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The Rights of a Childbearing Women in a Hospital

The Rights of a Childbearing Women in a Hospital

YOUR Rights as a Childbearing Woman

Particularly in a hospital setting.

There are a lot of women that feel like they are/were forced into decisions by care providers or medical staff because of “hospital policy” and they have/had no choice. It’s what has to be done, right?? The answer is actually No, you don’t.

Unfortunately there are too many women AND partners out there that don’t know their rights as they venture into one of their biggest life experiences.

Although hospital policy must be followed by medical staff because they are employed by the hospital, YOU have hired the hospital and their staff so technically you employ them. And because it’s in the healthcare field there are many rights you have, including to receive care regardless if it complies with hospital policy.

And guess what? Most of the time hospital policies are chosen by a board of administrators which include the insurance companies, many of whom are not even medical professionals. Hospital policies are mostly designed first with protecting the hospital and employees, and second for the well-being of their patients. I am not saying the patients are an afterthought by any means, it’s just that it’s a tricky business and they are trying to care for EVERYONE all the time. 

But you are an individual, with specific needs and desires that might not fit perfectly into their policies so become your own advocate. Don’t leave your next birth disappointed, leave empowered knowing you made all your own choices for yourself and your little family.

Please note that I am not saying we need to rise up and fight everything that is presented to us while we labor. In fact we might be perfectly happy with all the policies but in case something arises, being educated in your rights will make a huge difference in the outcome of your birth.

Source: http://www.nationalpartnership.org/research-library/maternal-health/the-rights-of-childbearing-women.pdf

 

#1. Every woman has the right to leave her maternity caregiver and select another if she becomes dissatisfied with her care. 

When I was pregnant with my first baby I started going to a group of midwives that was recommended to me by several people. I liked them well enough but as my pregnancy went on and I decided what it was that I wanted for my birth experience, I figured out what was important to me. So at 27 weeks pregnant I switched care providers.

I would add that you can change at any time. Even up through 40 weeks. Most of the time if you feel the need to switch it’s because the desires for your birth have evolved from what they were and you realize you can get better support and care from someone else. So it’s not about how good the care provider is, it’s about you and the birth YOU want.

I know mama’s who realized late in pregnancy that they weren’t going to get the type of birth they want with their current care provider so they switched (even at 40 weeks). I know some mama’s who don’t switch even though they don’t really like their care provider saying, “with the next baby,” because they feel badly about switching. Your care provider isn’t going to take it personally, and if they do; too bad, it’s not about them, it’s about you and the birth YOU want.

 

#2. While in labor you can “fire” a nurse.

If you are in the hospital and the nurse assigned to attend you is not supportive of your birth preferences, or your personalities aren’t meshing well, or whatever reason; you can request a different nurse.

I always recommend you do it in the nicest way possible: your birth partner can go to the nurses’ station and ask to speak with the charge nurse. Then very politely and kindly say “Nurse So-and-so is a great nurse and knows her stuff but I just don’t think she’s right for us, do you have a nurse that is more ­­_______ (fill in with what you are needing ie: supportive of an unmedicated birth, has a sense of humor, more straight forward, etc.). 

Typically, the charge nurse says “Sure” and it’s no problem. 

Think about it, at this point you have carefully selected your care provider and here you are in the hospital for hours not seeing them until the very end. Most all of your interaction during your birth is your nurses. Your nurse can make or break your labor experience. 

I have worked with a lot of nurses over the years and in my experience they have been absolutely fantastic!! Most nurses are so good at their jobs, they wouldn’t be there if they didn’t love what they did.

But we all have off days sometimes so just in case you have a nurse that is deterring your birth experience it’s nice to know you don’t have to suffer through until shift change.

 

#3 Every woman has the right to freedom of movement during labor, unencumbered by tubes, wires, or other apparatus. And to birth in any position she wants.

If mother and baby are low risk there is no reason she should be hooked up to monitors constantly. Request intermittent monitoring where the baby is only monitored for 20 minutes an hour. 

Also if there is need to be hooked up to monitors you don’t have to be stuck on your back in the bed, (unless you want to be.) Feel free to get in any position, those cords have some length to them. You can even be out of the bed standing, or sitting on a birth ball.

**You also have the right to give birth in the position of your choice.

Movement during childbirth is very effective, if not NECESSARY. When a woman is free to move around she helps her baby move down and into more optimal positions for birthing. 

