Crimes and Misdemeanors: A Forced IV and Forced Apology
What would you do if your obstetrician threatened to kick you out of the hospital when you were 8 centimeters dilated and progressing smoothly?
Angela, one of my HypnoBirthing students, was subjected to this unlawful threat last month during her otherwise-perfect natural labor. The doctor – also a woman – had assured Angela during the months of prenatal care that she would be fully supportive of a natural birth even though the hospital is known for its high rate of medical intervention and C-sections. Angela was grateful to have an obstetrician who supported and respected her wishes.
About-Face
When Angela arrived at the hospital she was already 8 centimeters dilated and progressing comfortably. It was her dream labor in real-time. The doctor then said it was time for an IV. Angela politely declined, having done her research in advance and knowing an IV would make her vaginal birth neither safer nor more comfortable. In fact, Angela knew every IV fluid from saline to Pitocin would come with risks to her comfort and safety.
The doctor said it was hospital policy and she had to insert a hep-lock at the very least. (A hep-lock, also known as a saline lock, is a catheter in the vein that’s strapped to the hand, with no fluids.) It has become commonplace for American women to labor with an empty catheter in the hand: a futile compromise with no known health benefits and some risks (because once the catheter is in place, it makes fluids and drugs far more likely). In fact many hospitals have recently moved away from this practice.
Angela said thanks-but-no-thanks to the hep-lock.
Hands Tied
The doctor knew she legally couldn’t insert the hep-lock after Angela declined. Doing so would be a breach of federal law; the doctor and the hospital could be sued by Angela for battery regardless of ‘hospital policy’ or the fallacy known as doctor’s orders.
Gloves Off
“Look,” the doctor stated plainly, “If you don’t let me put this in your hand right now, I’m going to refuse you as a patient and you’ll have to leave the hospital and find somewhere else to give birth.”
As Angela sat in stunned betrayal – with a baby that was soon to emerge – the doctor wasted no time playing her last card. She told Angela she would hate for Angela or her baby to die.
What did Angela do? If you’re a mother, you already know: Angela relinquished her hand and her choice to refuse. Why would she do this, you wonder, when she knew she was being bullied? When there was absolutely no medical concern at hand? When the catheter would be devoid of fluids in the first place? Because women love their babies more than they love themselves. And a woman will do anything – rational or irrational – once she gets a vision of her worst nightmare.
Miracles Do Happen
It’s a wonder Angela’s labor proceeded normally after such a blatant showing of disrespect and fear tactics on the doctor’s part, but somehow Angela kept her mind and body calm, with the empty tube in her vein. A short while later she naturally birthed her healthy girl.
When I heard this story later that day, I implored the couple to submit a letter to the hospital administration reporting the facts surrounding this event. Hospital administrators value knowing if one of their obstetricians is treating women wrongly and – I cringe that it must be said – causing grounds for litigation.
Blowing the Whistle
With Angela’s knowledge, I called the president of the hospital myself. I left him a detailed message reporting what I had heard, citing only my name, my business and contact information, and the doctor’s name. I said I was confused, because if the account was true, then clearly the doctor was engaging in unlawful threats and coercion. I genuinely wanted to know if this was something he condoned.
I wished my report would somehow lead to a positive outcome and that he would care. As it turns out – he did.
A Touch of Justice
The following evening, Angela was resting in the hospital room with her husband and baby.
Her doctor suddenly arrived. It took a moment for it to register with Angela because of how elegantly the doctor was dressed, and also that her own child was with her.
“I want to apologize for how I treated you,” she began. “We can’t deny you care or make you leave the hospital, and I should have respected your wishes to refuse the hep-lock. I was totally out of line. Nothing like this will ever happen again.”
For the second time in her doctor’s presence, Angela sat stunned.
Apparently it was the doctor’s turn to yield under pressure from hospital staff – in this case, the higher-ups in administration. Or we can dream it was her conscience that sent her to work on her night off.
Mutual Responsibility
In my work I hear stories like this – sans the apology – too often. What are we to do? Can we help to create the improvement we wish to see?
I’ll tell you what I think doesn’t work: Arriving in the labor and delivery room with your guard up and ready for a fight. For one, a safe and comfortable birth calls for relinquishing yourself and turning your attention inward, which is impossible when you’re in protection mode. But also, a general ‘mistrust of doctors’ would blind you to all of the good medical providers who perform their jobs with genuine care and ethics; providers who adhere to ‘First Do No Harm’; who respect that you get the final word on your body; and who don’t view informed consent as a pesky or inconsequential legal requirement that can be ignored when no one’s watching.
For Angela, the doctor’s apology brings a satisfying end to her story. But what matters is whether change can come of it. If the doctor meant what she said – that it will never happen again – then something more important than satisfaction took place: It’s called progress.
So the next woman’s birth might be better now.
What You Can Do To Effect Positive Change in Obstetrics Care:
✓ Learn your rights.
✓ Become thoroughly informed on any hospital procedures and newborn interventions you anticipate.
✓ Hire carefully and well. Not just your doctor or midwife, but your doula, lactation counselor, childbirth educator and pediatrician.
✓ Make conscious, informed decisions. Experience the peace that comes with ownership and responsibility.
✓ Get comfortable speaking up. You are about to become the grown-up in your child’s life. Stepping up comes with the job.
✓ Be courageous and true with your feedback. Trust that it’s worth your time and energy.
Remember…
It is unlawful for a hospital to deny you care;
All medical staff must obtain your voluntary informed consent before any test, intervention or procedure;
Relax. You have no liability.
It was Margaret Mead who said, “Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.”
One day our children will give birth. When we do the right thing for ourselves and others, we raise children who will do the same. Our small voices are what movements are made of.
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