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Patients right? Anyone know?

Posted by on Mar. 12, 2014 at 3:19 PM
  • 6 Replies
I'm currently still with the same doctor that delivered my DD. My main concern is about this practice is, during delivery so many things went wrong. So with baby #2 I made my first appointment specifically with the doctor who delivered my first, thinking she would remember everything we all went through that day. I expressed my feelings and how strongly I'm trying to encourage a c-section if any complications were to arise. The doctor looked at me like "well it's not up to you it's up to me" and simply said "ok, we'll see how it does when baby is ready to come" I was speechless! I was expecting something more along the lines of "oh yes I remember what we had to go through and a csection is probably best for you" and because I got the reaction I did from this doctor I'm leaning more towards finding a new one! I'm trying to avoid leaving if I can hold my ground and tell the doctor that it's not up to her and were going to do it my way if I feel necessary. But I need to know if that is possible to even say to a doctor!

I guess what I'm trying to ask is, what kind of information do you know about patients rights over what the doctor thinks is "best"?

by on Mar. 12, 2014 at 3:19 PM
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Luvmy2babies22
by Gold Member on Mar. 12, 2014 at 3:32 PM
1 mom liked this
I don't know about rights but I had a similar experience with my first. It was terrible and should have been a section. My second came early and easily. This time i'm looking at another big baby and am scared crapless of a repeat situation with my first. I have the same OB. She knows what I went thru and has agreed to a c section if I want since i'm not having anymore kids.

All I can say is that if I were you, I would not bother arguing rights with this doctor. I would not be comfortable with the level of care and I would look elsewhere, period.
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doulala
by on Mar. 12, 2014 at 3:33 PM

Well it is important to interview care providers.    We can make a list and set up appts with a few.    
WHO we hire can be our greatest risk factor!   (and the setting)

You do have rights.   It isn't fair to have to deal with those while laboring though!     So hiring the right care provider will be a priority.     Having an advocate like a doula helps a lot, too.



 

doulala
by on Mar. 12, 2014 at 3:35 PM


The Rights of Childbearing Women




The Rights of Childbearing Women

This statement outlines a set of basic maternity rights that Childbirth Connection has identified and promotes for all childbearing women. It applies widely accepted human rights to the specific situation of maternity care. Although most of these rights are granted to women in the United States by law, many women do not have knowledge of their maternity rights. Consideration and respect for every woman under all circumstances is the foundation of this statement of rights, available as a printed piece for educational and advocacy settings, as a downloadable PDF, and on this page.



Fundamental Problems with Maternity Care in the United States

This statement was developed in response to serious and continuing problems with maternity care in the United States, including: 

  • The United States is the only wealthy industrialized nation that does not guarantee access to essential health care for all pregnant women and infants. Many women, especially those with low incomes, lack access to adequate maternity care. 

  • A large body of scientific research shows that many widely used maternity care practices that involve risk and discomfort are of no benefit to low-risk women and infants. On the other hand, some practices that clearly offer important benefits are not widely available in U.S. hospitals. 

  • Many women do not receive adequate information about benefits and risks of specific procedures, drugs, tests, and treatments, or about alternatives. 

  • Childbearing women frequently are not aware of their legal right to make health care choices on behalf of themselves and their babies, and do not exercise this right.

We must ensure that all childbearing women have access to information and care that is based on the best scientific evidence now available, and that they understand and have opportunities to exercise their right to make health care decisions. Women whose rights are violated need access to legal or other recourse to address their grievances.


The Rights of Childbearing Women

* At this time in the United States, childbearing women are legally entitled to those rights.
** The legal system would probably uphold those rights.
 

    1 Every woman has the right to health care before, during and after pregnancy and childbirth. 
   2 Every woman and infant has the right to receive care that is consistent with current scientific evidence about benefits and risks.* Practices that have been found to be safe and beneficial should be used when indicated. Harmful, ineffective or unnecessary practices should be avoided. Unproven interventions should be used only in the context of research to evaluate their effects. 
   3 Every woman has the right to choose a midwife or a physician as her maternity care provider. Both caregivers skilled in normal childbearing and caregivers skilled in complications are needed to ensure quality care for all. 
   0 Every woman has the right to choose her birth setting from the full range of safe options available in her community, on the basis of complete, objective information about benefits, risks and costs of these options.*
   5 Every woman has the right to receive all or most of her maternity care from a single caregiver or a small group of caregivers, with whom she can establish a relationship. Every woman has the right to leave her maternity caregiver and select another if she becomes dissatisfied with her care.* (Only second sentence is a legal right.) 
   6 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.* 
   7 Every woman has the right to communicate with caregivers and receive all care in privacy, which may involve excluding nonessential personnel. She also has the right to have all personal information treated according to standards of confidentiality.* 
   8 Every woman has the right to receive maternity care that identifies and addresses social and behavioral factors that affect her health and that of her baby.** She should receive information to help her take the best care of herself and her baby and have access to social services and behavioral change programs that could contribute to their health. 
    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, and of all other reasonable options, including no intervention.* She should receive this information about all interventions that are likely to be offered during labor and birth well before the onset of labor. 
10 Every woman has the right to accept or refuse procedures, drugs, tests and treatments, and to have her choices honored. She has the right to change her mind.* (Please note that this established legal right has been challenged in a number of recent cases.) 
11 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.* 
12 Every woman has the right to unrestricted access to all available records about her pregnancy, labor, birth, postpartum care and infant; to obtain a full copy of these records; and to receive help in understanding them, if necessary.* 
13 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.* 
14 Every woman has the right to have family members and friends of her choice present during all aspects of her maternity care.** 
pregnancy rights 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.** 
16 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.* 
17 Every woman has the right to freedom of movement during labor, unencumbered by tubes, wires or other apparatus. She also has the right to give birth in the position of her choice.* 
18 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.** 
19 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.** 
20 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.**



