Mom needs to transfer - what happens to baby?

[Lisa85]

The carseat thread got me thinking - if mom needs a hospital transfer for whatever reason, but baby is doing just fine - what happens to the baby. Ideally I'd like for baby to stay with my dh so he/she does not become a 'patient', but is that possible? How much of a hassle would it be?

FWIW - I'm not pg or even TTC yet, but just researching my options until we're ready to TTC again.

[nashvillemidwife]

I would never send a healthy baby to the hospital with mom. First, the hospital is dirty and baby just doesn't need to be there. Second, that avoids them trying to take the baby and make him a patient. Third, the fact that they're dealing with a breastfeeding mom with a hungry baby at home will get the mom out quicker.

[the_lissa]

Well I guess it depends on where you live and the hospital. Here, that is definitely possible. If I have to transfer, my partner will bring the baby to the hospital and stay with us.

[Patchfire]

I've told the people who will be with me that if I have to transfer, the baby stays at home, at least for a couple of hours. That gives us enough time to figure out what the heck is going on with me and then evaluate if the baby needs to come visit me or what. I don't want to show up initially with a baby in tow, though, because I would not want her admitted.

[Lisa85]

In the case of an ambulance coming though - how likely are the responders to just accept that the baby doesn't need to go? I don't want the baby to be admitted just because, but I also don't really want to deal with CPS and medical neglect.

[barefootpoetry]

My midwives and I agree that in the case of transport for tear repair, I would be taken alone with them and my baby would stay home with DH. If there was something that would cause me to be admitted, DH would come with the baby after I was all squared away so we could nurse.

A week after my first birth, I had to go back to the hospital for PPH and since I was home alone, baby came in the ambulance with me. DH met us at the hospital and took him when we got out. Granted, this was a week postpatrum so I'm sure they weren't as keen on admitting the baby as they would be right after a birth, since OMG there's gotta be something WRONG with him if he wasn't born in the hospital.

[nashvillemidwife]

The only time I've had to transport a postpartum client by ambulance the grandparents followed with the baby, only to be sent home by the hospital staff because the dirty hospital was no place for a healthy newborn baby. The situation was a little different than usual as she was taken in through the ER of the regular hospital for a seizure that was not necessarily birth related, but the principle is still the same.

[ChristSavesAll]

Originally Posted by Lisa85

In the case of an ambulance coming though - how likely are the responders to just accept that the baby doesn't need to go? I don't want the baby to be admitted just because, but I also don't really want to deal with CPS and medical neglect.

I took an unnecessary trip to the er by ambulance (emts insisted though I insisted I was fine, really should've listened to my gut instinct) and left baby with grandma at home. The emts did not like that at all despite the fact she was two hours old already and they gave her a 10 for her apgar score.

CPS was called on me, I belive it was one guy in particular (jeff) because he had extreme attitude with me about the whole thing, while the other guys were enjoying meeting my dd and commenting on how beautiful she was.

Two sheriffs came out next day saw dd and ds and were very sweet, said they had 12 kids between the two of them and totally understood what was going on.

Then we had a public health nurse come out the day after the sheriffs and left a note on our door to call her back, we did and scheduled and apt with her to come back out a week later. She too checked dd out and though was not happy with my choice to homebirth or not vax she conceded that we were good parents and were not harming our children. I thank God that though CPS was called, the people that were sent out were very kind and did not cause us any additional and unnecessary trouble. Dd is 6 weeks now and I haven't seen anyone since. Hope I never do.

That being said, I would not change a thing except to say that I would definitely think twice before going to the hospital or calling for an ambulance next time.... Definitely go with your instincts, they trump everything!

[Lisa85]

My midwives and I agree that in the case of transport for tear repair, I would be taken alone with them and my baby would stay home with DH. If there was something that would cause me to be admitted, DH would come with the baby after I was all squared away so we could nurse.

Duh, I totally forgot that any midwife I hire will likely have an assistant. I'll probably have one stay with my dh and new baby and the other come with me. Dh would be nervous nelly left at home with a newborn while his wife is hopstialized - he's such wus when it comes to pain even if it isn't himself and I insist I'll be fine

What do you all do (plan/ned to do)about feeding then? Have dh come if it's been longer than an hour or so?

[Quaniliaz]

I went in to the hospital after my first dd was born for a high arterial tear. She stayed at home with my mom. She nursed and cuddled with me before we left, we went into the hosptial when she was about 2 hours old, and we were back about 2 hours later. If I had a similar situation, I would do the same thing again. Oh, and DH and midwives came with me to hospital.

[wild fire child]

My hospital may be a bit out of the norm, but when I asked my MW about this, she said that at this particular hospital, even if mom walks in with baby in her arms less than an hour old, the staff will not touch the baby, will not admit it, as it is not their patient. I imagine if the cord were still attached and placenta undelivered, this may be a different story. I know that when my mom had my little brother and went in for hemorrhage before birthing the placenta, they did admit the baby and one of the nurses called CPS while they were still in the hospital. That was a hospital in a different state though, I don't know how it would happen here.

