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

5K views 70 replies 36 participants last post by  kltroy 
#1 ·
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?
 
#27 ·
The bottom line like others have said is that you can refuse anything. I would make sure that your midwife knows what you'd like before hand though. It would be really sad to get there in labor and then have a fight between you and staff and not have the back up of your midwife.

When we have patients that want to have something different than the protocol the docs/midwives have to write that order. The EFM strip is the sole responsibility of that nurse (not the doc), so if the doc did not say that you can be monitored intermittently and something goes wrong the nurse is the one that fingers would be pointed at. It's unfortunate but true that the thought of a lawsuit or job loss can make people pretty grumpy when things are done by protocol.

That said, I'd stay home as long as possible, maybe you'll get there and be ready to push and you won't even have to worry about the protocols.
 
#28 ·
So, after the comments of an earlier poster whose sister had a HBAC in Virginia, I did some more research, called an Ican leader about an hour away, etc. and found out that I have completely been misled, and that not only was the law changed some time back permitting legal homebirths in VA, there are midwives in the area who will do HBAC, no problem. Except NOW the problem is that I'm 36 weeks and am trying to frantically find a midwife willing to take me this late and attend a homebirth... ARGH!

So I'm feeling really angry at the practice I go to, because both a doctor AND my midwife told me that not only would no local midwife do a HBAC, that it was ILLEGAL for them to do it!! And to make matters worse, we went on the hospital tour last night, and they said:

In emergency c-sections (unscheduled), they don't let the father/partner/midwife in the operating room, and no one could tell me how long until either parent gets to hold the baby!

They don't encourage cosleeping with moms and babies "because of the SIDS" - AAAAARRRRRRGGGGGHHHH!

They won't allow a parent to be present during any "routine" procedure such as heel-sticking/eye drops/etc "because of patient confidentiality in the nursery" - though dad can "watch through the nursery window."


I asked how I can refuse hospital routines, and the nurses just stared at me and then looked at each other like morons. They were all like "We don't know how to answer that question." In the end, they told me to ask my midwife. WHAT? I'm the FIRST WOMAN at this hospital to ever want a waiver for certain procedures???

The tour guide for this tour, by the way, simply quit answering our questions at the end, because "we all have other places to be." I AM ON THE VERGE OF FLIPPING OUT. I have to find some other situation before I go into labor. And I am just kicking myself for being stupid enough to assume that having a midwife and a "progressive" medical practice and a hospital that CLAIMS to be VBAC-friendly and "family-centered" would mean getting what I want.
 
#29 ·
Quote:

Originally Posted by Ellien C View Post

The nurse went all apeshit authoritarian on me. I guess no one had ever dared suggest a compromise. I think my doula got the nurse out of the room at that point. And pehaps DH stepped in. I thought I was being nice, offering her a way to get her damn strip. I think that nurse went off duty soon after and I got a better nurse.

Really, you don't need crappy people around you when you are laboring.

Exactly what happened to me! That's when i decided i had to pee....alot
 
#30 ·
Quote:

Originally Posted by LaughinWillow View Post
So, after the comments of an earlier poster whose sister had a HBAC in Virginia, I did some more research, called an Ican leader about an hour away, etc. and found out that I have completely been misled, and that not only was the law changed some time back permitting legal homebirths in VA, there are midwives in the area who will do HBAC, no problem. Except NOW the problem is that I'm 36 weeks and am trying to frantically find a midwife willing to take me this late and attend a homebirth... ARGH!

So I'm feeling really angry at the practice I go to, because both a doctor AND my midwife told me that not only would no local midwife do a HBAC, that it was ILLEGAL for them to do it!! And to make matters worse, we went on the hospital tour last night, and they said:

In emergency c-sections (unscheduled), they don't let the father/partner/midwife in the operating room, and no one could tell me how long until either parent gets to hold the baby!

They don't encourage cosleeping with moms and babies "because of the SIDS" - AAAAARRRRRRGGGGGHHHH!

They won't allow a parent to be present during any "routine" procedure such as heel-sticking/eye drops/etc "because of patient confidentiality in the nursery" - though dad can "watch through the nursery window."


