Protocol/policy for adoptive parents

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During my L&D rotation a couple weeks ago we had a pt that was giving her baby up for adoption. The adoptive parents came to the hospital a few hours after delivery. I found it a bit shocking that there wasn't any protocol/policy for adoptive parents in the hospital. The nurses didn't check any ID for the adoptive parents and gave them a room to bond with their son. No ID bands with the corisponding(?spelling) numbers were placed on infant or the adoptive parents (or the birth-mother). I felt uncomfortable with the whole situation. I am so used to checking the ID bands for verification when bringing baby back to parents it was just wierd. The adoptive parents came in and spoke with the birth-mother and gave her a gift basket, so we knew that they were the 'right' parents as the birth-mother actually choose them.

My question is: What, if any policy/protocol does your hospital have for adopive parents and situations as this?

Specializes in Postpartum.

This is a very good question. I'm not at work at the moment, but Monday I will be sure to look it up as I don't know what our policy is (never had this situation). I am curious about other hospitals though.

Dina

Specializes in Family NP, OB Nursing.

Over the years our policy has changed, but as of now the policy is:

1. Newborn is banded along with the birth mother. While in the hospital the birth mother has the right spend time with her baby, hold and see it at any time. She can also change her mind at any time.

2. If there is a legal contract lawyers for both parties must agree to adoptive parents visiting/bonding, being present for the delivery or contacting the birth mother in the hospital. If agreed upon the second "support person" ID band is placed on one of the adoptive parents. This band allows that person to be alone with the infant and if we have the room and both parties agree we will provide an area for the adoptive parents to bond privately with the infant.

3. Legal contract dictates who the newborn is discharged to. It is often a court official after 24 hrs.

4. If no contract is in effect, visitation is up to the birth mother as with any other patient. The infant must be discharged to the mother. Once the mother is off hospital grounds she can then hand the baby over to anyone she desires.

5. Social services is contacted when any "non contract" adoption is discussed. These adoptions are usually the type where the birth mother simply doesn't want another baby, and is farming it out to a friend. They usually end up as "guardiansnhips" rather than adoptions.

I'm a bit confused. Are you saying that this baby wasn't banded at all? Or that it was allowed with the adoptive parents without them being banded? ALL infants need to be banded. Does this facility actually have a policy? If it doesn't it REALLY should get one.

The infant had the security alarm placed on his ankle and a slip in his crib that said "baby whatever-birthmother's-name-was." There were no ID bracelets given to the birthmother as she requested not to see the infant (or even hear about him) and the infant was taken straight to the nursery. The adoptive parents didn't have any ID checked before they were given the infant. There was no ID bracelet placed on either adoptive parent. I asked the nurse about this and she said that the hospital didn't have a policy regarding the issue. I understand that it is a small hospital, but why wouldn't they have a policy for it as it is always a possibility?

Specializes in Family NP, OB Nursing.

Hey we are a small critical access hospital our OB unit has only 5 LDRPs and 1 postop room...so small isn't an excuse. Regardless of what the birth mother says, in our unit she still would have been banded along with the baby and then if she wanted a second bracelet on the adoptive parents so be it.

She wouldn't have to see or hold or anything the baby, but she would still have to sign any consents for that baby such as admission/hep B or anything else as until the baby is handed over to the court it is her responsibility.

The hospital really needs a policy, if something were to happen it would be a nightmare.

It was explained to the birthmother that she would have to sign any consents that were needed for shots and possible circ, but that is as far as it went while I was there. I found it very strange that there wasn't anything inplace that addressed this type of thing - regardless of it being a small hospital. I'm not sure what happened after my shift that night as it was my last day on the unit, but it still bothers me.

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