Monday, August 16, 2010

The Pregnant Patient's Bill of Rights according to an obstetric nurse textbook!

I ran across the following "Bill of Rights" today as I was reading through an obstetric nurse textbook and thought I'd share. It is really interesting to read!

The Pregnant Patient’s Bill of Rights
(according to Maternity Care The Nurse and The Family
by Benson, Jensen and Bobak)

The Pregnant Patient has the right to participate in decisions involving her well-being and that of her unborn child, unless there is a clearcut medical emergency that prevents her participation. In addition to the rights set forth in the American Hospital Association’s “Patient’s Bill of Rights” (which has also been adopted by the New York City’s Department of Health), the Pregnant Patient, because she represents two patients rather than one, should be recognized as having the additional rights listed below.

1) The Pregnant Patient has the right, prior to the administration of any drug or procedure, to be informed by the health professional caring for her of any direct or indirect effects, risks or hazards to herself or her unborn or newborn infant which may result from the use of any drug or procedure prescribed for or administered to her during pregnancy, labor, birth or lactation.
2) The Pregnant Patient has the right, prior to the proposed therapy, to be informed, not only of the benefits, risks and hazards of the proposed therapy but also of known alternative therapy, such as available childbirth education classes which could help to prepare the Pregnant Patient physically or mentally to cope with the discomfort or stress of pregnancy and the experience of childbirth, thereby reducing or eliminating her need for drugs and obstetric intervention. She should be offered such information early in her pregnancy in order that she may make a reasoned decision.
3) The Pregnant Patient has the right, prior to the administration of any drug, to be informed by the health profession who is prescribing or administering the drug to her that any drug which she receives during pregnancy, labor or birth, no matter how or when the drug is taken or administered, may adversely affect her unborn baby, directly or indirectly, and that there is no drug or chemical which has been proven safe for the unborn child.
4) The Pregnant Patient has the right, if cesarean section is anticipated, to be informed prior to the administration of any drug, and preferably prior to her hospitalization, that minimizing her and, in turn, her baby’s intake of nonessential pre-operative medicine, will benefit her baby.
5) The Pregnant Patient has the right, prior to the administration of a drug or procedure, to be informed if there is no properly controlled follow-up research which has established the safety of the drug or procedure with regard to its direct and/or indirect effects on the physiological, mental and neurological development of the child exposed, via the mother, to the drug or procedure during pregnancy, labor, birth or lactation—(this would apply to virtually all drugs and the vast majority of obstetric procedures).
6) The Pregnant Patient has the right, prior to the administration of any drug, to be informed of the brand name and generic name of the drug in order that she may advise the health professional of any past adverse reaction to the drug.
7) The Pregnant Patient has the right, to determine for herself, without pressure from her attendant, whether she will accept the risks inherent in the proposed therapy or refuse a drug or procedure.
8) The Pregnant Patient has the right, to know the name and qualifications of the individual administering a medication or procedure to her during labor or birth.
9) The Pregnant Patient has the right, to be informed, prior to the administration of any procedure, whether that procedure is being administered to her for her or her baby’s benefit (medically indicated) or as an elective procedure (for convenience or teaching purposes).
10) The Pregnant Patient has the right, to be accompanied during the stress of labor and birth by someone she cares for, and to whom she looks for emotional comfort and encouragement.
11) The Pregnant Patient has the right, after appropriate medical consultation to choose a position for labor and for birth which is least stressful to her baby and to herself.
12) The Obstetric Patient has the right, to have her baby cared for at her bedside if her baby is normal, and to feed her baby according to her baby’s needs rather than according to the hospital regimen.
13) The Obstetric Patient has the right, to be informed in writing of the name of the person who actually delivered her baby and the professional qualifications of that person. This information should also be on the birth certificate.
14) The Obstetric Patient has the right, to be informed if there is any known or indicated aspect of her or her baby’s care or condition which may cause her or her baby later difficulty or problems.
15) The Obstetric Patient has the right, to have her and her baby’s hospital medical records complete, accurate and legible and to have their records, including Nurses’ Notes, retained by the hospital until the child reaches at least the age of majority, or, alternatively, to have the records offered to her before they are destroyed.
16) The Obstetric Patient, both during and after her hospital stay, has the right to have access to her complete hospital medical records, including Nurses’ Notes, and to receive a copy upon payment of a reasonable fee and without incurring the expense of retaining an attorney.

