Military Hospitals vs Civillian Hospitals

JenniferNRN · Jun 16, 2004

I was wondering if anyone can give any insight in the differences between delivering and the postpartum stay at Military VS non military hospitals. I am interested more in the patients perspective, like do they have to same options for monitoring, mobility, showering and tubs, are iv optional, etc. Also, are hospitals different on miliraty bases abroad as opposed to here in the US. Any insight either personal or if you have family/friends who have delivered in one would be great. My sister just married into military and I want her to be able to make an informed decision when the time comes to choosing where to have a baby. Thanks!!!

Hello.

It has been almost 8 years since I had my son at Camp Pendleton Naval Hospital in California, but I will try to tell you what I can.

Pros:

I know they had advanced technology at the time and I have heard from several people that military hospitals tend to have newer techniques/drugs before other hospitals (I had Cervidil used on me there and 2 years later in Wisconsin, they said that they just started using it, although that could be just be CA vs. WI)

I remember the epidural placement going quickly. I had an intrathecal before the epidural, which allowed mobility. Before I was on Pitocin I didn't have an IV and was able to walk the unit as well. I did have continuous monitoring when I was in bed. I was an induction and all about pain relief, so I couldn't really tell you about refusing interventions. I was able to shower early on also.

Where I was there were a couple of Certified Nurse Midwives that I saw regularly and I really liked that care and attention they gave. I felt there was a multitude of education and resources available to me. They set me up immediately with WIC and childbirth ed classes. There were many different free classes offered.

I felt since it was a teaching hospital that I usually had a lot of attention and caring people at my side. I also felt that being a military spouse, rather than an actual member, I received a lot of respect from everyone, no matter what their rank.

There was a home visit during the first week from a nurse to check on my recovery (I was ultimately a C-section) and answer any questions.

Cons:

It was a teaching hospital so I had many different people checking my cervix and failing to start my IV on multiple tries. I had many different caregivers come and go throughout my long labor and postpartum stay.

They were strict about the baby rooming in and I practically had to beg them to take him for an hour or two so I could sleep a little that first night. They were very big on getting you to care for yourself and your baby immediately, which was hard after a primary C-section.

I don't think there was any private rooms although I was lucky enough to be without a roommate. They didn't have anywhere for my spouse to stay.

Those are the highlights that I remember. Many things may have changed over the last 8 years and I am sure that others have had different experiences. Now that I am an L&D nurse and have seen the good and the bad that can exist, I think overall I had a very good experience there and I retell it fondly. Best of luck to your sister no matter what she chooses.

SmilingBluEyes · Jun 16, 2004

Jennifer stated it well. This is true at the army and air force hospitals I have stayed in in my 20 years in military service and as a spouse.

redraccoon, BSN, RN · Jun 16, 2004

There are 3 major military hospitals in the area around me. I've only been to one - but have talked with nurses from all....

From what I can tell they offer all the options that most civilian hospitals do. One even just completed a refurbish of the L&D area to make it really homey.

Believe it or not many of the employees at military hospitals are actually civilians. And they are run pretty much like civilian hospitals. Your sister should be able to find good care. She's not going to be entering into some expanded version of a MASH unit.

The hospitals are up to date and because they are often teaching facilities, they usually have a lot to offer in the way of new equipment, tests, and care philosophies.

btw... I'm an active duty spouse and have never had a problem with any of the care that I received or that my family received!

CTRN1 · Jun 19, 2004

Thanks Everyone!!

BRANDY LPN · Jun 20, 2004

I used to work at a army hospital and the commander would not give out statements of unavailabilty so if you wanted tricare to pay you had to go to the base hospital, so if finances are an issue (and in the military they usually are ) your sister may not have much "choice" on where to deliver. That said in my experience I liked the military hospital much much better than the civilan one I work at now, I felt a lot less liability there. At the army hosp. we did not do "social" inductions for example. I feel like the care at the military hosp. was much more medically minded and thus safer. While we still had CNMs and low interventions, ect. Where at civilan hosp with soooo many non-needed inductions we have high intervention rate. KWIM?

mitchsmom · Jun 20, 2004

would not give out statements of unavailabilty so if you wanted tricare to pay you had to go to the base hospital

I have seen this go both ways depending on the area. My sister went to a civilian hospital b/c the military hospital was always overbooked (this was almost 2 years ago).

When I was 18, I was going in town for dr. visits/diagnosis but had to go to the military hospital for the surgery. This was 1989, at that time there were not as many creature comforts as the civilian hospital, for example no dedicated phone in my 4-patient room. As far as I know, the care was fine though. It was a teaching hospital too and I always thought my scar would have had a better appearance if the experienced doc had sewed me up though (it was thyroid surgery).

