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.

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