To whom it may concern:
I’m writing today in regards to the recently implemented policy at Robert Packer Hospital that requires women in labor to undergo continuous electronic fetal monitoring.
I’d like to start by introducing myself. My name is Tierney and I delivered my third child at Robert Packer Hospital on April 30, 2017. Of all my deliveries, my most recent was my favorite. It seems funny to use that word to describe giving birth, but when I think back upon all three of my experiences bringing children into the world, the most recent stands out for several reasons. I desired to birth my third child as safely as possible, and as a low-risk and informed patient, I knew that meant avoiding unnecessary interventions such as continuous electronic fetal monitoring, or an epidural, to name a few. Although this was also my goal for the birth of my first and second children, I was naive and unprepared for the labor and delivery experience with my first baby and I requested an epidural for pain relief. My second baby was born so quickly that I barely made it to the hospital- I walked into the door and delivered within 10 minutes. There was no time for interventions! With my 3rd I feel like I finally “got it right.” I hired a doula. I prepared myself mentally and physically. My husband and I were on the same page. And perhaps most importantly, I felt supported by my midwife and the labor and delivery nurses to deliver as I desired; as safely, and incidentally, as “close to nature,” as possible. In short, I was given the freedom to labor naturally in the hospital setting. I spent hours walking around the hallways of the labor and delivery unit with my husband and doula by my side, pausing for intermittent monitoring of my baby's heart rate. I ended up giving birth vaginally, without the assistance of pain medications. I walked away from it feeling as if I’ve never worked harder… yet empowered. I am convinced that giving birth is as much an emotional and spiritual event as it is a physical event. I had never before experienced childbirth in such a positive light! Granted I have no desire to do it again any time soon, but that empowerment carried me through the difficult newborn days. It changed my life for the better.
Imagine my surprise and disheartenment when I learned at my six-week follow up that Robert Packer had implemented a new policy that required all laboring moms to undergo continuous electronic fetal monitoring. It seemed unbelievable at first. As I mentioned previously, I am aware that this intervention is not recommended for low-risk patients. I am extremely concerned about what this new policy would mean for me, as a possible future labor and delivery patient at Robert Packer Hospital who wishes to avoid the risks that unnecessary interventions such as continuous electronic fetal monitoring carry. Where is my choice and right to have a say in my medical care? I don’t believe this policy empowers me to make wise medical decisions. I believe it forces my hand and makes me a victim of modern medicine, not a patient who is being empowered to live a healthy lifestyle both within and outside hospital walls. It pits me, as an informed patient, against the hospital staff being asked to implement the policy across the board. It invites unhealthy patient-provider dynamics. It causes me to consider that I might have to find somewhere else to deliver future children- another hospital, or even at home, neither of which would be convenient or what my husband and I desire. I am also concerned about what this policy means for all other patients and their providers. Most patients implicitly trust their providers to offer them the best standard of care, to offer best practice. This policy is detrimental for the relationship between such patients and their providers because it forces providers to fall short of that standard and break the circle of trust, which is a shame even if the patient is unaware that this is happening. And let's not forget about the providers themselves, namely those who must deny their own consciences and force an often unnecessary intervention on all their patients, even though continuous electronic fetal monitoring has not been shown to improve outcomes for low-risk moms and babies. These providers are being bullied into enforcing policies that seem to be more tailored towards the hospital not getting sued than they do towards promoting best practice. To put it simply, we ALL suffer as a result of this policy, patients and providers alike. Although I believe the policy was enacted with the best intentions, that does not mean it is acting in best practice.
I’ll end with this: Guthrie’s values are, “Patient-Centeredness, Teamwork, and Excellence.” I know I can’t see the whole picture, but from what I can see, this policy works in direct opposition to ALL of those values. As a patient, I feel neglected. I feel that my health has been put on a backburner in an attempt to protect the hospital from lawsuits. That is not patient-centeredness. As a patient, I see the tension this policy is causing between staff and the “bosses” that implemented the policy. That is not teamwork. That is bullying. As a patient, this policy causes me to see Robert Packer Hospital as subpar, as lacking in excellence. I implore those responsible for the implementation of the required continuous electronic fetal monitoring policy to treat this matter with the urgency it deserves.