I asked how I can refuse hospital routines, and the nurses just stared at me and then looked at each other like morons. They were all like "We don't know how to answer that question." In the end, they told me to ask my midwife. WHAT? I'm the FIRST WOMAN at this hospital to ever want a waiver for certain procedures???

The tour guide for this tour, by the way, simply quit answering our questions at the end, because "we all have other places to be." I AM ON THE VERGE OF FLIPPING OUT. I have to find some other situation before I go into labor. And I am just kicking myself for being stupid enough to assume that having a midwife and a "progressive" medical practice and a hospital that CLAIMS to be VBAC-friendly and "family-centered" would mean getting what I want.
Oh man mama! I am so sorry! THis sounds just like me. Don't worry- I found a blessing of a midwife at 38 weeks! I'll pray and cross my fingers and focus all my energy on you finding a HBAC midwife NOW! That whole practice/hospital sounds incredibly scary and dangerous!
:
 
#31 ·
Quote:

Originally Posted by LaughinWillow View Post
So, after the comments of an earlier poster whose sister had a HBAC in Virginia, I did some more research, called an Ican leader about an hour away, etc. and found out that I have completely been misled, and that not only was the law changed some time back permitting legal homebirths in VA, there are midwives in the area who will do HBAC, no problem. Except NOW the problem is that I'm 36 weeks and am trying to frantically find a midwife willing to take me this late and attend a homebirth... ARGH!

So I'm feeling really angry at the practice I go to, because both a doctor AND my midwife told me that not only would no local midwife do a HBAC, that it was ILLEGAL for them to do it!! And to make matters worse, we went on the hospital tour last night, and they said:

In emergency c-sections (unscheduled), they don't let the father/partner/midwife in the operating room, and no one could tell me how long until either parent gets to hold the baby!

They don't encourage cosleeping with moms and babies "because of the SIDS" - AAAAARRRRRRGGGGGHHHH!

They won't allow a parent to be present during any "routine" procedure such as heel-sticking/eye drops/etc "because of patient confidentiality in the nursery" - though dad can "watch through the nursery window."


I asked how I can refuse hospital routines, and the nurses just stared at me and then looked at each other like morons. They were all like "We don't know how to answer that question." In the end, they told me to ask my midwife. WHAT? I'm the FIRST WOMAN at this hospital to ever want a waiver for certain procedures???

The tour guide for this tour, by the way, simply quit answering our questions at the end, because "we all have other places to be." I AM ON THE VERGE OF FLIPPING OUT. I have to find some other situation before I go into labor. And I am just kicking myself for being stupid enough to assume that having a midwife and a "progressive" medical practice and a hospital that CLAIMS to be VBAC-friendly and "family-centered" would mean getting what I want.
Okay, a lot of what they're telling you is AGAINST THE LAW. A parent has the RIGHT to be present for any medical treatment their child receives (unless the parental rights have been legally limited or terminated, but that's not the case here). If there's a confidentiality issue in the nursery, they can damn well do the procedures in your room.

Start thinking and speaking using different language. Stop asking them and start telling them that this is the way you will do things, and that your husband WILL be present as allowed BY LAW for any and all procedures done to the baby.

Or, wait until you go into labor and then show up at a different hospital. Make up a story about how you were "visiting friends" or something and were closer to the other hospital.
 
#32 ·
Quote:

Originally Posted by grumpyshoegirl View Post
Okay, a lot of what they're telling you is AGAINST THE LAW. A parent has the RIGHT to be present for any medical treatment their child receives (unless the parental rights have been legally limited or terminated, but that's not the case here). If there's a confidentiality issue in the nursery, they can damn well do the procedures in your room.

Start thinking and speaking using different language. Stop asking them and start telling them that this is the way you will do things, and that your husband WILL be present as allowed BY LAW for any and all procedures done to the baby.
Yes!
MANY mothers have all procedures done bedside. Demand, don't ask. It's your baby, your call!
 