Trauma Columnist · Jun 20, 2004

Well - I'm the old lady of the bunch here but here's the history lesson. I was on active duty for my first pregnancy and delivery (1980) at Yokota AB hospital in Japan. Wonderful, easy delivery (precipitous delivery in labor room by RN) but I was responsible for changing my own linens immediately after birth because I was an E-4 (lower enlisted). Second delivery in 1985 was in a Spanish hospital in Zaragoza, Spain. Again, easy delivery and went within 12 hours since I don't like hospitals. No follow-up visits with either child but that wasn't the norm back then anyway. No pain meds either but again that wasn't the standard of care. Good luck...most of my military hospital experiences have been very good.

mother/babyRN, RN · Jun 20, 2004

I think it depends upon the staff....Most of my patients ( and we have a large military presence here) have tried both and not too many have great things to say about the military experience...My own mother was nearly killed by a botched surgery in one. As a military wife I had no occasion to delivery in a military hospital so cannot personally give a perspective. Overall, with our patients, it has been thumbs down for the military hospitals in that they didn't feel they had many options or autonomy....

missnurse01, MSN, RN · Jun 23, 2004

i had prenatal care and delivered at an army hospital for my 3rd child-it was awful. i had baby #1 at 32 weeks, baby #2 with cerclage and bedrest and many meds at 36 weeks. i don't know how i lasted to 36 weeks with #3, docs u/s me maybe 3 times-and showed my cervix getting shorter and shorter, refused to put in cerclage until they said oops, cervix is now too soft to put it in and i had to beg for tocolytics, even though they had tracings showing me contract. they also wouldn't refer me out to perinatologist and didn't put me on bedrest and no work untill like 32 weeks when i started dilating. i 'made' them see me on the 1st day of my 36th week, when they told me to stop tocolytics-i was very worried, i had always been in the hosp before and didn't know when to go to hosp. all they said was, you'll see a difference (since i was contracting all the time anyway). i finally got the doc to check me at that appt because i was so nervous about it, and low and behold-dilated to 4cm, they put me on the monitor-immediate major late decels and they induced me right then. (they knew that my 2nd had many hr/decel prob throughout the preg and, we almost induced many times, ended up with the cord wrapped). i rarely saw the same doc twice, and the doc that delivered me was in training and i never saw him or the supervising doc before either. father of baby was in iraq, nurses would come in the room to tell me to stop screaming and offer pain meds and leave again. pp was even worse, i would have left right then if baby wasn't in special care nursery for breathing prob-i had to walk from one floor to the other (l&d to pp) and walk around to get a tour of the unit and see where i was to dump my dirty laundry, and get my own water and snacks and...i can't say enough how shocked i was, esp after delivering before twice in civilian hosp. they also brought me a bag of meds and a paper that said when to take them and that was that. other than nsaids in the bag you couldn't get anything else for pain. as a nurse i wondered how many pts weren't taking their pnv/iron and taking too many pain pills. the pp area looked horrible too-plumbing rattled, tvs and shower didn't work-they changed my room 3 times because of things not working. i have heard stories like this from many women, from other areas too-not just this facility. oh, other than my initial pp nurse (i was there for 3 days) no one checked my bleeding, fundus...i think someone listened to heart and lungs and got vs once a day. oh, they also didn't do day after delivery h/h, just give you an rx for iron for 3 months. earliest pp check up i could get was 3 months after baby was born, with family practice-ob/gyn didn't do pp checks at all, at which time i was still bleeding and clotting (and i called many times about it) and seemed pretty tired, and they said that they didn't think that i was anemic enough to warrant a bld test and to just keep taking iron! sorry this is so long, guess i have a lot bottled up still! ugg, thanks for letting me vent!!!:chuckle it still makes me mad and that was a year ago.

Momto2Boys · Jun 23, 2004

I agree with Jennifer a lot when she wrote this:

They were strict about the baby rooming in and I practically had to beg them to take him for an hour or two so I could sleep a little that first night. They were very big on getting you to care for yourself and your baby immediately, which was hard after a primary C-section.

I have had 2 kids (one in a civilian hospital and the other on base). I have heard so many horror stories about base hospitals but mine was very uneventful and did not vary much from the civilian hospital other than the comment above.

CHATSDALE · Jun 23, 2004

delivered first child at Tripler in oahu, h i wouldn't brag about the care but i was first timer so i didn't know what was general practice or what was not basiclly i survived and i guess that is the important thing...no guarantee that your sis will find a good civilian hosp or a bad military h i wish her good luck