It is the obstetric patient and her baby not the health professional, who must sustain any trauma or injury resulting from the use of a drug or obstetric procedure. The observation of the rights listed above will not only permit the obstetric patient to participate in the decisions involving her and her baby’s health care, but will help to protect the health professional and the hospital against litigation arising from resentment or misunderstanding on the part of the mother.

Saturday, January 23, 2010

Physical Flare-Up, and God's Still Good!!!

The past couple of weeks I've been feeling odd and haven't been able to pinpoint what has been wrong. After recovering from a cold turned ear (and who know what other) infection I noticed some nagging things that were odd going on.
One thing that I noticed was that though my cold symptoms were gone, my throat seemed to be a bit constricted. I had a hard time getting foods that were ordinarily easy to swallow down my throat without drinking water. This was not something that came on suddenly and didn't seem to be changing so I gave it no notice.
Another thing that was odd was that I began to swell after being literally unswollen all of this pregnancy. I know that it's normal to have some swelling in the end, but this was somehow off. I had not changed my eating habits or done anything that was directly related to swelling.
There were others such as: uncalled for anxiety, some mental confusion, tiredness, etc... which all could have been passed off for pregnancy symptoms if I did not really feel an underlying feeling that something was different. I could not shake the feeling that something was wrong or out of control and I couldn't figure out what it was.
Fast forward a bit. Last night I was suddenly awakened at around 3am with a feeling of panic. My face was puffy and my lips were huge. I felt as if my body was carrying around 30 extra pounds of water as heavy as lead inside of it. None of the regular tricks for helping with the swelling worked (lots of water, tea, warm baths, elevating my feet, etc...) I wasn't sure what it was, but I knew that something was terribly wrong.
Thus began my prayer time this morning with a time of praising God, longing to trust Him and trying to surrender to His will for my body whatever that was. I tell you, it's really hard to surrender to something that you have no idea what it is! By the time I was done I still had just as much anxiety, but I was determined to lean on the Lord for His support and to trust Him.
Throughout the day I really struggled. I would start to think that something was wrong, and then I would begin to pray and fight to trust God and to seek His will on what I should do. Finally, I called a close friend of mine and talked it over with her for a few minutes. It was her who suggested that it might have been some kind of allergic reaction.
All at once I began to understand. I was having a flare up of the same sort that I had experienced several times over the past few years. You see, it seems that my body has some type of hystamine reaction to an overload of stress plus virus in my body. That was it! I have had these panicked feelings before! I will be okay!
I just want to give God all of the glory for this. I decided to trust Him for His grace and guidance and to do my best not to worry. He was faithful even when I had to come to Him every few minutes to renew my faith in Him. Thank you Lord for your faithfulness and for letting me know that it'd all be okay. I love you and thank you for loving me.

Saturday, January 16, 2010

A great "assignment" from my midwife that I thought you might enjoy.

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I had a good time dreaming and enjoying today. Thanks for this "assignment" it was so fun! I'm getting excited!
If I could plan my labor...

