This is an honest question. I want to be very clear; I understand the importance of rules. What I don’t understand is when the policy becomes the most crucial concept, people get left behind. This is what I occasionally see in hospital settings. Don’t get me wrong; I had all three babies in a hospital setting because each one was labeled high-risk. I want people to have their baby where they feel the safest, and if that is in the hospital, that is 100% where you should be. Here’s where I get concerned. When we ask questions and evidence states one thing, but the hospital policy is another, that is where the problem lies. We then find ourselves in a position where the policy becomes the most important topic, and the patient is left behind.
Let me give an example. This happened many years ago when I was a newer doula. I had a client that desired a lotus birth. Lotus birth is birthing the baby and placenta and leaving the two attached until the cord falls off. You can agree or disagree with this practice. However, it was how the hospital handled the request. This client was very clear on her wishes and was met with a fight every step of the way. First, she stated that my client would need special permission from her OB, who knew this was important to my client. The OB then stated that she could not approve this and it would be up to the hospital. The nurse then stated it was against hospital policy. So, you guess what happened next. My client asked to see the policy. Guess what was brought back. A printout from google ( the printed page said google on the top) was passed off as policy. I reminded my client that any “hospital policies” would come on hospital letterhead and that the document was not policy. When she pushed back, we were told that someone from the hospital administration would be in to speak with her. We waited. A while. We were told that this person was in a meeting, and while she waited in active labor, they continued to fearmonger her decision. At the end of the day, there was no policy, and yes, she had a lotus birth. However, it took HOURS of advocating and arguing. So, I ask, who did that so-called policy serve? Certainly not my laboring client, and it wasn’t hospital policy.
When you ask questions and are met with the answer, “well, that is policy.” Ask more questions. Again, I want to ensure that you all understand I am not against having rules in place. This is important, and most of the time, it is to keep people safe; however, it is a CYA for big organizations and insurance companies. Some of these policies are antiquated and outdated. Don’t be afraid to reference more current studies and data; sometimes, it can help. Questions that could be helpful would be, Can you show me that policy? Tell me more about why that is. Honestly, sometimes the so-called policy they are referring to isn’t policy but their biased opinion.
Another tactic that I have heard. “If you leave, your insurance may not cover your birth.” This is a false statement and fear-mongering at its finest. It is absolutely fine if you arrive at the hospital and you are in early labor. Insurance does not care if you go in and leave. The hospital uses a terrible tactic to get you to stay. Sure, they may have you sign a document that you have left on your own, “against medical advice,” but that is a decision you are entitled to make. Remember, a hospital is a business; they don’t make money if you are not there. There are plenty of situations where it is beneficial to remain if that is where you feel safest, however, being bullied into staying can lead to a a cascade of interventions that you may not want. These are all things to consider.
The best advice that I can offer is that you ask questions. If you are being told that something is hospital policy, you have the right to see that policy, and if they can’t provide, it most likely isn’t a policy. Period. Ask the questions, and know that you have the ability to be in charge of your birth. Always, and in all ways.