My rights in Hospital

Hobbitfeet · 26-05-2011 3:28pm #1

This is my first pregnancy and I'm trying to decide whether to have a home birth or go to the local hospital. I would prefer to have a home birth but live quite rural and am afraid if something goes wrong its a bit of a journey to the hospital this is my only concern with home birth.
I want to know what are my rights if having my baby in hospital? I know I will have a birth plan and want a natural birth, no episiotomies, no pain relief hopefully

I don't want to be given anything to speed up delivery of placenta, I want cord to have stopped pulsating before being cut and I want my baby given to me immediately and not taken away for checks until I am ready.

What are my rights? can I be forced to do any of these things?
Any help or comments on your experiences is appreciated.

Ayla · 26-05-2011 3:36pm

The short answer is that no, you can't be forced into anything (baring in the event of a real medical emergency). Your best option is to visit the maternity unit of the hosp & talk to the midwives so you know their specific procedures.

Put together a birth plan (knowing that when the time comes, it'll be flexible) and talk to your medical team so they are clear on your wishes.

A hospital birth doesn't have to be an emotionally sterilized conveyor belt, and you do have the option to attempt whatever you'd prefer.

As a note, what you discribed as what you want was exactly what i had with my first (a hospital birth). My second didn't have the time so some things happened which i'd otherwise have preferred to avoid (cut cord immediately, injection, etc) but it really didn't matter once i held my daughter.

Khannie · 26-05-2011 4:10pm

Just out of interest...what's the idea behind waiting for the cord pulsating thing?

In general the hospital will do whatever you want, but as was said, best to just ask them.

How Strange · 26-05-2011 6:29pm

Khannie apparently the baby gets the equivalent of a blood tranfusion via the cord.

I found the coombe completely open to an intervention free, pain free labour and birth. I had a birth plan, it was put on my file on admittance and every midwife read it.

I didn't put a note about no drugs for delivering the placenta but I was so tired after the delivery of my baby that I just agreed and definitely don't regret it. I delivered the placenta within minutes.

I actually couldn't hold my baby because I was so exhausted but we did skin to skin until the cord stopped
pulsating and then dad held him. He
was taken away for about 15 minutes
after we'd had some time with him but
again I didn't mind because I had a
shower and changed while he was
gone.

I'd say just be realistic rather than idealistic and talk to your midwives and if they want to do something which goes against what you wanted just ask why and discuss it with them.

I was on continuous monitoring during labour which was one of the things I absolutely didn't want but I talked it through with the midwives and conceded for the welfare of my baby. That was the only preference on my birthing plan that they couldn't
facilitate. In hindsight it doesn't matter one whit.

L

Moonbeam · 26-05-2011 6:33pm

I found Holles St brilliant when I told them I wanted a natural birth except in an emergency told them to do what was necessary.

dcfc · 26-05-2011 6:41pm

Most hospitals will try to adhere to your wishes as much as possible. As someone has already mentioned, it's a good idea to write your plan down and give it to your midwife. Things don't always go to plan so it's important that you are open minded to taking the advice given to you at the actual time. Good luck, hope everything goes well for you.

RachaelVO · 26-05-2011 6:43pm

How Strange wrote: »

I'd say just be realistic rather than idealistic

+1
Best piece of advice I've ever read!

Chinasea · 26-05-2011 6:44pm

What right have we to be asking what our rights are when it is us who decides to have a baby?

No one forces this.

It is my belief that you are in a fortunate position to have a baby, and, you are also lucky enough to have it all done for free and now you want to know what your rights are.

I wish you sincerely the very best with whatever way you decide to go but I am tired of listening to people in this country ready and waiting to take take take without thinking of what they are getting for free which in my opinion is still a very privileged life style....

liliq · 26-05-2011 6:46pm

Just a quick note on homebirth as well...
As far as I know (and I could be wrong...) with homebirths not being as common in Ireland, the rules are fairly stringent.
I think I read somewhere before that you have to be within a certain distance of the hospital for a homebirth option to be supported by the HSE, midwives, etc... I noticed in your original post that you mentioned distance from the hospital was one of your conerns with regard to a home birth. Would be worth checking that it's an option first, before you set you heart on it!
I love the idea of them, but don't think I'm brave enough!

Moonbeam · 26-05-2011 6:54pm

Chinasea wrote: »

What right have we to be asking what our rights are when it is us who decides to have a baby?

No one forces this.

It is my belief that you are in a fortunate position to have a baby, and, you are also lucky enough to have it all done for free and now you want to know what your rights are.

