from those patients first- before they even make a list of names to hand out to our clinical group- and the instructors looked at me like I had three heads


But it sounds like it was just a bunch of extra people in the OP's situation, people that hadn't even been involved in her care, which is upsetting.

[coyotemist]

Respiratory therapy student here-Any time the baby might need resusitation (meconium in the water or a caesarian birth) the senior respiratory therapist attends, and she/he often has 1 or 2 students. That being said we are very unobtrussive, and only there for the moment of birth and a minute or 2 after (if the baby can't be resusitated in that time frame the baby is often moved off to the nursery). Then we slink out of the room, we'd rather not disturb the energy going for the family, nor invade their privacy. The only way we are going to learn how to do this is by watching, and then by doing.

All that said, there are only 2 or 3 of us, and we don't make a point of staring at your birthing process. Its not quite a few people, and we aren't there for every birth. Most of the hospitals in our area are "teaching" hospitals, even if they don't advertise that fact.

A good practitioner will tell you who they are, what their role is, and what they are going to do to you/with you/for you. EVEN if they are a student.

No special forms have to be signed at any of the hospitals I have been learning at to allow a student to be in the room with you, they are overseen by a senior practitioner.

As a patient, I have requested that "so and so" not return to my room to take care of me because of their bedside manner (nurses generally, but I have fired a doctor or 2). You have the same rights.

[SublimeBirthGirl]

Originally Posted by rozzie'sma

This is not true. My son has had many procedures done at a major university hospital and I was always asked before any students were allowed in the room. Also I was a nursing student once and I had to specifically obtain patient permission before I could help care for a person. A right to privacy is in the patients rights statement that the hospital must provide every person upon admission under HIPAA. I would write a letter, they probably did not even think that it would bother you, some people attend so many births they forget a family is being created or added in that room. A friendly letter would remind them of that.

Nobody asked me.

[SublimeBirthGirl]

Originally Posted by Lorette

I wonder why your doula didn't ask them to leave?
It should not have been up to you to ask them to leave.
Isn't that what doulas are there for?

As a doula I would never tell hospital staff to leave the room. I would say to the mom something like, "Did you want to keep your birth private?" Something like that, to remind her (or dad,hopefully) to ask them to leave. I'm not afraid of getting sued. Who could sue me for asking someone to leave the room? I have no power as a doula, and they can just ignore me. All I can do by telling someone to leave the room is make them angry, and possibly make people in that hospital unwilling to work peacefully with doulas in the future.

[KnitLady]

I'm sorry that happened to you!

I birthed at the same hospital and did not have any gawkers. I had my mw, my dh, my doula, a mid-wife in training (which I okayed far in advance) and one nurse.

This hospital is not a teaching hospital, and it is known in the area as being the go-to hospital for natural births, so it shouldn't have been the first natural birth those nurses and other audience members have seen. :

[TattooedMama]

I am sorry your birth experience did not go as planned. I hope you are enjoying a beautiful babymoon now though.
It seems like everyone has assumed that the "extra" people that showed up at the moment of your birth were students. I have no way of knowing this, but I am wondering if they were in fact staff acting on hospital policy?? In our hospitals here if meconium is present then yes, it can seem like a clown car full of folks have suddenly showed up in your room.

Now I am an RN who does only OOH birth now and I DO think that WAY too many staff members are called in to hospital births...but...if your hospital was a midsized one like here, then... the nurses aid or tech is who you would have seen setting up your MW's table of instruments, your regular labor nurse is who was assigned to take care of you, another nurse would have arrived to be the baby's nurse, then respiratory therapy or NICU would be called there because of the meconium. They usually work in a team of 2 or more. The charge nurse or team leader for L & D would also be expected to attend if there were any complications, like the meconium. Now at home we would be handling all this with one MW and one nurse or assistant usually.

