Saturday, June 30, 2012

Pregnant Patients' Bill of Lynnette

     All healthcare providers get into this profession for their own reasons. Over the years I've considered my own reasons and have come to the conclusion my strongest passion is to give personal, individualized care. A pet peeve of mine is when a rational reason cannot be given for doing a procedure, or when something is being done for the convenience of a provider rather than comfort of the patient, or just because "it's what we always do". 
     When people are in the hospital the combination of being in unfamiliar territory and the attitude of care providers that they are the experts makes it difficult for patients to voice their individual requests. Women deserve and have the right to care that they are actively involved in formulating. The pregnant women's bill of rights defines those rights. !
     As the third trimester advances most women settle into the reality of the work they have before them and start preparing for the birth of their baby. Part of that preparation involves dealing with questions about what is going to happen at the hospital. Unfortunately, birth has been hidden away in hospitals for years now and has become a medical event where many families feel they lose control over decisions about their care. Many women have never been a "patient" in the hospital prior to labor and the institutional aspects of a hospital takes them out of their comfort zone. That along with the feeling that nurses and doctors are "experts" who deal with birth everyday so they must know what's best for them make women more willing to hand over control or less likely to question "routine " procedures. Often procedures are just "done" without fully informed consent or explanation- IV starts, continuous monitoring, withholding solid food, limiting ambulation. Knowing your rights will enable you to assert your rights when it comes to procedures you may or may not want or need!
     In addition many providers are so busy in the office there is very little time during visits to ask questions or discuss what the birth will actually be like. Women need to remember that as consumers, paying for the services they are there to get, they have the right to have input in their care. Women also need to keep in mind their provider is in charge of their care, not the hospital staff or institution. Nurses are carrying out orders from the provider, so it is essential that you've discussed and participated in the formulation of the plan of care for you labor, birth, newborn care and postpartum care. You along with your provider make the decisions for yourself and your newborn after you obtained informed consent from your provider. Keep in mind that the consents you sign as you enter the hospital are very broad and that you the right to question and amend those consents. 
     The Alliance for the Improvement of Maternity Services (AIMS) has outlined the Pregnant Patient's bill of rights. It's an important document that all pregnant women should read and consider as they prepare for birth. Birth should not be a "one size fits all" event. It's a very individualized, very personal experience that will be remembered for a lifetime. Women and their partners should have input into their care and the bill or rights helps to ensure they are given informed consent regarding procedures so they can have that input, knowing also that plans may need to be changed under various circumstances. But knowing your rights will strengthen your ability to deal with changes as they arise. The bill of rights gives you freedom in making choices for you and your baby that are aligned with your personal desires to make your birth something to happily anticipated and remember with satisfaction. Please follow this link to read and learn more about the Bill of Rights.