Saturday, October 31, 2009

Uli's Birth Story, Part 3: Escape from the Hospital

Here’s a spooky story for you...

(If you want to review Part 1 it’s HERE and Part 2 is HERE.)

So, calling it an “escape” sounds a tad dramatic, I know. But honestly, that’s just how it felt last Halloween and there’s a reason I haven’t written about it until now. It was a really difficult day to get through. But it’s time to get it out of my system:

A day or two after her birth Uli was jaundiced and the hospital staff were concerned. However, our family practitioner wasn’t so I wasn’t worried either.

We did wish she’d eat more, though. With the delay in my milk and her sucking/latch issues she wasn’t getting much at the breast and with each passing hour the hospital staff grew more insistent about giving her formula. I continued to turn it down and told them that we had access to human donor milk and preferred to use it versus formula. We were told the hospital’s policy red-tape wouldn’t allow us to bring in donor milk. Seriously? They were refusing to allow us to feed our baby a superior food because it wasn’t addressed in their guidelines? I found that extremely foolish on their part—they were following idiotic guidelines that weren’t in a baby’s best interest, encouraging the use of formula over breastmilk. Whatever. In the end it may have been a gift—they said we’d have to be discharged before we could feed her the milk, and they had thought about keeping us another night but for my refusal of the formula.

I was so excited to go home. Since we’d planned for the homebirth, I’d never really considered what staying in a hospital might be like. And I tell you what: I didn’t like it. Sure, being able to call-in my order of food whenever I felt like it was nice. But on-demand institutional food is not a good enough reason to be in the hospital with a newborn, IMO.

That hospital bed—up and down with the push of a button—was handy after a surgery that cuts your stomach open. That didn’t help me feel better about having an unnecessary surgery, of course. Plus, for all its wondrous mechanisms, the mattress itself was seriously lacking. A twin bed is not the best when you’re cuddling your newborn and trying to co-sleep (though we made it work nevertheless—it was a very rare minute indeed that she found herself placed in that clear bassinet roller carriage thing). And the mattress was covered in plastic, which, while perhaps a positive from a cleaning perspective, was absolutely dreadful to have against your skin (separated by just a thin sheet)—after four days of resting against that plastic I had developed painfully sore red blister-like spots on my back, behind, and legs. I don’t know if they could be considered bedsores or not, they were NOT fun.

Worst of all was the constant interruption. Every few hours for my pain meds. Every few hours to check my stats. Every few hours to check the baby. Bleh. I understand that after surgery you must be monitored, but if I’d had my homebirth there wouldn’t have been a surgery or a need to check on me and wake me up every other hour. I longed for the time when I was well enough to enjoy the peace of home.

Some of the nurses were great (in particular, the nursing student who’d been assigned to me was so full of enthusiasm, encouraging words, and interest in the more mundane jobs of tending to a new mother and baby) but some of the others… There was the nurse who gave me a nipple shield (which, it turned out, I didn’t really need) without instructions on how to use it (note: using it incorrectly causes tissue damage and HURTS). And there was the nurse who had asked the first night which names were trying to decide between and then, after we’d decided upon Uli, she made a face and said, “Oh, you picked that one.” I think it may have been the same nurse who told me that Justin wasn’t supposed to have the baby in bed with him (he was in the other twin in my room and was cuddling Uli while my vitals were being checked and I took a bathroom break).

The morning of our discharge from the hospital I was SO READY to get outta there. Feed my baby the way I believed was best. Shower in my own bathroom. Sleep in my own bed—with my baby and my husband. Rest when Uli was sleeping and get up when she woke up with no more interruptions by staff.

Unfortunately, there were hours and hours between the doctors telling us that we would be going home and us actually getting out the door, which really brought down my mood. My mother- and father-in-law arrived to say hello, and I was so grouchy that I didn’t appreciate the gesture and was instead quite unnecessarily rude to them.

Then there was the debacle over Uli’s outfit. Justin has packed it (he’d told me what he was doing and you’d think I’d have spoken-up if I’d had issue with it, but at the time the problems that might occur with his plan hadn’t occurred to me). She had a onesie (embellished with a “Squirt 2008” from Auntie Katie), but we hadn’t brought any pants to go with it. Instead, Justin had packed a pair of his tube socks, intending to slip them over her legs and thighs. And really, that would have kept her perfectly warm. But, and I don’t remember if it started with me being a crabby whiner or my MIL asking the nurse for baby pants or the nurses exclaiming that we didn’t have any pants for her, but however it came to happen I distinctly remember one of the staff saying, “We cannot discharge her unless she has some pants!” And that really raised my hackles. This was my baby. I can decide if she needs pants or not. It was a beautiful, sunny October day. The socks Justin had packed would have been fine. But no. Instead, the nurse(s) scrounged about and came back to me with an ugly Precious Moments long sleeved pajama outfit. (I admit to taking out some of my frustrations over the hospital stay upon the pjs at a later date).