#33 ·
THANK YOU for the encouragement! I keep forgetting I can "just say no" to the stuff they want to do. It's so weird, how you get in that hospital environment, and it's like these people are going to tell you what they're going to do to your body or your child's body, and it's like THEY'RE in charge. I'm going to write up everything I don't consent to before I go to my mw on Tuesday and ask her to keep it with my records and bring a copy for the nurses at the birth and afterwards. Unless I get lucky and find a willing homebirth mw.

I had contacted the Farm, and they actually said I could come there, but their fees would be about $5500 - ARGH (as opposed to FREE, since we have insurance for the hospital birth)! And no option for a payment arrangement or anything - just that amount of money up front. So unless I get lucky on a scratch and win ticket, that's probably out.
 
#34 ·
Quote:

Originally Posted by LaughinWillow View Post
THANK YOU for the encouragement! I keep forgetting I can "just say no" to the stuff they want to do. It's so weird, how you get in that hospital environment, and it's like these people are going to tell you what they're going to do to your body or your child's body, and it's like THEY'RE in charge. I'm going to write up everything I don't consent to before I go to my mw on Tuesday and ask her to keep it with my records and bring a copy for the nurses at the birth and afterwards. Unless I get lucky and find a willing homebirth mw.

I had contacted the Farm, and they actually said I could come there, but their fees would be about $5500 - ARGH (as opposed to FREE, since we have insurance for the hospital birth)! And no option for a payment arrangement or anything - just that amount of money up front. So unless I get lucky on a scratch and win ticket, that's probably out.
Stay strong, you CAN do it!
Just remember, don't get into discussions, say no - mean it - and change the topic at hand.
Good luck!
 
#35 ·
I just kept ripping it off and handing it back to the nurse saying "No thankyou, I'd rather not." Then when she tried to put it back on me anyway I said, "I said it nicely the first time, now back the F$%^ off B$%%!" And she let me be for an hour. Then later she came in and asked nicely if she could put it on me and I said, "Sure, as long as I'm comfortable. But the moment it makes me feel uncomfortable or stressed I'm removing it again." She said, "Thank you." and put it back on me.
 
#36 ·
Quote:

Originally Posted by moondiapers View Post
I just kept ripping it off and handing it back to the nurse saying "No thankyou, I'd rather not." Then when she tried to put it back on me anyway I said, "I said it nicely the first time, now back the F$%^ off B$%%!" And she let me be for an hour. Then later she came in and asked nicely if she could put it on me and I said, "Sure, as long as I'm comfortable. But the moment it makes me feel uncomfortable or stressed I'm removing it again." She said, "Thank you." and put it back on me.

Now YOU are grand!
 
#37 ·
I wanted to clarify though, I've never had a c-section. I was considered high risk for other reasons. I have a clotting disorder and was swelling up like a balloon
Every time they stuck their hands up inside of my my blood pressure shot up like crazy and my ankles doubled in size!!! I really HATE hospitals!
 
#39 ·
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 suggest you find a friendlier environment to birth in...or go for a HB. The hospital has many ways to take away your rights and your baby's rights.
 
#40 ·
Quote:

Originally Posted by Fyrestorm View Post
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 suggest you find a friendlier environment to birth in...or go for a HB. The hospital has many ways to take away your rights and your baby's rights.
I'm so sorry! That is sooo scary!
And, as far as the last part...a resounding
: !!
 
#41 ·
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.
 
#42 ·
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.
 
#43 ·
Quote:

Originally Posted by LaughinWillow View Post
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.
 
#44 ·
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.
 
#45 ·
Quote:

Originally Posted by Fyrestorm View Post
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
 
#46 ·
Quote:

Originally Posted by kprown@mac.com View Post
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!
 
#47 ·
Quote:

Originally Posted by kprown@mac.com View Post
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.

Quote:
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.

Quote:
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.

Quote:
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.
 
#48 ·
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.
 
#49 ·
Quote:

Originally Posted by rmzbm View Post
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.
 
#50 ·
Quote:

Originally Posted by Fyrestorm View Post
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...
 
#51 ·
Quote:

Originally Posted by rmzbm View Post
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.
 
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