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Expectant and Postpartum Moms
adjunct to sibley thread -- early checkout experiences?
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Anonymous
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Hello lovely DCUMers,
I'm a wanna-be homebirther with a medically oriented husband and a fondness for compromise. I've found the perfect OB and perfect pediatrician, both of whom have priveleges at Sibley. I've discussed my misgivings about a hospital birth with both and feel absolutely reassured that I'm getting the best care for my situation and can completely trust these professionals with my life and health and that of my baby, while keeping me as a fully informed participant. The only remaining issue is that I do not want to stick around in the hospital after the birth. (I'm not fond of the risk for infection, disruptions in the form of hospital routines, and other things). I'm not looking for guidance about whether or not I'll change my mind and want to be in the hospital and I'm not looking to be cautioned away from a bad choice, so I'm hoping people can respect that I've made up my mind and that of course, I will most certainly stay in the hospital if there is any medically compelling reason (with me or baby) to do so. My OB and baby's pediatrician-to-be both know my desire to check out early and have talked to me about my plan to make sure baby gets top of the line care once we are home. This includes my willingness to bring baby to the pediatrician's office on day two and three of his / her life and also includes seeking the help and guidance of private lactation consultants as needed. Fortunately, I've got a comfortable home, engaged husband and the means to hire folks to cook and clean for us so my job will be to feed and enjoy my baby and adjust to the joys and tribulations of motherhood outside of a hospital setting. This is all great, except my pediatrician is going out of town the week of my due date, and she said that the neonatalogists at Sibley will most likely defer to my OB on an early discharge but she could not be sure they would. I tried phoning the patient advocate at Sibley but have not gotten a clear answer -- they can't seem to understand why anyone would want to check out early...and wouldn't answer me directly. Obviously, everything depends on baby's health, but assuming everything is okay, I'm wondering if anyone else has successfully negotiated an early discharge at Sibley and if so, how you went about doing this peacefully. I know I can check out AMA, but don't want to go there. Thanks! |
Anonymous
| OP again, to clarify, not only do my OB and pediatrician know of my desire to check out early, once they heard my plan they were actively supportive of it. Just want to reassure folks that I'm not going against medical advice here. |
Anonymous
| My first day at Sibley I was in a shared room (ick!) My roommate had 2 kids at home and desperately wanted out. I think she spent about 12 hours in the hospital before leaving. |
Anonymous
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I'm not sure what you are asking here. Either someone (not your ped, who clearly is on board) will say that the only way they will let you leave is if you sign AMA, or they will agree to your plan if you explain it the way you have here. I'm really not sure what else there is to discuss....some women leave very early after birth, and either they signed AMA (like myself), or the attending ped agreed to let them leave without signing AMA. I think the best thing you can do is decide for yourself ahead of time which route you will likely take.
In the scenario that your ped is out of town, the attending peds/neonatologists won't defer to your OB, AND they are being stubborn and refusing to discharge your babe at 12 or 24 hours (how many hours are you planning, by the way?) then you simply need to decide whether or not you are willing to sign AMA -- sounds like you aren't from your post, but best to make sure you have fully clarified that in your own head. In my experience, most hospital staff peds find a reason to keep a babe the required two days. So honestly, I'm not sure you can fully plan out this situation. I don't think any staff person at the hospital can speak to this particular question ahead of time, because their policy is to keep babies 48 hours and no one is going to waive that in advance, over the phone, etc. Granted, a flexible minded staff ped could very likely hear what you have to say and discharge baby when the time comes. The other option of course would be to induce/stimulate labor so that baby is born while your ped is in town - it doesn't sound like you'd be interested in that, but hey, it's an option. Another idea -- would it be possible for your ped to leave orders that assuming no complications, your baby is allowed to leave after (12, 24, whatever) hours? |
Anonymous
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Op here. Thanks. I'm just hoping that somebody will have experienced this at Sibley and can tell me what kinds of discussions it took. I asked my ped if she'd be willing to recommend an early discharge if no complications ahead of time but she explained (and it made perfect sense) that it would not matter at all what she said, because the baby would not be in her care at that time and the liability would still fall completely to the discharging doctor.
