what does "hospital policy" really mean?

[P Harris]

I am afraid I am not a
going-along-with-things-just-because-I'm-told-to kind of person (this
is one side effect of being trained as a scientist - you get in the
habit of drawing independant conclusions about things :-P), and this
may be a potential problem when it comes time to give birth. So, just
so that I know what the playing field is, can anyone explain to me
what the status or force really IS of "hospital policy"? What does
"hospital policy" actually MEAN?

Yes, I admire and would probably USE the "golly, your required
electronic fetal monitor just keeps falling right off me, how
inconvenient!" type of tactic :-) But that approach won't work for
*everything*, like, say, if hospital policy says that the baby must be
taken off elsewhere after birth to be examined rather than staying in
the room with the mother.

So, how does "hospital policy" work? How much is it possible to put
one's foot down, and what is the best or most successful way to do so,
and what will they actually DO if you do? Is it simply a matter of
'whatever your doctor or midwife agrees to", or is it more complex
than that?

I asked one of the midwives about this at my last appointment, and she
told me that since the midwives have admitting priveleges at the
hospital, they can write orders for things to be different in
'whatever' ways, as long as the midwife agrees that the patient's
wishes are medically reasonable. But I got a lingering feeling that
this was partly a happy lil' story I was being told (no offence meant
to her, but this particular midwife and I just do not seem to be on
the same wavelength much of the time, am kinda hoping someone else
will be on duty when I go into labor ;-)).

Also, surely at least SOME aspects of hospital policy are not
negotiable at all; for instance when I had a preterm labor scare at 30
wks I was told that if I *were* in preterm labor then I would have to
be transferred elsewhere as hospital policy was that they only handled
labor at 32 wks+ at this hospital. (Mind, I can certainly understand
the rationale for that). What other kinds of likely issues would be in
this category?

On the one hand I agree that in many ways it is unconstructive for me
to go into this *expecting* conflict... but OTOH I really handle life
much much better if I have thought about what problems may crop up
rather than being taken by surprise. I am annoyingly prone to bursting
into tears during stressful situations (let's not discuss my PhD
defense, back in grad school :-P), which in turn does NOT make it
easier to get people to take me seriously at those times (just because
I am crying does not mean I am irrational, dammit, but just TRY
convincing other people of that), so all in all I think I probably
really am better off having thought this sort of thing through ahead
of time and 'processed' the likely options and limitations.

So, if anyone can throw some light on the subject I'd really
appreciate it. FWIW I'm in Canada (will be delivering in Lakeridge
hospital in Oshawa, ON).

P.S. please *don't* suggest a homebirth. I think if I were fifteen
years younger and living closer to a real hospital it would be exactly
the right thing for me, but it just does not "feel" right at this
particular time and place, and given the available options I really AM
quite comfortable with my decision for a hospital birth even though I
know it does have some drawbacks.

Thanks very much for any insights,

Pat
edd July 21

[Ericka Kammerer]

P Harris wrote:

> So, how does "hospital policy" work? How much is it possible to put
> one's foot down, and what is the best or most successful way to do so,
> and what will they actually DO if you do? Is it simply a matter of
> 'whatever your doctor or midwife agrees to", or is it more complex
> than that?

It's more complex.

> I asked one of the midwives about this at my last appointment, and she
> told me that since the midwives have admitting priveleges at the
> hospital, they can write orders for things to be different in
> 'whatever' ways, as long as the midwife agrees that the patient's
> wishes are medically reasonable. But I got a lingering feeling that
> this was partly a happy lil' story I was being told (no offence meant
> to her, but this particular midwife and I just do not seem to be on
> the same wavelength much of the time, am kinda hoping someone else
> will be on duty when I go into labor ;-)).

Could be. Depending on where you are, sometimes the
midwives do not have the political standing to make too many
waves.

> Also, surely at least SOME aspects of hospital policy are not
> negotiable at all; for instance when I had a preterm labor scare at 30
> wks I was told that if I *were* in preterm labor then I would have to
> be transferred elsewhere as hospital policy was that they only handled
> labor at 32 wks+ at this hospital. (Mind, I can certainly understand
> the rationale for that). What other kinds of likely issues would be in
> this category?

This is really variable, and how much you can get
away with can depend on how much clout your caregiver has
at that particular hospital.

> So, if anyone can throw some light on the subject I'd really
> appreciate it. FWIW I'm in Canada (will be delivering in Lakeridge
> hospital in Oshawa, ON).

Try to find women who've delivered there who have
similar preferences to yours. It can be difficult to get
a straight story from people who may have hidden agendas.

Good luck,
Ericka

[Jenrose]

"P Harris" > wrote in message
om...
> I am afraid I am not a
> going-along-with-things-just-because-I'm-told-to kind of person (this
> is one side effect of being trained as a scientist - you get in the
> habit of drawing independant conclusions about things :-P), and this
> may be a potential problem when it comes time to give birth. So, just
> so that I know what the playing field is, can anyone explain to me
> what the status or force really IS of "hospital policy"? What does
> "hospital policy" actually MEAN?

Well, I gave birth at a hospital with a 90% epidural rate, newborn nursery,
etc.

I had no IV or heplock. I just said, "No. Period. I clot too easily to have
people making "just in case" punctures in my veins."

"Hospital policy" said I had to be strapped to the monitor for 20 minutes.
*I* said they could do that with the heart monitor but not the contraction
monitor. I told them whenever i had a contraction and they wrote it on the
ticker.

Hospital policy said listening to the heart every so often "on the strip". I
said, "Okay, but no straps. If you want it there, you hold it there." They
got bored faster that way...

Hospital policy said I had to give birth on the bed. I said, "No stirrups"
and was sideways on the bed, with my midwife and mom holding my feet.

Hospital policy said quick cord cutting and deep suction for any meconium.
The doc helped me cut the cord, even though it was fast, and I stood up,
shoved her out of the way and demanded my baby back when she stood blocking
my view. They gave me the baby.

Hospital policy said *nothing* about Leboyer immersion baths. I had to argue
that one but got my way. Idiot nurse thought we wanted to fully submerse the
baby and was worried she'd drown. Dingbat.

Hospital policy gave every new mother a large box of medicines, stool
softeners, analgesics, and a couple other things I don't remember what... I
never opened the package.

I walked and stomped and squatted my way through labor. I had no drugs of
any kind other than the local anesthetic to repair the tear. I was not cut.
I was not suctioned or forcepped or sectioned. The only time my daughter
left my side was for a brief test the next day--her father was with her the
whole time.

And I will *never* give birth in a hospital again unless I'm deathly ill or
my baby is immediate danger. Period. I'd rather do it myself than have to
argue every damn thing.

I snuck french bread in under my maternity clothes and ate it when the
nurses weren't looking, because hospital policy said "no food."

Anyway...

Jenrose