must allow nursery observation?

Specialties Ob/Gyn

Published

Due to being high risk (had my 2nd child preterm) and for insurance reasons my choice of hospital has been limited to one. They have an incrediably good NICU and I have no quelms about delivering my baby there except one...they have a policy of removing the child to the nursery for observation about 1 hour after birth for an hour or two.

When I heard this I approched the childbirth instructor at one of my classes as the class is taught by a L&D nurse from the hospital I will be delivering at about the possiblity of the 'observation' being done in room as was done with my oldest and would of been done if second was full term (both born at different hospitals). She stated they would not allow this as they examined the baby during it's first bath (no I could not give the first bath) and put the baby under a warmer and even if I stated no artificial nipples they did give a very small amount of gloucose water to make sure everything inside was flowing smoothly! I kindly thanked her for the information and went on my way. Wasn't about to blow my top as I realize she isn't in charge of policy and answered my questions honestly.

Now a few weeks later I find myself seething more and more over what probably is a minor issue but feel it over rides my choice to have my child stay with me the entire time. I can't help but wonder after 2 children why I am not 'allowed' to bath my own child, where they 'have' to give gloucose water...as I don't see that working through 'all the piping' in one or 2 hours ...and i had no problems nursing my children or where a warmer is any warmer then my little one snuggled up to my own skin.

My first child I had with me the entire time and my 2nd did go to nicu for 2 days with no breathing assistance needed and I even gave her little tiny body the first bath.

Basically my question is barring any complications (believe me if there were any questions about her well being I would diffinately let them take my child) can I refuse to let them do this and insist the baby stay the same room as me? I hate to be a bad patient and totally understand this isn't the nurses fault but administrative policy. If I state I will absolutely not let them take the baby out of the room can they still do it? I am totally willing to let the nurses assist/observe my feeding, bathing, caring for my child. Just feel it should be Mom and Dad's choice if a baby goes to a nursery if it's doing well... am I wrong for thinking/considering these things?

sorry for the long post and any spelling errors. Any advice and thoughts on this matter is truely appriciated.

Originally posted by L&D_RN_OH

I'm sorry if I misunderstood your statement. I read it to mean that parents were freaking out about babies getting sugar water,

You didn't misunderstand, I meant parents freaking out about the sugar water AND about the personel. Pretty much anyone freaking out about anything. I am a strong proponent of everyone just relaxing and letting things happen (until there is a real reason to get upset).

Now you do bring up an interesting point concerning sending moms home with a diaper bag full of formula. One of the worst things to have happened to our babies was the commercialization of infant formula. Unfortunately now there is no way to go back and our campaigns in support of breastfeeding are undermined by their marketing.

Breast is always best!!

Up Vote Up Vote ×
Originally posted by DoctorRN

One of the worst things to have happened to our babies was the commercialization of infant formula.

No kidding. :o

Personally though, as a parent, I would be upset if my newborn was given formula or glucose water w/o my knowledge, and I respect those feelings for my pts.

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

where I work, one of our PED's actually has a written standing order to remove all formula from the bags of BF moms. We are happy to comply. But that does not change the strong message these companies send across anyhow. And when the rep's have luncheons, dinners, etc at Olive Garden or Outback for us, I do NOT attend. I can't ...on principle. Even though they will tell you it's for EDUCATION (changes etc to their formulas). I will NOT be bought in such an overt way. That is ONE thing I can do something about, if nothing else. They WILL NEVER convince me formula is even a close second to breast milk.;)

Up Vote Up Vote ×
Specializes in ICU, ER, HH, NICU, now FNP.

Check out this thread re formula and pharm companies:

Pharmaceutical marketing thread

Up Vote Up Vote ×
Originally posted by SmilingBluEyes

And when the rep's have luncheons, dinners, etc at Olive Garden or Outback for us,

Are they allowed to do that? We have a hosp policy against "gifts" from any reps. This means no more pizza lunches or bagel breakfasts. :eek:

