After Mom's Wistful Remark, A Maternity Ward Inquisition

[rcrush]

After Mom's Wistful Remark, A Maternity Ward Inquisition
http://www.washingtonpost.com/wp-dyn/content/article/2009/04/22/AR2009042203635.html?hpid=news-col-blog

By Marc Fisher
Thursday, April 23, 2009

Woozy from pain medication after a Caesarean section, swinging from joy over her newborn boy to exhaustion from the strain of delivering him, Karen Piper mentioned to her doctor that she'd been hoping for a girl. She would come to regret those words.

There she was at Washington Hospital Center on an early spring afternoon, three days after giving birth. She'd be taking Luke home to the room she had lovingly prepared, to a time she'd dreamed about for years, just the two of them getting to know each other, reveling in the miracle of new life.

When nurses finally told Piper she was free to leave, no discharge papers for her son were brought out. Instead, she faced a parade of inquisitive official visitors, including uniformed police, a social worker, a psychiatrist, and assorted doctors and nurses. Her baby had been placed on medical hold while government investigators considered whether Piper was fit to take Luke home to Prince George's County, the authorities said. She had failed to bond with her baby, a nurse told Piper.

For three days, Piper fought through a bewildering nightmare of lawyers, investigators from the District and Prince George's, and hospital officials. A night nurse reported that Piper had declined an opportunity to breast-feed her baby, according to the mother and her lawyer. "I was so groggy, I don't even remember that incident," Piper says.

A psychiatric intern asked Piper to spell "world" backward. A nurse-practitioner told Piper that it was awful that a new mother could be disappointed not to have had a girl. "She told me the burden was on me to prove that I should be allowed to take my baby home," says Piper, a lawyer who works at the U.S. Department of the Interior.

Like too many parents before her, Piper had fallen into the rigid, overlawyered maw of a child protection system that substitutes mandatory reporting for the judgment and human sensitivity medical professionals should exercise.

Washington Hospital Center spokeswoman Paula Faria says medical personnel "have a legal obligation to report to local agencies any concerns staff have about discharge of a patient, and especially little newborns." She says it was the medical staff's "professional recommendation that we had to take steps to make sure the best interests of the baby were protected. We really believe we did do the right thing."

Mindy Good, spokeswoman for the D.C. Child and Family Services Agency, says her agency got involved after hospital personnel reported their concern. "Mandated reporters often err on the side of being cautious," she says.

The Prince George's and D.C. agencies eventually found no cause to keep mother and child apart, but for the better part of a week, it seemed to Piper, her family and her attorney that the hospital's care was being used against her. The hospital gave her pain meds that made her woozy, the hospital took her son to be circumcised, and then investigators wanted to know why Piper hadn't spent more hours with her baby.

When a social worker asked for details of Luke's conception -- Piper is a single mother and, at 50, an unusually old one -- Piper concedes she blew up. "My attitude with her was confrontational because I was getting scared they would take my son from me," she says.

When uniformed officers came to take Luke, she yelled at them: "This is my child, in my custody." Piper says one D.C. police officer dug her fingernails into Piper's palm "to make me let go of Luke's crib," then blocked her way when she tried to visit her son in the nursery. Citing privacy rules, hospital officials won't comment on the incident.

"I've been practicing family law for 31 years, and I've seen many abuse cases, but this is unique," says Joel Anders, who represented Piper. "To accuse Mom of neglect as a result of her not spending adequate time with the child in the hospital is just extraordinary, especially since Ms. Piper was postoperative and highly medicated."

The Prince George's child welfare agency refused to comment. A social services source familiar with the case says that "the issue is, Ms. Piper really believed she was going to have a girl and made some comments that caused concern." A hospital spokesman says putting a medical hold on a newborn is a rare move.

Anders says child protective services personnel "embraced the complaint no differently than if they had seen bruises on a child. Don't they have an obligation to sort out what they do and don't investigate?"

Astonishingly, that's a matter of debate. When I wrote about a similar case of overzealous child protection last year, D.C. Attorney General Peter Nickles argued that "this is a very law-driven process that can have very unsatisfying results. . . . The law is skewed properly toward the protection of the child." But in that same case, Roque Gerald, then deputy chief of the city's child protection agency and now its head, criticized "defensive child welfare. In our attempt to protect, we have also lost the ability of balance for fear of retribution."