I wish you sincerely the very best with whatever way you decide to go but I am tired of listening to people in this country ready and waiting to take take take without thinking of what they are getting for free which in my opinion is still a very privileged life style....

*mod warning*
Please do not post unhelpful off topic posts here, If you do it will result in an infringement.

Chinasea · 26-05-2011 7:15pm

Mine is an observation, an opinion and a comment.

The fact that it might not be a considered helpful is a fair comment but none the less I feel that I have a right to voice my opinion - especially having worked in a hospital and dealing with the public on a daily basis many of which quote us chapter and verse 'on their rights'. I think we provide a fantastic maternity service (all be it extremely stretched) for free.

January · 26-05-2011 7:19pm

Chinasea wrote: »

Mine is an observation, an opinion and a comment.

The fact that it might not be a considered helpful is a fair comment but none the less I feel that I have a right to voice my opinion - especially having worked in a hospital and dealing with the public on a daily basis many of which quote us chapter and verse 'on their rights'. I think we provide a fantastic maternity service (all be it extremely stretched) for free.

A lot of women feel forced into the decisions they have to make in Irish maternity hospitals. Whether it's free or not should have no impact on what way you want to give birth. Yes, we are lucky to have a free maternity service but everyone whether private, public or semi private gives birth the same way and just because you are public doesn't mean you should just give up and let as many interventions as possible rain down on you.

Ayla · 26-05-2011 7:23pm

chinsea, would you feel so objectionable to the query if the OP had asked what her options are instead of what her rights are? I would imagine the two are synonomous in her mind.

RachaelVO · 26-05-2011 7:29pm

Chinasea wrote: »

Mine is an observation, an opinion and a comment.

The fact that it might not be a considered helpful is a fair comment but none the less I feel that I have a right to voice my opinion - especially having worked in a hospital and dealing with the public on a daily basis many of which quote us chapter and verse 'on their rights'. I think we provide a fantastic maternity service (all be it extremely stretched) for free.

Saying that Irish health care is free is offensive in any case. It's paid for by taxes, which we all have to pay, whether it's income tax, road tax or VAT!

And yes the OP has rights, all hospitals have a patient charter that says that very thing. Your two posts have quiet a sting in them, and to be fair this thread was started as a request for information NOT a debate!

Chinasea · 27-05-2011 8:33am

RachaelVO wrote: »

Your two posts have quiet a sting in them, and to be fair this thread was started as a request for information NOT a debate!

This is a forum - part of a forum is to inform but also importantly it is a chance to debate, to let people voice their opinions, their observations etc.

January · 27-05-2011 8:38am

Chinasea wrote: »

This is a forum - part of a forum is to inform but also importantly it is a chance to debate, to let people voice their opinions, their observations etc.

True, but, and I'm sure my co-mods will agree with me here... The primary focus of the Parenting forum (and it's sub-forums) is for advice. There is scope for debate, but it's more in a general sense and some threads are started in that vein and carry on in it.

We'd prefer if people come looking for advice on this forum that they are given what they ask for and not feel belittled by other peoples opinions on what way they should and shouldn't give birth. Your tone is more of a "shut up and put up" kind of opinion, or at least that's the way I, and others, have taken up your post here.

Hobbitfeet · 27-05-2011 11:32am

Chinasea wrote: »

What right have we to be asking what our rights are when it is us who decides to have a baby?

No one forces this.

It is my belief that you are in a fortunate position to have a baby, and, you are also lucky enough to have it all done for free and now you want to know what your rights are.

I wish you sincerely the very best with whatever way you decide to go but I am tired of listening to people in this country ready and waiting to take take take without thinking of what they are getting for free which in my opinion is still a very privileged life style....

I think I have every right to ask about my rights when I give birth to my child. I understand in some countrys women have no rights when it comes to things like this and a lot of other matters but does that mean that for us the lucky people who can ask for and be given our rights should just give them up forget about them? It was not so long ago in this country women and pregnant women had zero rights, they had their babies taken from them without consent because they were unmarried. Women in this country fought for the rights we can now enjoy and it would be a damned shame if we all thought like you and forgot about them. Comments like yours do not help anyone especially less fortunate pregnant women who have no rights.

