Thursday, October 20, 2005

Yo Hospitals: Your Customer's Experience Does Not End With Birth

My officemate brought in her new baby today. You can guess that I barely let her set down the baby carrier before I asked if she would tell her birth story. It was a good story. A first-time mother, she arrived at the hospital at 5 cm; was 9 cm several hours later and had the baby in another hour and a half. No drugs, no IV. The birth she'd wanted.

Her face was radiant as she talked about the birth. Then the shine vanished and she said, "But after the birth? It was horrible." She delivered at the newly opened Family Birth Center I critiqued in an earlier post. My complaints then were with the labor and delivery unit. I forgot to remark about the postpartum piece.

This hospital used to have LDRPs (Labor Delivery Recovery and Postpartum rooms) where you spent your entire hospital stay. When they renovated, they changed to LDR rooms. That means that now, after women "recover" from delivery -- which apparently takes only an hour -- they are moved to rooms in the Mother/Baby unit. Some of the rooms are private, but many are semi-private. They are closet sized and the shower is down the hall.

My officemate said her spouse wanted to spend the night with her and the baby. The only chair in the room did not recline, so they shared the hospital bed. Some of her family had to stand in the hall when they came to visit because only three people can comfortably stand in the room at one time.

She expected to receive some breastfeeding support, but got nothing beyond a periodic check-in from nurses who would note whether the baby was feeding or not.

She also thought someone would bring a wheelchair for her when it was time to leave. Instead, the nurse cut off the ID tags from her and the baby's arms, handed her the discharge papers and walked out of the room. After waiting a while for someone to come back, my colleague shuffled out the door and down the hall, carrying her baby. She had a second-degree tear with stitches.

My own experience at this hospital was similar. My second night the "code" button kept malfunctioning and I was repeatedly awakened from cherished sleep by a crew of doctors and nurses bursting in to resuscitate me; this ended only after a crew of maintenance workers came in a 4 a.m. and did 1/2 hour of drilling and rewiring above my head. A nurse came at 2 a.m. my first night to bathe the baby (I declined) and 5 a.m. to take the baby for his hearing test (I declined).

I have heard similar complaints from clients who have delivered there.

How can a hospital do a multi-million dollar renovation, bill the new product a "Family Birth Center," and yet facilitate none of the elements of a successful post-partum period? No concerted breastfeeding support. Sleep interruptions. Lack of privacy and lack of space for family bonding.

Postpartum doulas take note! There is an unmet need here. Hospitals are washing their hands of MotherBaby care as soon after delivery as possible. Yet as you all know, that is just the beginning of many families' most challenging period.



Blogger Casey said...

Ha! I read your post thinking, "Wow. That sounds just like my postpartum experience." Then I realized you're in Ann Arbor and are talking about St. Joe's. I gave birth there before the Family Birth Center was completed. I'm sad to hear they haven't improved their postpartum care.

8:59 AM  
Anonymous M.S. said...

Don't get me started! Postpartum care doesn't seem to have any standards. I think we've forgotten what it should be.

10:25 AM  
Blogger doulicia said...

Casey, that's too funny (or, sad).

I suspect the experience is pretty transferrable, even if yours happened to be at the same hosptial I'm writing about...

m.s.: amen

9:22 AM  
Blogger Sandy said...

Wow...I just ran across your blog and since I delivered at St. Joe's, too, this post rang a LOT of bells. Thank goodness my midwife was so wonderful, both during & after the birth.

For us, the absolute weirdest thing that happened there was when we arrived at 4am - there was no one in the lobby. Deserted. No security guards, no one at the desk, nada. Luckily we had taken a tour a week earlier and my husband remembered how to get up to the delivery rooms where we found a nurse.

But for a few minutes there I felt like I was in some bad horror movie, where everyone in the hospital had been abducted by aliens right when I was overcome by really strong and fast labor pains.

This was Nov 2001, btw. In 1996 I delivered at U of Mich (different insurance), and though the room was nicer the care wasn't as good. I don't know where I'd pick if I had to deliver again!

5:09 PM  

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