I do feel safer with the knowledge that they won't admit the baby if I go in, but I still don't know what I would prefer to do - being a first time mom moments after a birth, I don't know that I would be okay with leaving the baby with anyone else, be it my fiance, the grandparents, or the assistant MW. But then I'd be scared of hospital germs....it's a hard decision.

[peainthepod]

The baby would stay home with the midwife's assistant and DH and my midwife would accompany me to the hospital (she has privileges there). I like to think that no one will call CPS on us if my midwife (a CNM) is the one helping me at the hospital. Regardless, I would refuse to let them check in the baby as a patient unless he sincerely needed it.

[rockportmidwife]

It really does depend on the hospital. We had a PPH immediately following the birth. All of us headed over to the hospital. She ended up needing a D&C because of retained placenta. They immediately tried to admit the baby. Even the EMS was telling them that the baby wasn't to be admitted. All of us were being treated ugly. They kicked the midwives out of her room, since I was still a student I got to stay. We eventually decided to take the baby and leave (with the parent's permission of course). Because we did, they called CPS on the parent's. One of the midwives lived nearby, so the baby stayed with her at her house. Well, after being questioned by CPS, CPS actually sided with us and told the hospital that they needed to be more cooperative. We ended up bringing the baby back, because they wouldn't let the mom leave until the next day. They wanted to be able to keep breastfeeding.
Another time in a different town, we had no trouble when taking a mom in for a repair. At least when it came to the baby. But the rest of the story is for a whole other post.

[laohaire]

If I had another birth, I don't know what I'd do. I did transfer post partum to get stitched up at the ER. We had already discussed this question in general, and decided that if I needed to go but baby didn't, then midwife and DH would take me, and baby would stay at home with the assistant and my mother. And that's what we did.

The hospital was a little wary about me showing up post-partum without a baby, but it didn't go beyond that (CPS not called or anything). I think they could see from my sheer JOY that the baby was definitely ok, and they didn't have cause to suspect anything.

So that part was fine. But ER visits take FOREVER and I hadn't counted on that. There were a lot of reasons for that, for example having to wait for the OB on call to come in, plus an argument with him about letting my midwife stay for the procedure (we were all doubly resolved that she should stay given the objection - I was suddenly afraid the OB would hurt me - he was the same OB who, on an early neonatal visit, actually convinced my DH to go with homebirth because he was such a UAV). Anyway, it took forever, and it was far too long to be away from my baby who had not even latched on yet.

The whole thing makes me sad. My baby had trouble nursing, my midwife was of no help, and then my baby was admitted for severe jaundice (above the critical level). I don't know how much the separation might have played into that. (She did not get any milk or colostrum until the 3rd day of her life).

I guess I'd still go in by myself rather than risk them admitting my baby, but I would be just worried about the separation.

[mwherbs]

for the most part it is a baby we have been transporting and we send mom along in the ambulance so she can be with the baby.
I have discussed this with parents and it really depends on where and why we are transferring - if we had to take just mom in say for a retained placenta and baby rides with us or if in an ambulance then the baby rides with the partner- then it is up to the parents how they want to handle it after that do they want to admit the baby and sometimes they do or do they just want to have baby close by to be able to nurse-- with the rules on birth certificates here if the placenta is delivered in the hospital then that is who files the birth certificate - and actually what I have had happen is every transport placenta out or no the hospital has filed the birth cert--- I know it is a not the best place for a healthy baby but being seperated from mom is not the best either just a choice clients have to make-- we probably have had one baby that stayed home with mom gone, the other concerns have to do with how is mom doing and very often partners want to be right there to be sure everyone is ok

[NaturalMamaof2]

I just had an unexpected unassisted home birth on the 24th of August. Mine was unplanned, but because when I'm pregnant I am high risk, both the baby and I were sent to the hospital about 15 minutes after her birth. My baby was fine but they insisted on taking her with me. I was having problems delivering the placenta on my own without assistance.

[starling&diesel]

I'm a paramedic, and we usually transport babe with mama because most mom's I've had as patients don't want to be separated from their newborn. Baby doesn't necessarily become a patient at the hospital, either. We encourage babe to come so that mom and babe can continue bonding and breastfeeding can progress unhindered.

It is always a patient's right to refuse care for themselves or their minor children, however, we will require that mama signs an Against Medical Advice form if we think there are concerns with baby's health, or her own, and if she is refusing transport or treatment.

I know I'll be stepping on toes with what I say next, but I stand by it.
We paramedics are trained to watch for signs and / or symptoms that signal a medical concern. If we see that in you or your newborn, we are legally responsible for following up with due diligence and care. With all respect to mama's out there who birth their babies at home (I'm planning a homebirth myself in February), you may not be your infant's most clear-headed advocate immediately after birth. We turn to the midwives for their opinion. And if we still leave Against Medical Advice and we still have concerns about baby for whatever reason, we are obliged to call CPS. It's the law. And a good one, for the rare occasions where baby is truly at risk.

That said, our midwife will be our post-birth advocate should any problems arise that result in a hospital transfer. And I know a lot of paramedics who think poorly of home birth ... so if we were to come up against that, I'd happily sign the AMA form and they can call CPS and we'll deal with that rather than be bullied into an unecessary transfer.