So don't think in any way I am saying that I think all that staff is necessary.
But it is how things are done in hospitals, and I don't mean to be blunt but you kind of signed up for that when you signed up for a hospital birth. So it's not that folks weren't busy with other jobs and just decided to come "watch" or "showed up uninvited." They were "invited" into your birthspace as soon as your MW let them know that there was meconium. It was policy, it was their job. I am so sorry for the fact that you did not get to have the waterbirth you planned. I have seen this happen many many times over the years, where people (couples usually) choose a hospital MW for their birth attendant seeking a very personal event. What they might not be aware of is the number of staff that typically are assigned to cover a birth in the hospital. Now I have seen the MW call off everyone but the one nurse to handle a very low risk birth. But that is the MW's call. Not your doula.
Also, I do personally think that hospital staff can do a fairly crappy job remembering that this is a sacred event and not just a job. We need to work on this as doulas and nurses, showing the way as advocates for peaceful, low-key, natural birth especially in hospitals.
I too do not usually desire students to be involved if my family is accessing medical care. I understand and I hope your memories of your birth can be reconciled. I believe too that if you felt that the staff members were not behaving courteously or professionally in any way that a letter would be in order.
Honestly this is great reason why people choose out of hospital birth-you have more control and a much smaller staff to meet ahead of time and get used to working with.
Peace and Blessings on your new baby,

[PassionateWriter]

ive done alot of work w/ HIPAA and it does not guarantee you privacy from other medical professionals. period.

as far as what doulas do, yeh..there is a bit of a controversy there.....women who are in labor, who are focused on birth adn may not want something to happen when its happening but be unable to say anything...doula's dont really advocate for you...most of the ones i have read about will say something like "the dr. is about to cut an episioptomy, are you ok w/ that" (i took taht from Pushed, not personal experience) and its the moms job to say no. even if the doula knows thats not what the mom wants, its the mom who has to speak up.

there is an interesting section in Pushed about Doulas and their work.

after all that, i am having a Doula at my birth but im not birthing in a hospital. after reading what i have read, i would not depend on a doula to protect my rights in a hospital. i dont feel that i can rely on anyone to protect my rights in a hospital, which is why im birthing at home.

honestly, it really is their turf when you are in a hospital and other than a letter of complaint, there isnt much you can do about it. ;(

[not now]

Originally Posted by coyotemist

Respiratory therapy student here-Any time the baby might need resusitation (meconium in the water or a caesarian birth) the senior respiratory therapist attends,

I work closely with a lot of RT's since most of my patients are on vents or have just been extuabated. I told them that if they attend my birth they better watch "waist up only!"

[agnieszkaj]

Thank you so much, TattooedMama. You really explained it all so well. My two previous births only had my OB and nurse in attendance - and these were both very interventive births. So, I never would have thought this could happen at my natural mw birth.

I remember seeing these nurses standing near my door, appearing to be observers with no reason for being there. My dh says that there was one tech who was assisting my mw. And my dh says all these young girls looked like candy stripers, except they weren't. From my understanding, there are *not* students at this hospital.

I guess the *light* meconium may have been the cause of the big presence. I did not have meconium in my previous births. But, no one examined my baby at all. My mw gave him to me immediately. My nurse suctioned him a little while I held him. My baby did not have a nurse of his own. As soon as he was born, the room cleared. Do you think that these nurses, etc. were present in case of a problem but went away because my mw said my baby was fine? Or would these people automatically expect to examine my baby due to meconium?

So it is sounding more like this may be yet another problem related to hospital policy...

Originally Posted by TattooedMama

I am sorry your birth experience did not go as planned. I hope you are enjoying a beautiful babymoon now though.
It seems like everyone has assumed that the "extra" people that showed up at the moment of your birth were students. I have no way of knowing this, but I am wondering if they were in fact staff acting on hospital policy?? In our hospitals here if meconium is present then yes, it can seem like a clown car full of folks have suddenly showed up in your room.

