Sunday, July 17, 2011

I do not understand some people....

Here in my state, you have the right to refuse any and all treatments offered to you or your children in the hospital. I don't know if it's a universal/federal deal, but it is how it is here.

So last night, I had the interesting experience of taking care of a set of brand new parents who refused everything. I mean everything. Mom was not tested for GBS (a bacteria that can cause fatal sepsis in the newborn), hepatitis (which can also be passed on during delivery) or rubella (which can cause mental retardation), which are all standard parts of prenatal care.

They also refused ultrasounds on the baby, except to determine gender. Because dad had read somewhere that the sound waves can cause developmental delays. Based on a study done on the cell division in mice. Having done some googling, it looks like the study itself admits that there is need for further investigation, and that they themselves cannot formally correlate anything to human babies. They finally agreed to one when the mom's fundal height at 34 weeks didn't correlate with the baby's age, which is a sign of IUGR, just to make sure the baby wasn't severely undersized.

While in labor, according to the notes, mom wanted IV pain medication, but didn't want an IV in place. Sorry hon, but they are not going to inject directly into a vein every time you need some fentanyl. Multiple breaks in the skin are just asking for infection risk. Or you'd look like a heroin addict.

When the baby is born, they refuse the "eyes and thighs," which means erythromycin eye ointment, a Vitamin K shot, and the Hep B vaccine. Ok. Here's my beef with this particular issue. I understand refusing the eye ointment if you are certain that mom does not have any dangerous vaginal bacteria (like GBS). I'm totally fine with that. But since they refused GBS testing, and GBS can cause blindness, it seems like a foolhardy risk to take. If they'd tested mom for GBS and she was negative, sure. Skip the eye goo. I'm not sure why they refused the Vitamin K. Probably to avoid the baby being poked. Again, it's their right to refuse things, but the baby had a rather large cephalohematoma. I would be *so* worried about continued bleeding into the space because of lack of clotting factors. And of course, the vaccine refusal was related to autism risks. Don't even get me started.

They refused the jaundice test. They said if the baby turns yellow, they'll just put it in the sun for awhile. She's a small baby, not eating very well, with a hematoma. Jaundice can cause brain damage if it's untreated, and this baby had so many of the risk factors for it.

They also refused the newborn screening which tests for treatable but possibly fatal metabolic and endocrine diseases, like the inability to digest milk sugar. Wouldn't you want to know if your baby could get brain damaged by breastfeeding?!

In addition they refused the hearing screening. I guess also because of dad's fear of sound waves? This is the most benign test we do. We put squishy rubber headphones on the baby and little sticky wires on the forehead and measure what the brain does in response to sound. It takes 15 min and the baby stays asleep through the whole thing.

I guess the thing that baffles me about all this, is why bother coming to the hospital in the first place if you don't want anything the hospital provides? I will defend people's right to make their own choices in medical care, but it would be *nice* if they were based on reality and sound scientific fact rather than "shit I read on the internet."

When you come to the hospital armed with information from Dr Google, while categorically refuting everything an actual MD tells you, it does not look good for you as a rational human being.

And when your stubbornness could impact the health of your baby.... ooooh not good. I just hope that the things they take for granted (the baby won't get an eye infection, the baby's hearing is just fine, the baby doesn't have any metabolic disorders, the baby will not become jaundiced) end up being true. They have a really sweet baby.

But for me, it seems so bizarre to refuse testing/treatment on the remote chance they may cause problems, when the chances are fare more likely that refusing these things will lead to problems.

It would be like spending all your money on alien-proofing your home, while neglecting to put locks on the doors. Sure, there's a *possibility* that ETs will invade your house, but it's far more likely that someone will waltz right in and steal your TV.


  1. WHYYY do people like that breed? Seriously? How selfish and paranoid can you be.. Ugh.

  2. I'm not even sure how I came across your blog, but patients like this REALLY annoy me! I totally get that you can choose what kind of care you want, but when you're rejecting things that we KNOW work, it's ridiculous. Or when people pretend to know more than science that has been developed over decades and prescribed by doctors who went to school for 7+ years post-college. I admit that doctors don't always know best or that the doctor may not be the greatest, but they're certainly better than a poor google search by someone who doesn't even know how to read the findings of a study.

    End rant. But really, if you're going to refuse all care, just go home.

  3. I am a nurse. I home-birthed my 2 children, ages 2 1/2 and 5 months. I applaud this woman for standing up for what she believed in. We refused everything as well (besides testing for metabolic disorders). I had healthy pregnancies and deliveries - and I was the one that was in control. This story definitely reinforced my reasonsing for choosing the home birth path. I say: to each their own.