Up Vote Up Vote ×

It breaks my heart to hear that there are still hospitals caring for newborns and their families in such outdated nonresearch based ways. Family Centered Maternity Care became the standard of care in this country in the 1980's and anything less indicates a hospital that is behind the times, happy to continue status quo even though such care is not supported by research. These nurses and administrators cannot be attending conferences, reading the journals, and staying updated. There are hospitals in our area that don't even have central nurseries any more and found it to be much more cost effective to provide mother/baby care. There is ample research to show that parents rest better if the baby is in their room, that breastfed babies get more feedings and gain weight better if left at bedside, that the newborn baby's temperature is more stable if left skin to skin (investigate kangaroo care even for pretermers-it's being done with great success all over the world), that even one bottle of anything can significantly alter the intestinal tract in the newborn and cause problems for certain infants and should only be given if medically indicated. I could go on and on. The point is that this hospital is providing very outdated care. Why? Because they get away with it. When will it change? When health care consumers are educated enough to demand change or take their dollars elsewhere and that will involve insurance companies and HMO's. Whose baby is it, who will remember the precious moments after birth years from now? You may not have the energy it takes to effect change on a large scale but you do need to make your requests, which are very reasonable, known. And the hospital does need to respect and honor your requests. It is your birth experience not theirs. I have worked in this specialty over 30 years and have raised 4 children of my own. I work in a rural hospital with a level 2 nursery. All nurses are cross trained to work all areas as well as gyne surgicals.We have limited dollars but strive to stay updated and provide the very best care to our families. Frankly, I don't see how this hospital passes muster when Joint Commission comes through. They certainly would never achieve Baby Friendly Hospital accreditation, but of course it doesn't sound like they would even know what that is or why it is important. My heart goes out to you. Pregnant women should not have to fight these battles-you have too much else to think about right now. Your energies should be focused elsewhere. Just do the best you can-my thought will be with you.

Up Vote Up Vote ×

Hello everyone! Wanted to update what's happened since my original posting. First I would like to thank everyone once again for their thoughts and advice. Looks like this turned into quite a conversational thread!

Katie ended up being born on Dec. 6th at 12:31 AM . Exactly at 36 weeks. She was 6lbs 1 oz and 19 inches long. My water broke and because I was strep B positive we all decided pitocin to get my not so regular contractions going...thank goodness for Epidurals..wishing I had gotten them with my other two kiddos now! *winks*

As I had already decided if the baby was early, she went to the nursery with no requests other then 'please bring her back to me ASAP'. So after a very brief (less then 5 minutes) of getting to hold her off she went. Her apgars were 7 and 8 BTW and she was doing great. The only real thing that bothered me was ASAP ended up being 2 1/2 hours after she was born (I know I was bugging the nurse to tears at this point for my baby but I figured an hour later and was very much wanting time with my baby by this point but later found out they were way understaffed in the newborn nursery so nursery nurse couldn't bring her back...not nurses fault but whoever schedualed them should of known better at such a busy hospital... over 4000 births a year)! And by then she was too sleepy to nurse. So we didn't get that in till about 5 hours after she was born. Besides that and 3 quick trips for glucose tests she was with me the entire time.

I did end up asking to leave the hospital 36 hours after having her because I wasn't getting any sleep...not from Katie..she's been a perfect angel sleeping except when hungry..but because I had a roomate..who while very nice was hard to sleep around.

Anyways, everything has gone well since then besides a bit of jaundice...me having the nastiest time when my milk came in...and losing weight faster then expected (hubby says I did with the other 2 during the first week also but I don't remember 10 lbs right at birth and 7lbs since) and sweating up a storm (what's the deal with that?!) But.... baby has already gained back her birth weight (WTG breast milk!!! *cheers wildly*)

So there's my lengthly update :)

Up Vote Up Vote ×

I wonder if the policy for observation has any roots in the current staffing levels, as it would take 1:1 staff to keep the baby in the room, but less staff to have a baby in the nursery with all of the other newborns under observation. Just a thought on the rationale.

If you really would like to have the observation done in the delivery room, you might want to consider writing a "birth plan". this document is created by the parents, and then discussed with the OB to be sure that what you both want can indeed be done. Then, parents and OB sign it and it is placed on the mom's chart during labor. The birth plan can specify who is in the room for labor and who can stay for the delivery, wishes for pain control, and anything special that is desired.

One little word about birth plans that I've noticed from experience....those couples that take the time to write a birth plan usually end up having a c-section and the birth plan becomes a useless document, as the patient really doesn't ahve control over what happens in a c-section.

STG

Up Vote Up Vote ×
Specializes in many.

Just wondering about a couple of things...What part of the world are you in that they still whip the babe away as part of "policy"? And did they actually give her glucose water? So glad you had a healthy baby!

Up Vote Up Vote ×
Specializes in NICU.

Congratulations, glad baby and mom are doing well.

My question: Were you given anibiotics prior to delivery,with your positive GBS status. Or did your baby have a CBC and blood culture drawn, especially as you did not stay for 48 hours observation?

mimi

Up Vote Up Vote ×
+ Add a Comment