Now I am an RN who does only OOH birth now and I DO think that WAY too many staff members are called in to hospital births...but...if your hospital was a midsized one like here, then... the nurses aid or tech is who you would have seen setting up your MW's table of instruments, your regular labor nurse is who was assigned to take care of you, another nurse would have arrived to be the baby's nurse, then respiratory therapy or NICU would be called there because of the meconium. They usually work in a team of 2 or more. The charge nurse or team leader for L & D would also be expected to attend if there were any complications, like the meconium. Now at home we would be handling all this with one MW and one nurse or assistant usually.

So don't think in any way I am saying that I think all that staff is necessary.
But it is how things are done in hospitals, and I don't mean to be blunt but you kind of signed up for that when you signed up for a hospital birth. So it's not that folks weren't busy with other jobs and just decided to come "watch" or "showed up uninvited." They were "invited" into your birthspace as soon as your MW let them know that there was meconium. It was policy, it was their job. I am so sorry for the fact that you did not get to have the waterbirth you planned. I have seen this happen many many times over the years, where people (couples usually) choose a hospital MW for their birth attendant seeking a very personal event. What they might not be aware of is the number of staff that typically are assigned to cover a birth in the hospital. Now I have seen the MW call off everyone but the one nurse to handle a very low risk birth. But that is the MW's call. Not your doula.
Also, I do personally think that hospital staff can do a fairly crappy job remembering that this is a sacred event and not just a job. We need to work on this as doulas and nurses, showing the way as advocates for peaceful, low-key, natural birth especially in hospitals.
I too do not usually desire students to be involved if my family is accessing medical care. I understand and I hope your memories of your birth can be reconciled. I believe too that if you felt that the staff members were not behaving courteously or professionally in any way that a letter would be in order.
Honestly this is great reason why people choose out of hospital birth-you have more control and a much smaller staff to meet ahead of time and get used to working with.
Peace and Blessings on your new baby,

[TattooedMama]

Originally Posted by agnieszkaj

I guess the *light* meconium may have been the cause of the big presence. I did not have meconium in my previous births. But, no one examined my baby at all. My mw gave him to me immediately. My nurse suctioned him a little while I held him. My baby did not have a nurse of his own. As soon as he was born, the room cleared. Do you think that these nurses, etc. were present in case of a problem but went away because my mw said my baby was fine? Or would these people automatically expect to examine my baby due to meconium?

So it is sounding more like this may be yet another problem related to hospital policy...

Yes, the staff would have been "observing" him from afar and taking subtle cues from your MW (or OB). They must have determined that by your MW's actions and the nurse doing gentle suctioning (I hope gentle!) that a full blown resuscitation was not necesssary and they faded away to leave you in privacy. I am still sorry that it wasn't explained to you so you could anticipate. As a doula or a nurse I will ALWAYS let the woman and partner know what is coming next, "Jane, it looks like there is some light meconium in the bag of waters. At the moment of the baby's birth there will be extra staff people on hand to help out." Maybe your doula is not experienced enough or didn't feel comfortable saying that, but I feel that is a very important part of what a doula DOES do.
HTH,

Jessica

[Lorette]

Originally Posted by SublimeBirthGirl

As a doula I would never tell hospital staff to leave the room. I would say to the mom something like, "Did you want to keep your birth private?" Something like that, to remind her (or dad,hopefully) to ask them to leave. I'm not afraid of getting sued. Who could sue me for asking someone to leave the room? I have no power as a doula, and they can just ignore me. All I can do by telling someone to leave the room is make them angry, and possibly make people in that hospital unwilling to work peacefully with doulas in the future.

I meant that the doula should have helped facilitate the onlookers leaving.
However doulas do that kind of thing--
The doula should have helped the mama get the onlookers to leave.

[Lorette]

Originally Posted by TattooedMama

Now I have seen the MW call off everyone but the one nurse to handle a very low risk birth. But that is the MW's call. Not your doula.

I guess the reason I see this as the doula's job is that in my case I see a mw practice of 8 mws. I don't feel that each one knows me and how I feel about birth or what I want my birth experience to be like, whereas my doula and I have a more personal relationship and have talked at length about my wishes and hopes for my birth experience. My doula would be more likely than my mw to realize that I don't want onlookers in the room, because each of the 8 mws who might be at my birth don't know me personally.

