Hospital policies are negotiable?

Just thought I’d share: hospital policies aren’t always non-
negotiable, though they tell you they are.  When I was pushing for a
natural vbac in the only hospital available to me at the time, I put
up a good fight and compromises were made in my favor.

The hep-lock discussion reminded me of this. In that particular
hospital it was required that I receive all my fluids via IV, and I
fought back using their own evidence to prove my point. I was granted
a hep lock and natural hydration if I so wanted it. Huge victory!  It
didn’t come easy, but they will at least hear you out if you’re making
educated arguments in favor of what you want.

For this pregnancy, my fifth vbac, the OB informed me that it was
policy that all vbac moms get their water broken and an IFM upon
admission. I told him he was crazy, illogical, and asking for trouble,
and why, using medically sound arguments in his medical language.  A
month later he came back and said he and the partners in the practice
would honor my request for EFM instead.

I think they don’t budge because they’re not used to having to! And
many have confessed that they see hundreds of moms a month who have no
clue about anything.

I told my OB, “I understand you’ve always done it a certain way, and
you’ve been trained a certain way, but I want to encourage you to
think for yourself, because what you’re insisting on doesn’t even make
logical sense!  I know you fear someone is going to sue you for a bad
outcome, but I’m not one of those people. I believe in personal
responsibility. I’m prepared to accept the consequences of my choices
and the fact that sometimes there’s nothing anyone can do anyway. But
I want that choice!!”

Boy can I tell you stories! That first hospital I mentioned gave me
the run around! I even went so far as to go to the public relations
office to get a copy of the patients rights and responsibilities that
I saw hanging up on all the walls.
They never had a request for that
before and didn’t even have a copy to give me. So I had them take the
framed one off the wall and photocopy it. I took it to a private
meeting with the head if OB/GYN and pointed to the right that says
“The patient has the right to refuse most treatment.”. I asked her to
define “most treatment” and she gave me a laundry list of what I,
personally, didn’t have the right to refuse because I was a vbac.
Among some of these was the IV, augmentation if labor if I didn’t stay
on average, and continuous EFM. If my husband wasn’t there to calm me
down I would have given her a piece of my mind.

To make a long story short, I got what I wanted.  And the second in
charge of the hospital called us in for a meeting, apologized for the
behavior of those “young doctors who think they can just tell you what
to do” and admitted the “policies” unfortunately are really individual
doctors’ preferences.
Oh, I had my natural vbac, (made some
compromises for their sake on some things) and had some lofty big-wig
visitors the next day, congratulating me on getting what I wanted!

So that’s why I typically encourage moms to educate themselves,
believe in what they want and why, and if they have the courage, speak
up for themselves. It’s the only way to change the system. :-)

Angela in VA

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6 Comments on “Hospital policies are negotiable?

  1. Brava, brava!! This reminds me of the fight after my second birth. (I did not work this out before the birth, because I’d been assured that rooming-in with my baby was not a problem.) After my son was born, I was informed that the hospital was “too busy” to “allow” me to keep my baby with me in my room, because I had failed to file the necessary paperwork (that I didn’t know about), so they didn’t know in advance to have enough nurses working that day. This led to a tense discussion where someone in charge threatened to call security and take my son to the nursery by force, and then caved after I politely offered to have the police meet them at the door.

    After that, nurses came to my room every hour, the whole time I was in the hospital, insisting that they “had” to take my son to the nursery for some evaluation / test / shot / whatever, that they absolutely *could not* do in my room. I was repeatedly told that certain equipment was not portable, and could not leave the nursery. When I stubbornly refused, suddenly the equipment became portable. Hmmmm…

    I never thought of using the hospital’s Patient Rights and Responsibilities against them. I usually see it posted on the walls and just scoff.


  2. Yes they do negotiate. Presently I am a geriatric mother wanting to VBACx2 and the high risk OB wants standard geriatric care to be followed with me, which means I have to deliver by 40 weeks. Well, both of my sons were born after 41 weeks – that’s just not happening. So yesterday my group that I go to were going to discuss this case after speaking to the high risk OB since they know it’s very unlikely that such an expectation will result in a vaginal birth, they are willing to work with me as I am willing to work with them (including 3 glucose challenges this pregnancy despite never ever having a poor result, whatever if it makes them happy and I know it will not cause problems!). When you are cautious enough like I am to not labor and deliver at home due to my personal issues, it pays to be gracious and assertive as often they are willing to work with those patients that make sense.


  3. My wife and I had an accidental home birth for our 6th child and when we got to the hospital shortly after the birth for a checkup they threatened to arrest me for “illegal possession of an organ” for not bringing in the placenta.

    We were able to convince them not to IV my wife, but not to forgo with 5 glucose tests (read: they cut the baby until she bleeds over and over) because she was 1 point below the minimum established by hospital procedure.

    With several of our pregnancies it was all we could do to leave the hospital with a healthy baby. They coerced us, threatened us, made us sign AMA paperwork (against medical advice), played passive-aggressive, but ultimately our determination got us our way: we got to go home.

    I don’t get it. What’s in it for them to force us to do it their way?


  4. Pingback: Best of the Birth Blogs – Week Ending February 21st | ICAN Blog

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