Declining Hospital Procedures - Answers by Henci Goer

From now until Thursday, October 27, obstetric research expert Henci Goer is answering your questions on the Lamaze Facebook page. Check out the following Q&A that were recently posted and then head on over to post your own question:QI wasn't sure where to post this, but my hospital has a "mandatory" 1 hour "observation" period in the nursery 1 hour after birth. When I called and asked for their rationale, they said the baby was at high risk of complications during this time and needed to be monitored by a professional. Do you have suggestions for research that addresses this? Suggestions for how to effectively decline the observation period (other than changing hospitals)? Thank you!!AWe have abundant research that the best place for a healthy baby to be in the hour after birth is skin-to-skin with its mother. Here are links to studies showing the benefits of this practice and therefore the harms of separating them. The first one is your money study because it is a Cochrane database systematic review:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17636727http://www.ncbi.nlm.nih.gov/pubmed?term=Matthiesen+2001+oxytocinhttp://www.ncbi.nlm.nih.gov/pubmed/12725547Frankly, I would recommend changing hospitals or planning out-of-hospital birth with a qualified caregiver because if staff don't practice evidence-based care with regard to how they treat healthy newborns, then they almost certainly aren't practicing evidence-based care in other arenas as well. If changing venues isn't feasible, women need to know that not only do they have the right to informed refusal, but parents have the right to make refusals on behalf of their children. That being said, they will have to be prepared to withstand scare tactics or other coercive efforts as well as the fallout that can come from being labeled "difficult patients."