Thank you everyone for your advice, it was very helpful. I have heard so many stories from friends who were not clear on what rights they had giving birth and were scared into things they did not really want or need. It can be scary time being pregnant and giving birth especially when it is your first. So I just wanted to inform myself as much as possible before the most important event in my life.

cbyrd · 27-05-2011 1:14pm

You should have enough time in the delivery room to tell the midwife what you want too. Things like can i hold the baby straight away and that you don't want to be cut or given the injection for the placenta. Bear in mind that they have to perform the APGAR test, at 1 and 5 minutes after birth (Appearance pulse Grimace Actvity Respiration)
http://en.wikipedia.org/wiki/Apgar_score
It's routine and a score of 2 is given for each response, but it's a fairly vital test.
A natural tear heals quicker than a cut. But everything you put in the birth plan is a guide, not an absolute. I have 3 children and every birth was different. Go into the delivery room with an open mind. Don't rule out pain relief, while you imagine you can cope with a lot of pain, you have to take into account that you could be in pain for hours with no let up and it may make your birth experience better to take some of it away.
Home births usually have to be within a certain distance of the hospital to be approved
http://www.homebirth.ie/
Generally you won't be 'forced' to do anything but in a lot of cases procedures are not carried out on a whim but for your or the baby's safety.
Just don't build your hopes up that you will have a completely natural birth, aim for a good experience and a safe one.

The end result of a healthy baby and mammy is all everybody aims for.

Cat Melodeon · 27-05-2011 2:36pm

Hobbitfeet wrote: »

This is my first pregnancy and I'm trying to decide whether to have a home birth or go to the local hospital. I would prefer to have a home birth but live quite rural and am afraid if something goes wrong its a bit of a journey to the hospital this is my only concern with home birth.

Many independent midwives will be unwilling to assist at a homebirth if you are further than a 30min drive (at the legal limit!) from a hospital. I would love a homebirth and have investigated it but it is simply not an option here in rural Tipp.

Hobbitfeet wrote: »

I want to know what are my rights if having my baby in hospital?

I really don't see what chinasea's issue is with your question. Patient rights have been secured in the Irish health care system since the Patient's Charter was introduced in 1994. Anyone who has worked or trained in a hospital here must be aware of the importance of ensuring that peoples' rights are protected when they are at their most vulnerable, and nowhere is an individual more vulnerable than in a hospital. With the history of abuse of patients in this country, particularly women, and particularly in women's reproductive health (Dr Neary, Magdalene laundries, Anti-D, faulty scanners and misdiagnosis of miscarriage in OLOL), any woman entering the health care system for the first time is perfectly sensible to be finding out as much as she can about her rights, as those rights have been so carelessly ignored and trampled on over the years.

I have to say that although I felt pressured once or twice during my antenatal care, I felt completely respected during the actual labour. My birth plan was mostly adhered to even though I had to be induced. There was some concern about my blood pressure which meant we did have to be monitored but it didn't affect my mobility at all. I hadn't mentioned the cord being left and the midwives suggested to me that they leave it to stop pulsing. In the event, I was too wrecked to hold my boy for long so they set him up skin to skin with my husband without being asked. It was an intense experience but I wouldn't have changed a thing, any changes to my birth plan were made with our full consent and in the interests of our well-being only. Nothing was done to 'speed things up' or to help the staff out rather than us. In other words, I felt my rights were respected by the hospital at all times, as they should be.

carwash_2006 · 27-05-2011 3:35pm

Chinasea wrote: »

What right have we to be asking what our rights are when it is us who decides to have a baby?

No one forces this.

It is my belief that you are in a fortunate position to have a baby, and, you are also lucky enough to have it all done for free and now you want to know what your rights are.

I wish you sincerely the very best with whatever way you decide to go but I am tired of listening to people in this country ready and waiting to take take take without thinking of what they are getting for free which in my opinion is still a very privileged life style....

Well you may have your opinion, but personally I find your opinion insulting to women. You may not mean it, but you give the impression that a woman becomes a piece of meat when she becomes pregnant and the healthcare workers should be just left to it to do what they see fit.

Every woman should have the right to decide what she is comfortable with or not, she should be informed of every procedure, what the benefits and the possible downsides can be and allowed to choose which risk she is happier with, cause lets face it there are risks as well as benefits to interventions.

However, with these choices does come some responsibility. A woman who desires to avoid interventions and hoping to have as natural a birth as possible has the responsibility to keep herself as healthy as possible during her pregnancy, she needs to eat well and healthily and take appropriate exercise. She needs to research as much as she can so she knows beforehand ways to avoid the things she finds distasteful. I can't remember where I read it, it could have been a comment or article on the AIMS facebook page or maybe another forum, but some very wise person said that no woman should try for a natural birth, she should prepare for it. Obviously things still go wrong even with the preparation put in and that is where we are very lucky to live in a world where we have medical interventions available to us.