After speaking with many caregivers I learned that when a woman is left alone to figure out what position she likes to labor and birth in, the majority of mothers will choose the “prayer position”; On their knees, kneeling up to something; a chair, bed, a person, etc.

The medical professionals prefer mom on her back in a semi-reclined position with her feet in stirrups because that’s what’s easiest for them to see what’s going on to catch the baby and all the “birth” can drop down into a handy little garbage bag for easy cleanup. Sounds great for the Doctor. But for mom? If you are on your back you have to push a baby up over your sacrum going against gravity. You might love that position, you might hate it. Just because it’s convenient for everyone else doesn’t mean anything, do what works best for you.

 

#4 Every woman has the right to receive full advance information about RISKS and BENEFITS of all reasonably available methods for relieving pain during labor and birth, including methods that do not require the use of drugs.

 She has the right to choose which methods will be used and to change her mind at any time. 

Don’t want an epidural but not fully convinced about having an unmedicated birth? Needing something to take the edge of labor off? There are other options! 

There are even more options than the ones we highlighted. Other analgesics they can administer via an IV or I’ve known a couple moms get a morpheme injection in their muscle so they could sleep for a few hours. Talk to your care provider and discuss all your available options. Be sure to discuss the benefits and risks of each method.

 

#5 Every woman has the right to have family members and friends of her choice present (or not present) during all aspects of her maternity care. 

I have had a few moms choose to have their children with them in the room while in labor (as young as a two-year-old). Hospitals often have a policy in the winter months that children under a certain age cannot be allowed in certain areas. Fortunately for you, your rights trump hospital policy so if you really want someone there, you can. 

Like a doula, photographer, mother, or whomever you want and feel comfortable with. I definitely recommend inviting people who you know will be a support and comfort to you. People who you feel safe with, people who will help you achieve your birthing goals.

I would also say that if you don’t want a particular person or people, it is your right as well. I had a mama who was going through a divorce and as her doula I was her main support. She was concerned her soon-to-be ex-husband would show up when she was in labor and she absolutely didn’t want him at the birth. The hospital notified security about him and the whole staff was very accommodating of her wishes.

 

#6 Every woman has the right to accept of refuse procedures, drugs, tests, and treatments, and to have her choices honored. 

This one is pretty straightforward. If you search for patient rights in a hospital you will find that you have the right to be respected. 

If you feel your rights are being violated it’s important you speak up.

 

#7 Every woman has the right to wear whatever she wants while she is admitted to the hospital.

The NUMBER ONE QUESTION we get about our labor gowns is, “I’m delivering in a hospital, am I even allowed to wear anything other than the hospital gown?” .

YES! The answer is a big Yes! It is within your patient rights to wear whatever you want. You can wear your favorite T-shirt, a robe, a Dear Darby labor gown, or be completely naked. It’s 100% up to you.

The hospital gown is offered as a curtesy by the hospital to every single patient, that includes patients who may have a skin disease or unable to maintain healthy hygiene. 🥴 And all their gowns after being used are sent to a central laundry and washed then re-dispersed. The hospital gown was designed to cover the sick and disabled people as they need treatment while laying in a bed.

The hospital gown was not made to move or function for laboring women who are NOT sick or disabled but are there for an incredible transformative life experience and should be treated like the goddesses they are instead of someone in need of medical treatment. 

Changing what you wear in labor is one of the best ways of changing how everyone, including yourself and medical staff perceive you. So dress how you want to feel in labor. 


#8 Every woman has the right to information about the professional identity and qualifications of those involved with her care, and to know when those involved are trainees. 

Not only do you have a right to know qualifications but you can ask a care provider their C-section rate, their episiotomy rate, their unmedicated delivery rate, etc. 

This information can be very revealing as to what kind of birth you can likely expect with that particular care provider.

And if you don’t want trainees involved in your care, you can have them leave. Or maybe you don’t care if they are there witnessing but you don’t want them practicing their suturing or phlebotomy skills on you. That is totally within your rights!

 

#9 Every woman has the right to full and clear information about benefits, risks, and costs of the procedures, drugs, tests, and treatments offered to her. As well as all other reasonable options, including no intervention. 

That means you can request and receive information about all interventions that are likely to be offered during labor and birth, well before the onset of labor. 

Sometimes while in labor things are suggested or offered or presented like it’s your only option but it’s important for you to get all of the information so you can make an educated decision.