If labor began during the day, I would begin labor with gentle contractions. I would continue with the normal daily routine, but probably with a little bit of a spring to my step. I would feel excited and take the time to discuss with my baby and my children what to expect and how we all felt about it. I would let everyone who was going to be joining us know that labor had begun and that they were welcome to come any time as long as they understood that early labor would probably not be extremely exciting. LOL! I would also have a good plan in place for contacting my husband at work as well as having the boys taken out to keep them occupied so that we would avoid any stress or tension that might come with arranging this in the moment. Labor would progress in its own time: not so slow that I'd become exhausted, but not too fast that I couldn't enjoy and adjust to it.
During early labor I would laugh and joke with my friends talking about funny stories or remeniscing on good times. Maybe we would look at old photos, scrapbook, watch old family movies or listen to a funny book while working on a project. Those around me would not make a big deal out of my contractions and labor leaving me to do as I need to do and enjoy myself. As labor progressed and I had to start concentrating no one would make a big deal, but every once in awhile someone would let me know they noticed what was going on.
At a point that things get much more intense I'd have a very respectful atmosphere. I'd be surrounded by the people I love and who love me. We wouldn't be talking or joking so much unless I lead that way, but we'd all be working together to bring this baby into the world. I wouldn't mind if people wanted to take a break or chit chat together, but maybe in a different room or part of the house. I'd want those around me to touch me instinctually and not to wait for me to ask if they can help me. On the other hand, I wouldn't want them to be offended if I rejected the kind of touch or help they offered.
During second stage I would want to just go with the flow of my body. Whatever it told me to do I'd want to feel safe and supported to do. I wouldn't want to be the "spectacle" or the "bringer of everyone else's joy". I would want us to be there working together, not meaning that anyone would have to touch or physically be there, but I'd want to feel the whole room working together to bring the baby out. We'd all have worked hard by this point. We all do this together! Immediately after the baby is born I would have a still moment, a moment of wonder and awe at what had unfolded, a moment when my little family could bond. Then it would be time to celebrate!!!
After the baby is born I would like to have everyone celebrate and be happy, not just with me or the baby, but with themselves...with us as a group. I'd like them to celebrate the life and the miracle that happened, to bask in it, not as if the baby's birth is the end, but a beautiful transition that they had a part of. I would have everyone stay and enjoy a meal and some birthday cake maybe. The same joyful and light atmosphere as in early labor would return and tears of joy and love would flow.
When people began to leave I would have my immediate family at home. Maybe some close friends or family would stay at the house to help the boys transition. I would take a beautiful nap with the baby and just enjoy his smell, his little life. Maybe Sage would join us if he felt like it.
Over the next few days I would have preparations in place so that life would not just seem like an endless stream of work, but that it would seem to stand still so that we could bask in the joy of our little blessing. The transition out of this would be calm and peaceful... an unforced transition back into daily routine. A new and fresh life for our family.
If labor began at night, I imagine a serene, peaceful enviroment. People sleeping as they could, not waiting on me as if I was a ticking time bomb, but enjoying the process and letting me do what I need to in some soltitude. I imagine less people at the house and a full moon shining into the skylights in the living room. We would make "beds" on the couches and floor for everyone to rest on. I think I'd want to be there with everyone, just doing my own thing. Maybe I'd have some beautiful peaceful music on and be drinking warm tea or resting.
This would be my labor if I could plan it. If labor did progress very quickly, I think that I'd need lots of celebration and support afterwards. I'd probably need lots of friends to drop over so that I could talk over what happened during the birth and for them to be joyful over the miracle. If things went slower than expected, I think I'd welcome much more hands on help, naps, alone time, etc...

It won't be too long before I will be able to compare this "dream" with what the Lord has in store for the birth of this baby. I'm glad that He is in control and knows what is happening always. I choose to trust Him throughout the birth of His wonderful blessing, and to give Him the praise for His work.

Thursday, January 14, 2010


I have been throwing around the idea of writing a journal to record my experiences in my own pregnancies and things that I learn while working with others who are expecting for quite awhile now. The problem is I just haven't done it! SO... why not? Well, I always have a good reason to procrastinate! Lately it has been that I just don't have a blank notebook around the house and I keep forgetting to pick one up when I go to the store. Finally I decided that it would be better and easier if I just wrote my "journal" in the form of a blog. So, I'd like to welcome myself to this blog where I hope that I will learn and discover much.
Well, I suppose you all should know a little about me besides the fact that I'm a perpetual procrastinator. There are a lot of aspects to my life so let me just list a few. First of all, I am a Bible believing Christian. I am thankful to have been raised in a wonderful, godly home as a missionary kid. I lived in Southern China for four years of my life and loved the simple life I enjoyed there. I am a 26 year old wife to an amazing husband, Sage, and mother to 3 children (Gideon 4 years, Gabriel 2 and one due on March 1, 2010). I enjoy being a stay at home mom of two boisterous boys who definitely keep life interesting. I also am a birth doula, trainig childbirth educator and aspiring lay midwife. Birth is very much a part of my everyday life.
I entered the birth world as I became pregnant with my first child and never gave it up! I had an awesome natural birth that was the most powerful thing that had ever happened to me, and I wanted to help others have their birth wishes come true as well. For four years now I have experienced with families the wonders of childbirth. I am learning so much along the way that I often have a hard time keeping up with it all. This is the purpose of this blog: to share and sort out the miraculous gifts that I am given by being part of the birth community and by being a mother. I hope that you enjoy and that it means as much to you as it does to me.

Danielle Rylander
A Blessed Birth Doula