Copyright 2012 Childbirth Connection


Our Sources

The following sources, in their present or earlier editions, helped guide the development of this statement of rights:

american hospital association American Hospital Association. The Patient Care Partnership: Understanding Expectations, Rights and Responsibilities, 2003. 

A national bill of patients' rights Annas, G..J. A national bill of patients' rights. New England Journal of Medicine 1998;338(10):695-699. 

the rights of patients Annas, G. J. The Rights of Patients: The Authoritative ACLU Guide to the Rights of Patients, third edition. Carbondale, IL: Southern Illinois University Press, 2004.

childbearing and knowledge is power  The Boston Women's Health Book Collective. Sections on "Childbearing" and "Knowledge is Power." In: Our Bodies, Ourselves: A New Edition for a New Era. New York: Simon & Schuster, 2005;417-524, 699-758. 

the mother-friendly childbirth initiative  Coalition for Improving Maternity Services (CIMS). The Mother-Friendly Childbirth Initiative, 1996.

guide to effective care in pregnancy and childbirth Enkin, M., Keirse, M. J. N. C., Neilson J., Crowther, C., Duley, L., Hodnett, E. and Hofmeyr, J. A Guide to Effective Care in Pregnancy and Childbirth, third edition. New York: Oxford University Press, 2000. 

the pregnant patient's bill of rights International Childbirth Education Association, Inc. The Pregnant Patient's Bill of Rights. Minneapolis: ICEA, 1975. 


consumer bill of rights and responsibilities President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry. Appendix A: Consumer Bill of Rights and Responsibilities. In its Quality First: Better Health Care for All Americans.

universal declaration of human rights United Nations. Universal Declaration of Human Rights, 1948.


Thank you to George Annas, professor and chair of Health Law at the Boston University School of Public Health, for clarifying the legal status of the individual rights.

Most recent page update: 12/18/2013



© 2014 National Partnership for Women & Families. All rights reserved. 

Founded in 1918, Childbirth Connection has joined forces with and become a core program of the National Partnership for Women & Families. Together, these two women's health powerhouses are transforming maternity care in the United States.


Heather2001
by on Mar. 12, 2014 at 3:35 PM
1 mom liked this

Well honestly, I'm siding with your doc on this one.  C-sections should be last resorts and you can't really compare one delivery to another.  To start talking c-section at the very beginning of a pregnancy is jumping the gun, IMO.  You may have a super-smooth labor and delivery that give no indication for a c-section.  What issues did you have with your first that leads you to think you might need one this time around?

doulala
by on Mar. 12, 2014 at 3:39 PM

I agree--   it is worth working for health and safety first, avoiding unnecessary risks and interventions for the sake of both baby and the mother.

Quoting Heather2001:

Well honestly, I'm siding with your doc on this one.  C-sections should be last resorts and you can't really compare one delivery to another.  To start talking c-section at the very beginning of a pregnancy is jumping the gun, IMO.  You may have a super-smooth labor and delivery that give no indication for a c-section.  What issues did you have with your first that leads you to think you might need one this time around?


Luvmy2babies22
by Gold Member on Mar. 12, 2014 at 3:56 PM
1 mom liked this

 I think her point isn't totally about wanting a c section but also toward the reaction she received from the doc under the circumstances of her first delivery.  I also had a horrible experience and common sense and rationality can say "it's a different baby, your body has done this before, blah blah blah" but the fact is that once you have a scary/traumatic experience, it's hard to push that aside.  I think the doc acknowledging her fears and anxiety and calmly saying "let's wait and see where we are in your third trimester" would have been a better approach.  That's the approach that my OB took with me.  She continues to reassure me that it's my 3rd baby and things will be fine but it doesn't change the fact that my first experience has terrified me...even 7+ years after the fact.  It also doesn't matter that my 2nd baby came so easily.  The fear overshadows a lot... 

A little gentler more empathetic bedside manner seems to be lacking in this doc which is why I say "don't bother arguing."  I'm not saying c-section is the answer but confidence of care goes a long way in reassuring a patient who has had a tough delivery...

Quoting Heather2001:

Well honestly, I'm siding with your doc on this one.  C-sections should be last resorts and you can't really compare one delivery to another.  To start talking c-section at the very beginning of a pregnancy is jumping the gun, IMO.  You may have a super-smooth labor and delivery that give no indication for a c-section.  What issues did you have with your first that leads you to think you might need one this time around?

 

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