It's not that I am completely unwilling to sign out AMA, but I suppose my hospital experience might have to be pretty bad to make me do that. When I'd want to sign out would depend on when I actually had the baby. I do want to give the pediatricians a chance to take a look at the baby and make sure baby is fine, and I want some time to recover myself, so if I have the baby in the evening, sometime the next afternoon would be ideal -- so basically a 12 hour discharge. In the event that I had the baby at 2 PM after an all-night labor, I'd probably be looking at a very different type of recovery and might fare better staying there until the following afternoon, so in that case, 24 hours would be perfectly acceptable. I think it would depend on what seems best for me and baby at the time. To the poster who checked out AMA, do you mind sharing more about your experiences? Did you plan to do this ahead of time? Were you using your own chosen pediatrician or the hospital's attending peds and why did they refuse to release you? Did you run into any trouble from CPS when you left? I read on someone else's thread on this website someone saying that the hospital sent CPS to their house when they checked out AMA. Most of me thinks that is ridiculous and unlikely, but I am afraid to risk that kind of thing. You are correct that I would not induce labor. Baby either has to come now or come a little bit late to avoid my ped's vacation and I'm only just getting to 38 weeks so, even if I were more open to induction than I am, I wouldn't risk it so early. This is my first child, so I understand there's a very good chance that baby will come late. As for why I'm posting here, well, I know that nobody here can guarantee I'll have the early check out I want, I'm just hoping someone can share their experiences with me. |
Anonymous
| I gave birth to my second child at Sibley at a 7 am on a Thursday in October and was released at 3 pm the following Friday and did not have an issue with it. My son was born healthy at 39 weeks and both he and I were in great shape so I saw no reason to stay in the hospital (and I wanted to go home to my toddler). The nurses told me repeatedly that they prefer to have people stay for 36 hours but when I talked to my OB she cleared me and then I talked to the pediatrician (Sibley's) and she was also ok with an early release as long as I promised to bring my baby to our own pediatrician within 24 hours. I did not have to sign anything specific because of my early release. Just talk to your OB and Sibley's pediatrician and if everyone is healthy then I'm sure you will be able to go home. |
Anonymous
| What is signing out AMA? |
Anonymous
| AMA = "Against Medical Advice" |
Anonymous
Well, I hadn't planned on being in the hospital at all, but I decided to transfer in from my homebirth because my water had been broken for 3 days and my cervix was still pretty closed, despite 30 hours of active labor. Baby was born easily a few hours after getting there and getting some pitocin. I was very polite and respectful, but made it clear I was leaving. Pediatrician wanted baby to stay so that they could observe her due to the prolonged broken water. (I had been on antibiotics all through my labor at home, so I was not too worried about infection). I also felt perfectly qualified to observe my baby once we were home, and I had already been planning a day 3 trip to the pediatrician anyway (most homebirth midwives ask that you arrange this ahead of time). DD was born at 7pm, and I was home by noon the next day, happily signing AMA. The one thing that they REALLY gave me grief about was the PKU. I just repeated over and over, "oh yes, I absolutely plan on doing it with my ped, I realize it is the law and I really want it done, too!" The PKU test is really inaccurate if done prior to about 48 hours, and I wasn't interested in doing the test when my baby was only 12 hours old for the SOLE benefit of letting the hospital staff "check it off" their list. I belong to an HMO and when I went in for that day 3 appointment, they really didn't say anything at all about the birth or my choices. I don't have a close relationship with the ped, really, I just go to them when my kids are sick and don't really look to them to approve my choices, if that makes sense - so I didn't really care what the hospital OB, hospital ped, or my ped thought about any of it. Though I will say the OB was very supportive, she understood that I hadn't planned on being there at all, said everything looked great, and readily discharged me. |
Anonymous
Thank you to you and the other posters for sharing your experiences. If it came down to it, and I was really feeling miserable in the hospital, I might consider checking out AMA, but it would depend on the situation. It's heartening to read that others have had the backbone to do it when they knew it was the right thing. It also sounds like it wasn't all that dramatic -- I've read people say they checked out AMA and it's always seemed like this huge drama, like they had to pack up their baby and make a break for it, like a prison escape! Sounds like it was more of signing a piece of paper and enduring some pooh poohing for you. Still unpleasant, I'm sure... I'm always surprised at the insistence of doing the PKU test so early. Our chosen ped told us she waits until after 48 hours to do it anyway, but I imagine if she is on vacation the neonatal attendings will push the issue. I don't mind being there 12 hours, so they can do it if they insist, but that's kind of annoying. (We also have POS insurance so I have to share expenses for every test, etc, so I guess I'd get the pleasure of paying for this one, twice!). Good for you for sticking to what you felt was right for your baby. |
Anonymous
| With my second child, I checked out after one night at Sibley. I don't remember any discussion, opposition, forms, etc. |
Anonymous
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to the OP -- can you share who your providers are?? i am pregnant with my first and very interested...
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Anonymous
| email me at famst7@gmail.com and I'll share the provider info. Not sure that they'd want to have their policy for one woman and baby on a website and I'm starting to feel kind of identifiable based on my due date, providers, preferences, etc. Good luck to you and feel free to email me for more info. |
Anonymous
Um do you think your doctor is scanning this forum during their lunch break looking for their patients? Come on... |
Anonymous
What's the point of this post? You post your docs info if you want, I'll do what I think is best. Please go and spread your pissiness elsewhere. No need for it here, weirdo. |