[TattooedMama]

Originally Posted by Lorette

I guess the reason I see this as the doula's job is that in my case I see a mw practice of 8 mws. I don't feel that each one knows me and how I feel about birth or what I want my birth experience to be like, whereas my doula and I have a more personal relationship and have talked at length about my wishes and hopes for my birth experience. My doula would be more likely than my mw to realize that I don't want onlookers in the room, because each of the 8 mws who might be at my birth don't know me personally.

Oh I get what you are saying about having a closer relationship with your doula than your MW. But we are comparing apples to oranges here. This was not a time or space for either the doula or the MW to go, "Oh yeah. Jane and her DH really wanted a private birth with no unecessary staff or students attending."
This was a medical issue (meconium) at that point and I'm sorry to say the couples desires go flying out the window in the hospital birth setting when something unexpected arises.
I think it sucks personally, because we don't do that at home. That is one of the reasons I love OOH birth. We roll with it and don't trample a birth plan in the process usually.

I have said for a long time if a baby of mine were ever to need minor resuscitation or say I needed an IV postpartum for blood loss I would be SO GLAD my experienced homebirth team can handle it at home with mom and baby close by and no one freaking out.
Sadly, this doesn't happen in the hospital. There is still the perception that birth is a surgical/medical event and that is why in the hospital they feel it takes 6+ staff members to facilitate a baby's normal, vaginal birth.

So absolutely as a doula with a close relationship you would realize that this woman had not wanted "onlookers" in the room. At this point it became even more important for someone (the doula, MW, or nurse) to let the couple know about the change in plan. They let her know that per policy she could no longer labor/give birth in the tub because of the meconium.They needed to also let her know about the staff that would be arriving for the birth. How many times have couples (usually the Dads) been scared unnecessarily when 6-8 moon suited people show up with no warning to them? I have heard from Dads before that they thought their partner and /or baby were going to DIE. How sad at the moment of the baby's birth to have that fear in the room.

I don't want top hijack this thread anymore... I just didn't want to see the hospital staff vilified with no one giving an explanation of why they would have been called in to attend this woman's birth. Oh wait one more thing, it drives me nuts when MW's play good cop bad cop with their clients. By saying "Oh if it was up to me I would let you deliver in the tub. But it's hospital policy so you can't have your waterbirth now..." That wasn't fostering a trust relationship with this couple. Or making the MW seem cool or whatever. It was setting up a pardigm of distrust that extended to this birthing mom feeling violated by having strangers at her birth.

It would have been handled so much better, I feel, if she had approached it as a teaching moment about why they change from a waterbirth was happening and how the rest of the birth was going to go, by acknowledging that they had wanted no one else in the room and how she as the MW would (within reason) convey that message to the staff. Like I said, I have seen really good hospital MW's call the shots and tell the nurses aide and the charge nurse, for instance that they would not be needed. Also if a deep resuscitation was not anticipated (light mec only) then the respiratory team or NICU could have waited right outside the door or behind a curtain while they waited to see if they were needed.
But this is just what I would do if TattooedMama was the MW calling the shots.
OP, I hope you feel a little better after reading this thread and have some feedback to offer your MW and doula about how your needs might have been better met.
Peace,
Jessica

[kate3]

Nursing student here. There is no permission to be gotten from a patient- we're just assigned to them- or them to us, however you look at it.

I have to repectfully disagree with this. I'm a nursing professor who takes students to a large teaching hospital for their OB rotation. EVERY patient gets asks if they could be assigned a student. I do this prior to my students showing up. Only patients who agree get a student, and most post partum patients agree. I get more refusals in L&D (for obvious reasons). If patients are not being asked about students and given the chance to refuse (which is their right), there is something very wrong with the nursing school and the hospital that allows it.

