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Response to Transport Problem

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In Response to an Obstetrician's Refusal to Treat A Transported Laboring Woman until the Midwife was Off The Premises

In my mind, this treatment of a professional midwife is intolerable and must be responded to before another such situation occurs. Hospitals are usually VERY interested in public relations and meeting the needs of the consumer, especially if there is a competing hospital in the area. Individual docs who have chips on their shoulders don't care about alienating a few people if it furthers their own delusions. The best course of action here, in my opinion, is to schedule a meeting with the hospital administrator and the OB manager (or head nurse, or whoever is in charge of the OB unit). Prepare your case so that you can address the problem with them articulately, professionally, and hopefully without a lot of emotional defensiveness or aggressiveness that can come from being in the "one down" powerless position. Emphasize that your clients were VERY unhappy that this situation could occur in that hospital - bring a written letter saying so. Have the client let the hospital know in the letter that she will NOT be using any services of hospital for any member of her family until the situation is corrected. She might even suggest that she will encourage her friends to also boycott the hospital if they are willing to allow their patients to be treated with such disrespect.

Once you have presented the problem to the folks in charge of policy, you then need to clearly ask how they plan to deal with this problem so that your clients can get the safe, respectful care that they deserve from any hospital. I would suggest keeping the focus on the clients' right to have support people of their choice present, ESP. the care-provider who has managed her labor for perhaps hours and hours. This continuity of care is extremely important for the well-being of the client and the success of her birth experience. Ask if a policy can be written that allows you this continuity inside the hospital setting as long as it is clear that you are not trying to continue managing the labor (though you should not give up advocacy!!). Be helpful and always courteous in this process. Communicate somehow that you KNOW they want to correct this problem.

If they blow you off after this kind of effort, you might consider going straight to the problem (which you might want to do anyway). Try to get in to see the doc herself. Call her office and ask her receptionist when she has a gap in her schedule or when her lunch is and show up. Maybe a face-to face meeting, which this woman so rudely avoided at the time, might be less threatening to her at a time when she's not being asked to care for one of your clients. You run the risk of being treated rudely here, but at least you can say that you gave it a shot. Again, if she'll spend a couple of minutes with her, try to be professional, non-defensive, open to what she has to say. You could ask about her experience with midwives and let her know that you're trying to understand her behavior. I know of docs that can't stand midwives doing homebirths because the docs HAVE cleaned up way too many messes that the midwives bring in. It may be that you're being punished for the incompetencies of others. It may be that she's an incurable jerk....

Of last resort is to launch a media campaign - go to the press, have the client (or all of your clients)write a letter to the editor, write letters to the Better Business Bureau your Chamber of Commerce and your licensing board and the medical licensing board and anyone else remotely connected and of some importance. It may not actually change anything, but hospitals don't like negative publicity and if your clients raise a stink publicly, an uncooperative hospital administrator may become more cooperative.

Whatever you do, don't hide, don't just "take it," don't be less assertive than you have a right to be for fear of alienating medical staff. If you are approaching the problem in a mature, responsible, professional way, you have no reason to worry about their response. Just make sure you take the high road. Assume prejudice born out of ignorance - your job is to politely educate.

This Web page is referenced from another page containing related information about Transfer of Care - Transport


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