Hospitals may not be able to incorporate midwives or revamp the operations of the Labor and Delivery Unit overnight. However, they can educate labor staff and work on the widespread disregard for home birth, disregard for intimacy of experience, and forced isolation in the hospital setting.
The view that mothers-to-be are consumers must also be changed. At four in the morning, we overheard a nurse talking to the patient next door, “Okay honey, wake up. You delivered a healthy baby. Your cab is waiting downstairs.” That a woman needs to be woken up and sent home at four in the morning without her baby is not in any way healthy for the mother or baby. Such treatment is the product of our view of health care as a business. The hospitals enforce early discharge so they can make more money by putting a new patient in the bed. In my health policy work, it is not uncommon for hospitals to describe obstetrics as a “service line” and patients as “clients”. This touches on the larger issue of whether health care is a human right; I’m simply suggesting that L&D would be a great place to start reversing that consumer mentality. How can we be okay with reducing initiation into motherhood—one of the most important roles in our society—as a product line?
Similarly, because of the business mentality in hospitals, there is a lack of concern surrounding patient rights. Women are not informed that they have a right to refuse any aspect of the care they are uncomfortable with. Hospital staff is not given any incentives to customize care for patients, or to educate patients. We would hope that in the future hospital practices are driven by patient comfort rather than cost efficiency.
All in all, we feel very blessed with the entire birth, including the hospital experience. We were with her and kept the experience intimate; we delivered the placenta ourselves and she didn’t require surgery. My sister received exactly what we needed, but only because we knew what to insist upon, and what to refuse. This made me feel for the many women that go through delivery without that knowledge and support.
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