[herbanmama]

Just another doula's point of view here...

I agree that the doula should have protected you, not so much as intervening directly with hospital staff, but if your relationship was such that she would have known your desire for a more private birth, a simple word aside with your dp to remind the him of your wishes would have either cleared the room, or gotten you an explanation. He has the power to inquire as to why so many people are necessary and if they can please thin out a bit. As a doula, I see that as a primary part of my role - to be the Birth Partner's reminder when he/she is too emotionally involved in the moment to immediately remember every item on the birth plan, and general source of info when he/she does not understand a procedure etc. When I see something happening that violates the birth plan and mother cannot speak for herself, the first thing I do is casually pull the partner aside and say, "Remember - the birth plan says 'X' and they are about to do 'Y', would you like to find out why?", and 99.9% of the time, they jump on the opportunity to protect the birth plan and be of service to the mother.

[Lorette]

Originally Posted by herbanmama

Just another doula's point of view here...

I agree that the doula should have protected you, not so much as intervening directly with hospital staff, but if your relationship was such that she would have known your desire for a more private birth, a simple word aside with your dp to remind the him of your wishes would have either cleared the room, or gotten you an explanation. He has the power to inquire as to why so many people are necessary and if they can please thin out a bit. As a doula, I see that as a primary part of my role - to be the Birth Partner's reminder when he/she is too emotionally involved in the moment to immediately remember every item on the birth plan, and general source of info when he/she does not understand a procedure etc. When I see something happening that violates the birth plan and mother cannot speak for herself, the first thing I do is casually pull the partner aside and say, "Remember - the birth plan says 'X' and they are about to do 'Y', would you like to find out why?", and 99.9% of the time, they jump on the opportunity to protect the birth plan and be of service to the mother.

Thank you for this.
This is exactly what I meant when I said that the doula should have protected her in this situation.

Lorette

[mwherbs]

write a letter of complaint -- several copies should be sent out-- to the hospital administration, to your midwife's practice, a copy to your insurance, and you could also address one to the nursing staff if you want.

now that I have said that- with an average birth at a hospital I often see extra staff show up-- first of all the nurse who has been monitoring and if it is near shift change the nurse who is coming on shift, then depending on the potential for complications- 1-3 nursery nurses-- since the nurse saw mec then I am sure you had atleast 2 nursery nurses there if not a neonatal intensive care nurse-- they were waiting to resuscitate the baby if need be- how to get the room clear of that many in a hospital I don't know-- at home there is usually 2-3 of us and we do resuscitation ourselves .

[leila1213]

Lotus Birth vs. Placentophagia (sp?)

Sorry! should have been a new thread!

[ollineeba]

Originally Posted by kate3

I have to repectfully disagree with this. I'm a nursing professor who takes students to a large teaching hospital for their OB rotation. EVERY patient gets asks if they could be assigned a student. I do this prior to my students showing up. Only patients who agree get a student, and most post partum patients agree. I get more refusals in L&D (for obvious reasons). If patients are not being asked about students and given the chance to refuse (which is their right), there is something very wrong with the nursing school and the hospital that allows it.

Sorry this has gone OT now that we've sort of cleared up that it probably wasn't a student issue with the OP's birth---

kate- just to be clear, I haven't done my OB rotation yet (I left to have my baby just as I was supposed to start that section).. so I was talking about med-surg, which is what we do 1st yr in our ADN program.
Pts aren't asked ahead of time- I also agree that they should be, but they aren't, unfortunately. I really hope they at least ask ahead of time for L&D, but since I haven't gotten there yet (soon!) I don't know for sure.
Our clinical instructor hand picks the pts based on their dx so that we can see a wide variety of cases. She never once asked any of them if they would mind a student- she just sent us in there.
But I can tell you that my clinical instructor was less-than-stellar (really, I have no idea why the woman is even in education- she hated students), and I hope to have a better experience when I return.
Anyway- that's just the way it's done here. One of my good friends attends another university and it's the same there, too, which is unfortunate.