That's welcome honesty; if only the authorities would act on it.

[baldguy]

1. Kafka is running the child protection service?

[librechik]

22. too often

[Ilsa]

2. Good god. And people have to wonder why women don't

want to have babies in hospitals anymore? I've seen perfectly lucid, unmedicated mothers totally ignore their crying newborns two days after birth and no one called CPS on them.

[madaboutharry]

3. Charles Dickens said it best:

"The Law is an ass"

[Warpy]

4. That's truly insane

but it seems like part of the "zero tolerance" fascist mindset that is infecting almost all our institutions.

I can't imagine how her behavior would have been seen as destructive, not even by an overzealous or really, really bored nursing team.

This whole thing is incredibly stupid and could have been handled much more appropriately by asking a few open ended questions and listening to the responses. Medical holds are only justified if abusive behavior is actually seen or if the mother has a system full of particularly nasty recreational drugs.

I think Ms. Piper has a great case should she decide to sue.

[Speck Tater]

5. Some on the right would say...

This is what happens when liberals run wild and do things "for the good of the child." And you know what, they might almost have a point.

Be careful what you wish for. This event is NOT a right wing plot. It's the dysfunctional dark side of "thoughtless liberalism". Yes, I am a liberal, and proud of it, but we must always balance our liberal ideals with avoidance of extremism and careful thought about unintended consequences.

[Merlot]

17. How is this considered liberalism?

It certainly doesn't fall into my definition of liberalism. If anything, it sounds more right wing with their authoritarian beliefs and willingness to impose their beliefs on others.

[Speck Tater]

23. You might be right. But I tend to think of "social services" as a liberal institution. nt.

[HiFructosePronSyrup]

6. I'd like to hear from the hospital's side of the story.

[eilen]

11. I agree.

It is very bizarre and unlikely that a hospital would move to retain an infant they can send home as early as possible without good reason.

The hospital is clearly not going to discuss anything because likely there is litigation pending. That and privacy laws prohibit them from disclosing any patient information.

[proud2BlibKansan]

20. LOL I say that same thing whenever there is a bad teacher story posted

[dbt]

29. You'd stick your dick in a blender for the attention, wouldn't you?

:rofl:

[Shell Beau]

36. I agree. I feel there has to be more to this.

Please let there be more to this.

[jbnow]

7. In so many places it is hard to get any checks on abused

or neglected kids...services to at risk families are cut...
and they do this?
Talking to her a few minutes would have been fine...if she'd been very resentful over having a boy when she was awake and alert and talked like she didn't want him she would need services of some kind. The way they did this was horrible and against all policies I can think of. A single comment under the circumstances is not just cause.

When I was pregnant I was sure I was having a girl. Everyone else told me it was a boy, everyone called the baby him, silly people. All the shower clothes were blue. That was fine, my girl could wear blue.

The doctor said "It's a boy!" once the baby was born. I made some comment about having been sure it was a girl. He asked if I wanted him to put him back. That is a better response than calling protective services!

[Manifestor_of_Light]

8. A C-section is overwhelming in the best of circumstances.

And apparently she had no one to accompany her to the hospital.

Heavy drugs and several days' hospital stay are required for a C-section. That's major abdominal surgery.

And what right did they have to circumcise the kid? The only person with that right is the child himself, when he's grown.

:popcorn:

[eilen]

10. The mother orders the circumcision ahead of time.

No one just "circumcises" anyone without consent. It's a billable procedure. Also, it does not take very long to do. Certainly not "hours." She should have had plenty of time to bond with her infant. If instead she chose to spend her time on her blackberry, I would not be surprised if it raised red flags with the care staff.

Also, no one receives pain medicine without asking or acquiescing to it. Nurses don't force pain medication on anyone.

Additionally, a C-section is relatively quick compared to a labor driven vaginal delivery and is often scheduled ahead of time to the convenience of the mother if that is the birthing choice she has made. Many professional women choose to do this.

