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I am finding it really very frustrating to talk to my clients about best evidence practice when our local hospital has so many policies for 'high risk' pregnancies that would see so many surgical births that just aren't necessary!
What is the best way to go about bringing about change for this archaic hole!?
I wish there was an easy way - I really do. I am a "high risk" as a grand multi, and their policies drive me bonkers at times. But I drive them back because "hospital policy" wont fly with me. It may be their policy, but its my body.
Best thing you can do is keep your clients informed. We could find out what some of these poilicies are and write up some quick faq one page flyers to keep and print out when they are needed so you can give them a brief overview of what it is about, and they can choose to look a little deeper into the situation. I would hate to be in your shoes and watching a mother go in for a completely unneccesary c-section because of a ridiculous archaic policy.
Truly, the most valuable weapon in a pregnant womans arsenal these days is our right to say no. We just need to be informed enough to know when to.
I think Tanya that change will be a slow process and will come only from women asking questions, refusing treatment and intervention that they know to be unnecessary, and demanding that the hospital practice in an evidence based manner.
That of course only happens when women are encouraged to take responsibility for their own births instead of handing responsibility over to everyone else - which is where you come in :)
I have also found over time that much of what is trotted out to women as "hospital policy" is, in fact "caregiver on duty at the time policy" and it's good to be able to distinguish between the two. I do alot of births in a large teaching hospital here and have spent quite a bit of time getting to the bottom of their policies on various things and have found that many of their formal policies are actually quite good in terms being current and evidence based. But what actually happens in antenatal clinic or birth suite can bear little resemblance to this at all.
When I hear things from my mums that don't sound right to me, I encourage them to first ask "what is the reason for that", then "can you show me some evidence for that". Finally, we ask for a written copy of the policy (all hospitals have these).
An example - a few months back I went to clinic with a mum who was 10 days post dates and she was told by an obstetrician that hospital policy was that she had to be induced at 14 days post. We asked to see this policy and when they actually looked it up, it stated that the mother was to be offered monitoring from 14 days post EDD. VERY different to what she was being told and much closer to evidence based practice to boot. Needless to say that was the end of the conversation and she went into spontaneous labour two days later :lol:
Sorry for the ramble this really gets my goat LOL.
double post :)
I too have found that what is stated as hospital policy is more often then not made up on the spot, to be used as part of the bulling and manipulation which is standard practice in this terrible system.
I would suggest asking the hospital for a copy of their Maternity Unit policy folder.
Write a letter to the unit manager, clearly outlining that you are requesting a copy of all policies in relation to maternity at their hospital - you don't need a reason, you are a consumer and this is a public service.
Keep it short and simple. Send it by registered post.
Give them exactly 14 days, if they do not send you a copy or they attempt to fob you off, write a letter to the regional health department, including your original request. Also send this by registered post.
The registered post lets them know that you are serious and keeping track of correspondence.
If you have no joy after these two steps, go to your local MP with all the correspondence and ask them to act on your behalf.
This issue really gets me, all hospitals should be forced to publish a complete set of stats and policies on their website, at the front counter and given to every person using their service.
Interestingly, Nicola Roxon thinks she can take away our access to homebirth servcies because she is going to make this system user friendly, in less then a year!
Right Nicola, you are going to get rid of the only form of women centre care in our whole country with the possibility of setting up models of care that will be system centred, within a system that isn't working now.
How are we meant to get quality care in the near future from services that can not even tell us the truth when we ask them, won't let the public know their policies and continue to allow bulling and manipulation to be standard ways of handling the provisions of maternity services.
I would be very interested to hear how your mission goes.
Good Luck!