Can I violate "hospital policy" on wearing a fetal monitor? - Page 3 - Mothering Forums
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#61 of 71 Old 08-12-2007, 05:17 AM
 
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Sorry, quick response to the OP. There was a fantastic article in last issue of the NCT's UPDATE for specialist workers about the hospital in Southampton who are using a monitor designed to work under water, and are doing something like 75% of their VBACs in water at some point- with higher success rates. The government guidelines over here (NICE) state that VBAC is the preferred option in most circumstances, that women should be under the care of an obstetrician and that continuous remote EFM should be used. although being the UK, theoretically women have the right to be stroppy and refuse. I can scan it and send it to you if you're interested.

Fyrestorm, I am so sorry this happened to you

Helen mum to five and mistress of mess and mayhem, making merry and mischief til the sun goes down.
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#62 of 71 Old 08-12-2007, 12:58 PM
 
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Originally Posted by wifeandmom View Post
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? :

If the team is the baby, I think ANYONE would "take one"-- within reason (there are exceptions to everything, and there are times where even a cesarean wouldn't save the baby, and where it means more risk for the next baby at no gain for this one). But team usually implies a group, and in the context of a thread on hospital policy, it could be inferred that they're the team.

And you know what? We owe "them" nothing. They're getting our money. I know many health care professionals, including a few in my own family, went into it for altruistic reasons, just like I went into teaching for altruistic reasons. But each of us is just one of hundreds of patients to them. Do you think in the long run the team really cares that much about us individually? I know in my profession, I love my students and do remember many after the fact (and remember, that's seeing them every day for 180 days, an hour at a time, and more time at concerts and dances, compared to what, 12 office visits at 20 minutes a pop and a few days in the hospital)....but no way do I remember all of them, and no way do I get bent out of shape if a few don't like me or my classes.

In that context, even if that's not what the poster meant by taking one for the team, I could definitely see one of us VBAC moms getting a little upset by the idea. The only people who matter to me in my next birth are myself, my husband, my daughter and the new baby. Having a repeat cesarean after a cascade of interventions caused in part by hospital policy hurts all of us.
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#63 of 71 Old 08-14-2007, 12:03 PM
 
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On hospitals requiring continuous EFM for VBACs, when I was planning my VBAC in coastal NC, there was a great CNM who just moved there that I was working with. I told her I really didn't want continuous monitoring and she didn't even bat an eye. Same thing about the IV. Ended up moving, and had a homebirth anyway, but you can find providers who are on board with no interventions in birth. You just gotta look around for them. I just got lucky with her b/c she was the first one I called.

CNM mama.

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#64 of 71 Old 08-16-2007, 12:21 PM
 
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Originally Posted by wifeandmom View Post
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? :
Yes this is *exactly* what I meant (that "the team" is my baby - not the doctors). I mean that if you honestly think your perfect birth experience is more important than your baby's lifelong health, well... I don't think any mama really thinks that, so I won't insult anyone here by suggesting it. Sometimes C/S save lives. (and many times they don't make any difference, and sometimes we don't get a choice about it, whether we think the odds are worth the risk or not). That's all I was trying to say.

And for the record, I'm planning a VBAC for kid # 2 too, so I'm in the same position as lot of you.

Mom to James (ribboncesarean.gif 5/2006), Claire (vbac.gif 6/2008), furry kitties Calvin and Bob, and wife to Dennis. 

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#65 of 71 Old 08-16-2007, 12:51 PM
 
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The problem is that "the team" is all of these doctors and CNMs telling you that IF YOU DONT DO THIS YOUR BABY WILL DIE which is scary, very very scary. But they are not always being honest. You need to do your own research and come to your conclusions, and hospital "policy" be damned.

I have spent a good 6 months researching birth in regards to MY specific body type/conditions (vbac, history of high bp, etc) and if something went wrong that I did not understand, I would go with their advice, but if I know dang well that a cesarean or internal monitoring or constant monitoring is not right for me, I'm not going to have it. I don't really care what the policy is.

As for the suggestion that "if you dont like it go somewhere else" I think its great that you have that option, but not every pregnant woman has that option. I interviewed EVERY SINGLE OB AND CNM in my health care plan (blue cross and blue shield) it was about 12 practices as well as touring every hospital that was within an hour drive of me (3 hospitals to be exact) and in all of that, my last pregnancy, I was told over and over again that I was not able to have a VBAC. (my records were destroyed and therefor they had no documentation on the incision type even though the probability was that my incision was the one they feel is "right") I had so many doors slammed in my face, but I kept pushing and pushing. I even read the patient rights, spoke with hospital administrators, got very involved in ICAN and tried to learn what I could from them (think I even spoke with Katie a few times when I was collecting information about my rights and legal options) You know what I learned from all of that? That not a single doctor in TWO COUNTIES would touch me and no hospital in those counties would "allow" me to VBAC. One of them would not even allow me to walk at all unless "doctor orders it" and would be taking the baby for 4 HOURS right after birth for monitoring (we get 20 min or so before they take her unless there is a complication - how sweet of them!) and there was no chance of avoiding that situation, period.