But whatever, we put her in the outfit. And then it was time to go! Oh no, wait. The freakin’ carseat. We had one, of course. But saying that we had one wasn’t good enough for the hospital. They couldn’t trust us farther than they could throw us. They demanded we show them the seat to prove it’s existence. Now, our seat of choice was a convertible, which means that it wasn’t a baby-bucket that you carried around but one that was supposed to stay in the car at all times. No matter, the staff demanded that Justin go unbuckle it from the car and bring it up to my hospital room before they would allow us to leave with Uli. I had a problem with this for several reasons: first (and second and third), it’s MY BABY and who are you (police officers aside) to tell me that I must show you that I do, in fact, have a carseat? Also, Justin took extra care in the week before we left for the birth to put the seat into the car snuggly and properly. And now you just want him to rip it out of there? Boo. And lastly, I felt like their power had gone to their heads. They lorded over us new, tired parents and were acting as though their requirements must be met or we would not be allowed to take our baby—as though they were legally allowed to deny us our parenthood over a carseat. And though they were insistent about seeing the seat there was no discussion about why they needed to see it or of WI law requiring carseats nor did they care that we reinstalled it properly nor did they give us any encouragement about baby’s first car ride. Nope. Just boorish demands. Unnecessary.

As Justin went back down to the car to unhook and lug-up the carseat, I faced the official discharge paperwork alone. It was a bunch of complete and total nonsense that I found not only annoying and disrespectful but full of scare tactics that weren’t based on medical evidence. Essentially, I was asked to respond to child-rearing questions in a manner that the hospital had previously deemed correct and good for every single family in the whole of Dane County.

“And you know not to co-sleep because it’s extremely dangerous and your baby might be killed, right?”

“Don’t immerse the baby in the bath until the stub falls off, okay?”

“Douse the stub with alcohol twice daily, alright?.”

I answered “Yes” or “I understand” to each edict even though, knowing it is safe and may even reduce the chances of SIDS, I fully intended to co-sleep, and we’d learned from our childbirth classes that studies don’t warrant the avoidance of water nor the use of alcohol on the umbilical stub (unfortunately hospital policies aren’t always based on best evidence since it can take a lot to get updates through the bureaucracy).

Others items I was supposed to nod my head to were just so obvious and ridiculous that it was insulting that they felt the need to inform me of them. Things like “Remember, your baby will need to eat often,” “Don’t leave the baby in the bathtub alone,” and “Don’t put your baby in a plastic bag,” (okay, they didn’t really ask that last one…) And then the last few: “Do you feel able to care for your infant? Are you comfortable going home with your baby? Are you certain? Really, truly? Triple swear?” were just the icing on the cake. The cake flavored with “We assume that you do not have a brain.”

I understand that when you’re moving large numbers of patients through a system you need a checklist of some-sort and, for simplicity’s sake, the checklist is standardized. But that’s the issue: labor and birth and child-rearing cannot and should not be standardized. It is not appropriate to approach them as one-size-fits-all. When you put a time limit on labors, when you refuse to attend a breech birth, when you discriminate against a woman’s choice of pain management, when you presume to know what’s best for each infant’s transition home you’re taking very personal matters and decisions and boxing them up in an inapt package.

I suppose that’s what having midwifery care meant to me: the midwives took time, real time, to get to know me and to personalize my care. They treated me as if I were an intelligent woman who wants to make good, appropriate choices for myself and my infant. They recognized when I was worried and addressed my concerns. They felt their duty as care providers was to explain various options, listen to any proposals I may have of my own, and then let me choose how to move forward rather than assuming I wanted something done this way or that. With them I never felt as though they were telling me I “had” to do something. They were more than willing to give me advice if I asked for it, but they respected my personal authority over my body and my child. That respect was severely lacking from the staff at Meriter.

When I think back on it, no, it wasn’t “that bad.” Being ‘disrespected’ isn’t the worse thing in the world. And yes, I was full of hormones and more sensitive than normal, but doesn’t that mean that hospital staff should be more accommodating and more understanding rather than bossy and insistent? Does something really have to be worse than a hot poker in your eye to qualify as uncomfortable, unnecessary, stupid and bad?

When I think about how a midwife leaves her homebirth patients several hours after the birth (after starting a load of laundry and offering to pop something in the oven) and then returns to check on everyone daily, I know that a homebirth would have made me happier. At least the part after the baby arrives. ;-)

Maybe next time...

So, that’s my spooky story. Happy Halloween, everyone!


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