So, currently considering my birth plan and VBAC intentions and a thought has popped in to my head. I am only asking this out of curiosity but was hoping some people know the answer.
If I go in to hospital and end up with a doctor who wants me to have a particular procedure done and I refuse, at what point do they wash their hands of me? I figure they would have to get me to sign something, but what happens if I don't? There are lots of variables to this question I know, such as is it a minor ar major procedure, is mine or baby's life or health at risk etc
I'd like to know the answers to all the scenarios, but to just to give a starting point here is an example which is kind of where this question has stemmed from.
My Ob is supporting my VBAC, but he went through a few conditions that are usually put in place such as labour must progress, continuous monitoring and a bung in my arm. They are fairly standard procedures for VBACs especially through the private system. I am ok (not thrilled) with the first two, but I really really don't want the bung in my arm. My Ob seems to be ok with this after a discussion, but he gave me the heads up that if he just happened to be off-duty when I go in to labour and I fall under the care of one of his colleagues then they will insist on it to the point where they will be quite rude about it.
So, if this happens and I end up with a different Ob and they do start to get rude and insistent about this procedure, I know what to expect. The way I see it is the bung is a "break glass in case of emergency" procedure, not one to have just because. So if I refuse, they can't stick it in my arm, but if they still insist and I still refuse what happens next? If I threaten to walk out of the hospital without signing any discharge papers can they stop me? Would they stop me? How would they stop me? Can I demand another Ob? I know I can demand another MW.....
See lots of questions and variables.... I am not expecting to do any of this, but am just wondering to what point can something like this escalate?
They are not going to hold you down if you say no.
Why don't you want the line in? Just curious...... If it's a comfort thing, they are actually not that bad. A small plastic tube which would just have a little cap on it and be taped to your arm/hand. The sharp bit is removed and it is a tiny plastic tube that is left, so assuming it is taped down well it shouldn't get in your way. You can do anything you want and wouldn't be restricted by it.
If you really don't want one, then that is your right. They can't make you. x
They make me feel physically sick!! I associate them I think with when I had my tonsils out and my vein collapsed so my hand swelled and puffed up to painful proportions and they wouldn't remove it because I hadn't finished the fluids!! Then when I was induced last time the same thing happened (although they did remove it when I complained because I was no longer needing it - DS had been born and I was back in my room). I know it is just a bung and they aren't putting anything in to it unless I need it, but just the thought of it makes my skin crawl and I feel sick.
Fair enough then, you don't need anything interfering with your positive state of mind. I'd just insist i didn't want it and they could put it in if it is needed. Surely they would be flexible enough to compromise?!
You could also say that you discussed it with your OB and she/he said it was ok.
Hmm a bit off thread but I was supposed to have one in in case of PPH with DD2 but I couldn't stay still enough to get it in I am not sure how it works with a VBAC tho. All the best for your impending birth! xx
At what stage would you have a cannula? Fair enough you don't want one. Me I'd prefer it there as a just in case I needed it later. In the case of life and death or serious illness they can take up precious minutes putting one in especially if your compromised making it harder to get in (like your haemorraging or something) and you can't guarantee someone experienced in getting them in will be there all the time.
As a midwife I would respect your decision not wanting it in but to cover myself I would have to document it in the notes that the client was refusing and the reasons behind that. Of course I would let the person know I was doing this not that I didn't agree with them just to protect myself. I would imagine the Obstetrician would do the same if you said no and of course are of sound mind so can not be made to have it in. I would say most reasonable health professionals would except your decision after telling you why they would want it there and then would cover themself incase something happened and an inquest was looking into what could have been done differently to chance the outcome.
In the event you did walk out depending on the circumstance (say your in labour and didn't want one in and said you were off to have a free birth at home) then legally the department of community services would be called and a report would be made to say that the medical staff did not think you were protecting your unborn child and they believed they were at risk of serious harm (in the case of failing to provide medical care) I am going to all extremes here. No one can hold you against your will except in the event they believe your not of sound mind but if a mandatory reporter (such as nurse or Dr) thought you were putting your baby at risk they would most likely report it (and nothing would probably become of it). A report wouldn't mean you would have the police on your door step dragging you back against your will.
The hospital were I work with have policies that we have to stick to. For a VBAC our policy is that continuous monitoring, a cannula is in place and a few other stipulations. If this is not done and say something happened like your baby was distressed and an emergency c/s needed to occur and say bub had some sort of disability (again going to the extreme) then that would come back to bite us if an inquest happened into the cause. Now this is going to the extreme I know but just outlining why these policies are in place. Unfortunately most maternity hospitals are medically based and don't protect the natural phylosophy of labour and birth.
If a health professional was following policy and you refused and knew the pro's and con's and were of sound mind when you made your decision then if it all went to court over something happening to you or bub then if it was documented that would cover them against medical negligency so to speak.
Once again I am going to the extreme but just thought I would add what would happen if that happened where I worked. The chance of this happening would be very low. Much more likely to come in in labour refuse a cannula have a troublefree birth, no complications, no need for a cannula.
I know it is not the same but I had to sign a form declining medical treatment when I had a physiological 3rd stage. Maybe ask your ob if you can sign a form declining a cannula as a routine thing but consent in case of emergency? that form is then put in your file and any other ob has to follow it.
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Then when I was induced last time the same thing happened (although they did remove it when I complained because I was no longer needing it - DS had been born and I was back in my room). I know it is just a bung and they aren't putting anything in to it unless I need it, but just the thought of it makes my skin crawl and I feel sick.
I am not sure how it works with a VBAC tho. All the best for your impending birth! xx
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