A common teaching tool many childbirth educators use is the acronym BRAIN. If you remember this acronym, you’ll be ready to ask the right questions and get the information you need when interventions are being suggested.

B-Benefits, “what are the benefits of that procedure?”

R-Risks, “what are the risks of this procedure?”

A-Alternatives, “are there any alternatives to this procedure?”

I-Intuition, use your intuition. Does it just not feel right? Does it feel like a good option/idea?

N-Nothing, “what if we do nothing now? What would happen?”

So don’t forget to use your BRAIN!

 

#10 Every woman has the right to be informed if her caregivers wish to enroll her or her infant in a research study. 

She should receive full information about all known and possible benefits and risks of participation; and she has the right to decide whether to participate, free from coercion and without negative consequences.

If ever asked to participate in a study, get all the information you can. Then do your own research and tap in to your intuition. Could the study hinder the goals and desired outcome you have for your birth and baby? 

Trust yourself to make the best decision for you and your baby.

For a couple years I had several mamas that gave birth in the same area they were each asked if they wanted to participate in a study that required they get induced at 39 weeks. .

That was basically all the information they were given. Depending on their specific care provider, some of the mamas felt like they were trying to urge them to participate in the study. With statements like, “Wouldn’t you like to get your baby out a whole week early? You will be so done being pregnant by then it will be great to get it over with.” Etc. 

They all went and did their own research and trusted their own intuition and ultimately all of them decided that what they wanted for themselves and their baby was to wait until labor started spontaneously. So they declined participation in the study.

A couple of the mamas had their babies by 39 weeks anyway and several of them went past their estimated due date. All were grateful they made their own decision with confidence and it was respected.

 

11. Every woman has the right to unrestricted access to all available records about her pregnancy, birth, postpartum, and her infant; to obtain a full copy of these records; and to receive help in understanding them if necessary.

I had a client who hired me as her doula with her second baby. She had an unmedicated delivery in a hospital with her first. She was trying to decide if she wanted to birth in a hospital or in a freestanding birth center for her second baby. She went back and forth seeing caregivers at both institutions. She loved the idea of laboring and delivering out of the hospital but she had some concerns from her first birth saying that she had hemorrhaged and wanted to be in a hospital in case that happened again. To fully understand what happened at her first birth she went and got the records. The report stated that she lost 400ml of blood which is completely in range of average blood loss; being anywhere from 200ml-500ml for a vaginal delivery. She carried around with her for two years the fear of hemorrhaging because something was said or done in her delivery to make her believe she had hemorrhaged when in fact she had not. Having the records in front of her and knowing the truth enabled her to actively pursue the birth she ultimately wanted and attained.


#12. Every woman has the right to receive maternity care that is appropriate to her cultural and religious background, and to receive information in a language in which she can communicate.


#13. Every woman has the right to receive continuous social, emotional, and physical support during labor and birth from a caregiver who has been trained in labor support.

Here is my plug for doulas! I have never met an OB or even a midwife in a hospital setting that provided continuous support in any area. But guess who does?? DOULAS!! And going along with your rights, if you have hired a doula you have the right to have her with you providing that continuous support.

 

#14. Every woman has the right to virtually uninterrupted contact with her newborn from the moment of birth, as long as she and her baby are healthy and do not need care that requires separation

This one is hard because there are MANY instances in the hospital when the things that are said, or the way the medical staff are acting make you feel like your baby’s life is in peril. Not to mention, you just had a baby and you’re feeling exhausted. But do your best to get all the information, especially if they’re telling you the baby needs to be taken away from you, even if it’s just across the room.  And guess what? Any newborn procedure they do at the newborn station in the room, they can do while mom holds the baby. And that’s not all! (am I starting to sound like an info-mercial?) Newborn skin to skin, especially with the mother, will help the baby to normalize and maintain all their levels. (blood pressure, temperature, heart-rate, metabolic rate, blood sugars, etc., etc.) So keep that baby with you!

 

#15. Every woman has the right to receive complete information about the benefits of breastfeeding well in advance of labor, to refuse supplemental bottles and other actions that interfere with breastfeeding, and to have access to skilled lactation support for as long as she chooses to breastfeed.


#16. Every woman has the right to decide collaboratively with caregivers when she and her baby will leave the birth site for home, based on their conditions and circumstances.

 

If you would like to watch the video of us discussing each of these rights:

 




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