I can hardly see how "exhausting" she had to be. The mother gets an epidural so she is not under any general anesthesia which would generally make someone very groggy. The incision made today is small, very different from the bikini cut of the 60's.

[kestrel91316]

16. She's 50. She's not gonna handle it as well as a 20-yr-old.

I'm 52. Ask me how I know about an aging body.

[eilen]

39. I concede

A single 50 year old woman probably had a hard time with it.

My C-section hurt but after following the directions, ie. splinting, walking, breast-feeding and in general, dealing with the constipation, discomfort (I took Tylenol for pain) it was a cakewalk compared to dealing with general anesthesia and pain, soreness from a total mastectomy. The incision seemed larger than it eventually became as my abdomen shrunk. I think the IV was removed once I started peeing and drinking which was fairly early. I don't know of anyone that actually stays 5 days in a hospital for this unless there are some complications. Heck, total knee and hip replacements don't stay that long post-op unless they outlie.

I was awake and was given the choice between a spinal block or an epidural. I have no judgments on her mode of delivery, just that the article exaggerated things.

I assume this lady had this planned given she is A. Single, B. 50, C. a lawyer who works for the Dept. of the Interior.

I don't know many professional 50 year olds that randomly get "knocked up." Sure it might be possible... if she were taking gobs of hormones.

[laundry_queen]

18. Trust me, a c-section is exhausting.

I've had 3 c-sections and one vaginal birth. I was far, far more exhausted from my planned c-sections than my 17 hour labor/vaginal birth. My last c-section I was in and out of consciousness for a long time after the surgery. I looked like I'd been hit by a truck, extremely pale skin, black eyes. It took me weeks to get any kind of strength or energy back. With my vaginal birth, I was home 12 hours later (By choice) and was walking around the block the next day. Only one of my c-sections was with a general anesthesia and it was the one I was the least groggy post-op (probably because they forgot to give me any pain meds...). Please don't say that a planned c-section is somehow less exhausting or 'easier' than a vaginal birth. It's simply not true.

As for this woman, I'd say her disinterest in the baby would have to be extremely pronounced for them to take action. I know a lot of people who didn't have much interest in the baby after giving birth, I thought that was normal. Birth itself is often traumatizing to the mother and it does take awhile, mentally, to recover. For some women (like me), having the baby there helps, for some, they need some space from the baby at first.

[janx]

19. That depends upon the circumstances.

If it's an emergency C-section, the woman is put under general anesthesia, or at least that was the case in the 80s. The epidural is not much better when it comes to the memory of the event. I had an epidural for my last child, who is now 21. I remember some things, but not much. The stress of having anesthesia injected into my central nervous system, my spine, rendered me pretty weak just after delivery and beyond.

My mother had an epidural in the 50s before a vaginal birth. She liked that.

They still did bikini cuts in the 80s.

C-sections are still major surgery. They ARE exhausting.

My C-sections were not scheduled because of my convenience. These were based on the best interests of the child about to be born.

I don't want to judge this woman.

[MissB]

25. Have you ever had a c-section?

I ask because you make it sound like some outpatient surgery. A c-section entitles mothers a five day recovery in the hospital if they choose- I.e. - the doctors can't kick you out before five days has passed.

You also can't lift anything over 10 (maybe 25?) lbs for many weeks.

Once the pain meds wear off, it hurts. Itsa wound that must be attended to each day. You don't just run out of the hospital at the end of your stay. I had two c-sections. I wouldn't assume hers was for convenience either.

[MissB]

26. Have you ever had a c-section?

I ask because you make it sound like some outpatient surgery. A c-section entitles mothers a five day recovery in the hospital if they choose- I.e. - the doctors can't kick you out before five days has passed.

You also can't lift anything over 10 (maybe 25?) lbs for many weeks.

Once the pain meds wear off, it hurts. Itsa wound that must be attended to each day. You don't just run out of the hospital at the end of your stay. I had two c-sections. I wouldn't assume hers was for convenience either.

[Crunchy Frog]

31. I was exhausted after mine. Between that and the preeclampsia.

I didn't spend as much time with my babies in the NICU as I'm sure some people would have thought I ought to.