Boardnashea · 27-05-2011 3:42pm

Hi Hobbitfeet. AIMS Ireland (Association for Improvement in the Maternity Services) have just brought out a free Healthy Birth Directory for the West of Ireland. It covers your options and rights and a directory of services. It is produced for the west of the country but everything in it will apply anywhere in the country. PM me and I will send you a copy.

Chinasea · 27-05-2011 7:22pm

My fundamental point seems to have been overlooked on the high horses. And let’s not constantly roll out time and time again our awful grim history when it suits us. MY point is that we really have it very good here; we have an excellent maternity service. To compare what happened in the past with the excellent maternity services we are receiving today, here and now for FREE is pointless.

Like I said, I didn't think my point of view would be popular and sadly it seems to have been received as an almost alien concept which, I believe stems from the fact that we just have all taken so much for granted in this country. I really think as a society we need to start reflecting on how good we actually have it, even in these harsh times.

Having a baby is a personal choice and a personal responsibility. I would like to see more focus on how lucky we are to have what we have, as opposed to what else we can get; what we can take; what we can DEMAND because it is our entitlement; what are our rights etc.,.

Obviously it goes without saying that H&S comes first but with the highest birth-rate in EUROPE and the wonderful healthy births that occur daily in our stretched hospitals I think we need to think!

How Strange · 27-05-2011 8:10pm

Chinasea, I don't think we have an excellent maternity system here. I think we have an adequate one which works well despite the limitations placed on it due to cutbacks etc. My experience of our health system during my pregnancy was great but I put that down to the great midwives I interacted with rather than the system itself.

Moreover and its been said before, its NOT free. We pay for our health services through our taxes and because we pay for it we are entitled (yes, theres that word) to expect certain things from it just as we would any other service we contribute to.

Having a baby may be a personal decision but just because it is doesn't mean pregnant women should put up and shut up. Thats what happened in Drogheda and look at the devastation putting up, shutting up and just being grateful caused there.

I also think you've seen one word in a thread title and have jumped on it and interpreted it in a very particular way even though the OP is asking what options/rights she has to influence the kind of birthing experience she will have. I would imagine its a human right to have choices and options with regards to how your body is treated while in hospital and to be able to articulate how you want to be treated by medical staff.

cbyrd · 27-05-2011 10:11pm

Chinasea. .I think if i go into hospital to have a baby i have the right to tell the midwives if i want my baby cleaned before s/he's put on my tummy, whether i want to go as long as i can without pain relief or whether i want an epidural as soon as i get the first pain. I certainly have the right not to have my body cut unless it's completely necessary or to say whether i'm breastfeeding straight away or not.

I think these rights are afforded to every woman in Ireland be she public or private.
What i don't have the right to is to demand a private bed if i'm a public patient, or to have a consultant at the birth if i have not paid for it. I've paid my PRSI and income tax all my working life, i also pay health insurance, i dont' think i'm getting anything for free.
No matter who you are or what you are in hospital for you have the right to say what happens to your own body. Without this right then the likes of the Neary cases would go on and on. And yes i am delving into history but not that far back. I was under Neary for my first child, he was suspended not long before i gave birth.. for a long time no-one questioned what was going on and for a long time Women were given hysterectomies that were not needed, they were Free too, should those women have been 'grateful' for the service that was provided to them? I think not.
The birth of a first child is always in ignorance of what goes on once you go into labour. I know that and every woman who has a 2nd child knows that the first birth is a huge learning experience. There's lots you'd change about your first given the chance, and i'm sure that's what the OP was thinking of.. not how can she get the most out of a free system.

Cat Melodeon · 28-05-2011 12:49am

Chinasea wrote: »

My fundamental point seems to have been overlooked on the high horses. And let’s not constantly roll out time and time again our awful grim history when it suits us. MY point is that we really have it very good here; we have an excellent maternity service. To compare what happened in the past with the excellent maternity services we are receiving today, here and now for FREE is pointless.

The dodgy scanners were still being used in Drogheda two months ago. This is not ancient history, it is now and it is ongoing. These are public services that we pay for as tax-paying citizens and that we entrust health professionals to manage and operate on our behalf. That does not give those health professionals free rein. They must be held accountable for what they do, they must be audited and checked and reminded that they are providing a service to us, we are the clients, we have rights. To do otherwise leads to mismanagement and unfortunately when it comes to the health services (as has been proved time and time and time again), mismanagement leads to unnecessary deaths.

Chinasea wrote: »

I really think as a society we need to start reflecting on how good we actually have it, even in these harsh times.