I then started calling midwives. Its illegal for midwives to attend home VBACs in south carolina because VBAC is classified as high risk, and midwives are not allowed to attend high risk births, or they will loose their license. Nobody would touch me with a ten foot pole. They felt bad for my situation of course, but had no desire at all (understandably so) to risk their license to help me. Even the doula I paid backed out when I decided to home birth regardless. My only options were to a) have a pre-scheduled cesarean, b) go into labor and then show up with no provider (my provider actually "fired me" for not agreeing to the cesaeran and the notice came ON my due date) and then fight tooth and nail to not get cut open without a reason other than not knowing my scar type (forget for a minute the many interventions that I would not want to have... I couldn't even be sure I wouldn't be forced to have a cesarean) or c) stay home and have the baby unassisted because everyone was afraid of the consequences of helping me.

Any guess what I did? ~

I had an unassisted birth and despite my original CNM Midwives assuring me that the baby would probably die if I tried a home birth, it was the most beautiful and perfect birth imaginable, and my daughter was born after 20 minutes of pushing and 3 days of labor, without a single problem, and in perfect condition. Pink, happy, bright eyed, and completely responsive in every way possible.

If I had not had the courage to UC, had not been 3 minutes from a hospital, had not been relatively free of complications, I would have had no choice but to have a hospital birth, and I am afraid to think of the consequences that would have ensued for both my baby and I, as far as the treatment and forced proceedures put to us.
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#66 of 71 Old 08-16-2007, 01:41 PM
 
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Originally Posted by wifeandmom View Post
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? :
That assumes that I agree that whatever they're wanting to do, CEFM for example, is what's best for the life of one of my child. If I don't agree that's what's best, then, no, I won't "take one for the team" just to make it easier on the hospital staff. IMO, doing so will only seek to further the attitudes of many docs/hospital staff and many times the ACOG themselves.

I for one am no longer willing to do that. Women have done it for long enough and someone, somewhere, has to be willing to say "enough!"
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#67 of 71 Old 08-16-2007, 01:58 PM
 
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Originally Posted by Jenlaana View Post

Nobody would touch me with a ten foot pole. They felt bad for my situation of course, but had no desire at all (understandably so) to risk their license to help me. Even the doula I paid backed out when I decided to home birth regardless.
Edited to add: This isn't directed JUST at the above poster, it's an overall attitude that I've seen time and again that just never made much sense to me.

Interesting that it's somehow acceptable for the midwives and doula to 'refuse to touch you with a ten foot pole', yet it's somehow different that an OB would feel the same way. An OB being unwilling (or unable in many cases due to malpractice insurance issues) to attend VBAC's is just as understandable IMO as the midwives' and doula's refusal, perhaps even more so since OB's are more likely to be sued should something go wrong.

A VBAC mom may not be a medical time bomb, but she certainly is a lawsuit waiting to happen from an OB's perspective. Why is it ok for a midwife and doula to refuse to attend a VBAC (at home or otherwise, due to law, due to hospital policy, due to insurance reasons, whatever), but somehow it's horrible for an OB to do the same thing?
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#68 of 71 Old 08-16-2007, 02:05 PM
 
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"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???

.

what they are saying is that your midwife's orders trump their policy.
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#69 of 71 Old 08-16-2007, 02:08 PM
 
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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.
they can meet you at the hospital at the last minute. they can also help navigate the staff so you get a good nurse. if money is an issue, some work on a sliding scale or take you on as they are getting their certification.
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#70 of 71 Old 08-16-2007, 02:11 PM
 
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Originally Posted by wifeandmom View Post
A VBAC mom may not be a medical time bomb, but she certainly is a lawsuit waiting to happen from an OB's perspective. Why is it ok for a midwife and doula to refuse to attend a VBAC (at home or otherwise, due to law, due to hospital policy, due to insurance reasons, whatever), but somehow it's horrible for an OB to do the same thing?
I actually don't think it's ok in either case. I think it's particularly odious for OBs to do it b/c their profession has put women in this position of fewer birth choices b/c of that first cut. Perhaps that's why so many women take greater issue with them.

Of course, on another note, the "due to law, due to hospital policy, due to insurance reasons" when it comes to midwives is most often out of the midwives' control b/c as a society we have given far too much power to OBs and their trade union (the ACOG). It's one thing to have to work as a midwife within an OB dominated birth climate and quite another thing to be an OB in that climate.

Yet another reason why so many of us are fighting for change.
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#71 of 71 Old 08-16-2007, 06:41 PM
 
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Originally Posted by Jenlaana View Post
I had an unassisted birth and despite my original CNM Midwives assuring me that the baby would probably die if I tried a home birth, it was the most beautiful and perfect birth imaginable, and my daughter was born after 20 minutes of pushing and 3 days of labor, without a single problem, and in perfect condition. Pink, happy, bright eyed, and completely responsive in every way possible.
Two unfortunate things strike me about your story, which turned out wonderfully (and I congratulate you!). First, is that so many women *DON'T* have the option for a supervised VBAC - or even an HBAC - and are left with only non-ideal choices (despite what other people think, IMHO an unassisted VBAC is not ideal). This is really unfortunate and is a serious problem with the medical environment we live in. (I think most women agree that having someone with medical knowledge at their birth gives them peace of mind just in case something goes wrong). If only the medical community would get a clue about this and maybe compromise by supporting VBACs we wouldn't be in this situation.

The second thing is that I sense so much *anger* in this post (and in many others). And rightfully so - I think a lot of us are angry about lack of good options and scare tactics. But it is unfortunate nonetheless.

Mom to James (ribboncesarean.gif 5/2006), Claire (vbac.gif 6/2008), furry kitties Calvin and Bob, and wife to Dennis. 

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