I'm sure you know best, though, what kind of condition this woman was in.

[Shell Beau]

38. C-section may be relatively quick. But after being in labor

for several hours and pushing for over 4, c-section became my only option. You are out of it after a c-section. You have just been cut to hell and back and had a baby ripped from you basically. You can try to sugar coat it all you want. My incision was at least 6 inches. That may be small to you. Nice way to try to make it sound all ooey gooey, but, yeah, that isn't reality. I just went through it. And mine was textbook. So, as nice and easy as you make it seem, that is BULLSHIT. It is a major surgery that you are AWAKE during. Let's get over the physical part, which is hard, and get to the mental part. That messes some people up. I could smell my own flesh burning as the were cutting into me, but hey, it such a quick and easy deal. :eyes:

[janx]

14. Tell me about it. I had three of them.

I disagree about circumcision, however. It's nasty, but it prevents some nasty diseases later on.

[Crunchy Frog]

33. I guess my little guys are going to be in trouble then.

;-)

Just wanted to let you know what I've been up to the past few months. http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=105x8614726

[TheMadMonk]

34. So does proper hygiene and a quick sniff test.

And this paraphrased from a Heinlein book.

If it's not clean enough for your mouth, it's certainly not clean enough for "elsewhere".

[Shell Beau]

37. Circumcision is a whole different ball game.

[TexasObserver]

9. Unfortunately, CPS tends to let hundreds of obvious cases slide and jump on one like this.

That comes up often in Texas. They do love to grab a kid in some situations, while in others, they allow children at risk to remain with those who are known to have hurt such children.

The case in the OP is one more tragic example of overzealous busy bodies using the law to beat up on a single parent.

[MichiganVote]

12. Yup. They just love the easy ones and let the real ones slide all the time.

What a bunch of assholes.

[janx]

13. How insane! n/t

[elleng]

15. Holy Sh*t!!!

DC child protective services can't care for placements, and they do THIS??? They're lucky I don't actually reside there any more!

HOLY COWS, that's MY LAWYER!

[AspenRose]

21. Good Lord

My son was born in Arlington....my husband said he was surprised, thought it would be a girl. Thank God they didn't take away OUR son!

[Badgerman]

24. Are we nearing critical mass?

I think perhaps there is a very great danger here that is being overlooked, and it's not the babies welfare, nor the mothers: it's the welfare of this nation.

Everytime a real or perceived affront to our dignity or beliefs come to light, their is a rage that boils up. Each time rage occurs in the tens of thousands of citizens, there is a percentage that do not let go...this builds up and each new outrage adds to the previous and each new 'recruit' add to the minions.

I hope that I am wrong, but all the external indications are that the population of the 'outraged' is reaching critical mass. When this occurs it is not the rational who rise to the top and lead, it is instead the very most irrational who achieve control.

Can we, the President,anyone! prevent this...I do not know.

[MissB]

27. When I got all weepy about not having a girl

I got the nice visit from my primary dr who started me on anti depressants... Which I clearly needed, and not just because I was bummed about having a boy.

Talk about overreaction. So many single moms are more emotionally prepared (especially at 50!) than a young mom.

[Crunchy Frog]

28. And they wonder why some women are choosing to have homebirths.

I hope this woman ends up owning that hospital.

[LisaL]

30. Boggles the mind. Many people might prefer either boy or

girl, for whatever reason.

[knitter4democracy]

32. So, the hospital creates the situation and then freaks out?

She was considered high-risk, so chances are, her doctor had already planned on a C-section in his/her mind before even walking into that room. The drugs they use with that are very powerful, and cause a cascade of all kinds of reactions. Birth itself messes up the mind with massive hormonal swings and such.

So, they drug her up, cut her open, drug her up some more, and then freak out when she says something in her drugged up state that doesn't mesh with some nurse's view of motherhood? That's just bizarre. Even in hearing the hospital's side, I'd have to say that it would make more sense to wait for the drugs *they gave her!* to wear off before making any major judgements.

[omega minimo]

35. Yup, that is one backwards W-O-R-L-D

that hates the planet, women and the power to give birth.