Yes we have it good in comparison to developing countries or to inequitable systems like in the US. But that does not mean that we should all pat ourselves on the back - our hospitals are understaffed and badly equipped. They are funded atrociously and managed horrendously. There is massive room for improvement, in terms of hygiene and infection rates, efficient use of resources, frontline staffing etc. How can you have worked in the health services and not admit that this is true?

Chinasea · 28-05-2011 9:35am

cbyrd wrote: »

I've paid my PRSI and income tax all my working life, i also pay health insurance, i dont' think i'm getting anything for free.

Thousands of people pay tax and contribute to PRSI and never avail of our 'free' health service, as do thousands of people on medical cards who don't contribute via tax, PRSI etc, avail of our FREE maternity service so I am not with you on that very much trotted out stance.

I as a citizen of this country feel privalaged to have a job and be able to contribute towards my country for the better of all even if I don’t directly avail of Services per se.

We all know exactly the failings of our hospitals and the blame is multi fold therein. I however am brining to the table the fact that our services are pretty actually pretty dam good all things considered – however this fact seems to be overlooked in the whipped up hysteria, not just here but in the media. I also importantly reference the fact that we have EUROPE'S HIGHEST BIRTH RATE (99 % perfect) bang in the middle of one of the country’s worst economic crisis, and we have a lady before she even starts wanting to know what her rights are, is a tad rigid in my book.

GoerGirl · 28-05-2011 12:40pm

Chinasea wrote: »

What right have we to be asking what our rights are when it is us who decides to have a baby?

No one forces this.

It is my belief that you are in a fortunate position to have a baby, and, you are also lucky enough to have it all done for free and now you want to know what your rights are.

I wish you sincerely the very best with whatever way you decide to go but I am tired of listening to people in this country ready and waiting to take take take without thinking of what they are getting for free which in my opinion is still a very privileged life style....

The Irish Constitution enshrine's the right to bodily integrity and informed consent.

Chinasea wrote: »

Having a baby is a personal choice and a personal responsibility. I would like to see more focus on how lucky we are to have what we have, as opposed to what else we can get; what we can take; what we can DEMAND because it is our entitlement; what are our rights etc.,.

While I agree, there are excellent components of the Irish Maternity System, we also must recognise the failings.

Lack of care options outside consultant led care, local and routine policy rather than evidenced-based practice, lack of transparency, lack of accountability, local/routine policy is not equitable nor consistent - changes from unit to unit and within units, from care provider to care provider.

Why are you so afraid of women informing themselves and knowing their rights?

OP - your rights in birth/maternity services are the same for all realms of health. You have the right to safe, adequate, and free care. You have the right to informed consent and informed refusal. You have the right to request a change of care provider or change units, and request second opinions, etc

Hospital vs Home Birth both have their own benefits and risks. The Cuidiu consumer guide is excellent for comparing hospital policy, stats, ect.

http://www.cuidiu-ict.ie/fulcrum.html?ep=13

Orion · 28-05-2011 6:59pm

Chinasea wrote: »

The fact that it might not be a considered helpful is a fair comment but none the less I feel that I have a right to voice my opinion

Actually no you don't. I'm not as nice as my fellow mods so I'm going to point out that posting here is a privilege not a right. And if you break the rules that privilege will be revoked.

The rules you are breaking here are:
1. Dragging the thread off topic.
2. Ignoring a mod warning / arguing with a mod.

Feel free to start a new thread in a relevant forum (possibly Humanities or Politics or State Benefits) if you want to discuss the ins and outs of the free maternity system in Ireland. But if you continue to go off topic in this thread you will find your posting privileges revoked in Parenting. Arguing on thread with mods will also result in this.

Now, and this applies to everyone, the OP asked a question about her rights during birth. Lets get back to that topic now please.

Chinasea · 28-05-2011 10:42pm

Freedom of speach doesn't spring to mind. Defination of a forum also doesn't spring to mind.

Typing in Bold seems a little Über necessary.

Mums the word so....

xzanti · 28-05-2011 10:54pm

Fair play to you OP.. I would imagine the Hospital would encourage as natural birth as possible.. and you are well within your rights to refuse any procedure you're not comfortable with..

One thing I would say though, and I'm sure you already know this, be prepared for the event of things not going as you would hope, no matter how determined you are to go 'eau natural' sometimes baby/fate just has other plans.. failure to progress/mekonium in the waters/cord around baby's neck etc.. anyway all I'm saying is, try not be too disappointed if intervention is unavoidable.. I think about 20% of births last year ended in a c section.. so be prepared..

But I hope things go as planned for you.. and best of luck

Orion · 28-05-2011 10:56pm

*sigh* You've three days to read up on freedom of speech as it applies to a private forum. And hopefully to read the charter too