The urban legend of the insurance policy that makes it a no-no for parents to carry their newborns in their arms, because the insurance policy only covers transport in a cot, rides again.  Can anyone find a copy of the insurance policy in question and cite chapter and verse on this?  I have even heard it mentioned where I live, and we *never* think in risk management terms after a baby is born.  During labor we used to require women who didn't want electronic fetal monitoring to sign something saying they took responsibility for the outcome if so - and when I asked the staff who were balking to please list on the disclaimer the specific outcomes the woman was risking (and 'taking responsibility' for) I did not EVER get an answer, just angry looks.  I haven't worked a shift on the labor ward in ages so I don't know whether we have come to our senses there.

I've even seen a sheaf of forms in a chart, signed by a pregnant woman who repeatedly discharged herself from the hospital prenatally (she was admitted for hypertension in late pregnancy), and not ONE of them was even dated to show when she had left the hospital!   

Phyllis asked about magnesium sulfate and pain relievers affecting mother's alertness.  We don't use magnesium sulfate and we use very little sedative medication on postpartum.  A preeclamptic woman who is deemed unstable will not be on the ward with her baby, but in ICU while baby is on postpartum if not in NICU itself.  A woman may get ketogan (ketorax? don't know what it is in the US) by injection the first 12-24 hours after cesarean section but usually she will be on paracetamol and codeine tablets or suppositories from when she arrives on postpartum from recovery.  These women do usually get relief from watching their babies the first night if they had an unplanned CS after a prolonged labor, but if it was a planned operation they may well have baby with them from the start. 

As I said, a US risk management person would probably have a stroke if they came here.   Babies have fallen on the floor, and incident reports written and sent by the correct channels, but no lawsuits in the wake of such incidents because no injuries and, astonishingly, no reaction from quality assurance that I know of.   We have 'quality assurance' and they are the ones who read and process incident reports, but we don't have a department called 'risk management'.  Just another quirky little cultural difference?  Personally I could handle slightly more risk management - but not so much that it would prevent babies and mothers from bedsharing. 

Get this: we don't require a woman to sign a consent before surgery, either.  I don't think anyone has to sign before surgery of any kind except if the surgery is sterilization or abortion, and the signature then is on the request for the procedure in question.

Rachel Myr
Kristiansand, Norway

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