“A Persons A Person No Matter How Small” : Policy Changes

Know that the Lord, he is God! It is he who made us, and we are his; we are his people, and the sheep of his pasture. Psalm 100:3

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Survival rates for extremely early preterm babies have improved dramatically over the past 15 years. In 1995, practically no children survived when born as early as 22 weeks gestation age, while in 2008 21% survived.

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The ”Fight”

Once the twins were transfered back to Windsor’s NICU I knew I needed to address the issues with Metropolitan Hospital here in Windsor, ON (if your unaware about what I’m talking about, the battle with the hospital can be found in my first two blog posts on here). My midwife filed a motion against the hopsital and the staff on the night I went into labour and I filed a complaint towards the hospital and the same people. My complaint was reviewed the next day (February 27th, 2019) and I was contacted by the hospitals patient representative letting me know the hospital was working on setting up several meetings with the Metropolitan Hospital staff, the Midwives agency I was a patient of, Londons Health Science Centre (where the twins were born) and myself. There was two goals that I wanted to accomplish here: the acknowledgment from the hospital that the way things were handled that day were horrible and they were setting in policies and applying new teaching to make sure no other person is treated that way and to discuss intervention of 22 week mirco-preemie’s.

The Meetings

The first meeting was with the Metropolitan hospital, the staff working the night I went into labour and the 4 days I remained a patient (including the Drs I encountered), the Vice President and Director of Family Birthing. I was told at this meeting they discussed my complaint and got the hospitals “side of the story”. The meeting was fully documented.

The next meeting was with Metropolitan Hospital and the Midwife agency I was a patient of. At this meeting they discussed what happened the day I was sent into triage (the fact that the triage staff forgot I was there for 4 hours while I laboured in the waiting room). They discussed and agreed on new policies when it comes to handling midwife patients in the hospital while the midwife isn’t there.

The third meeting was with Metropolitan Hospital and London’s Health Science Centre. At this meeting were 3 of London’s neonatologist as well as Drs from Windsor. At this meeting they discused what the ”new” steps were going to be when it came to handling 22-23 week preemies. I learned from this meeting that London eagerly takes 24 week preemies but before the twins they were not willing to take 22-23 preemies (sometimes exceptions were made for some 23 preemies) Before this meeting the understanding between Windsor’s hospital and Londons hospital was “do not even call us unless the mother is 24+ weeks pregnant”

The final meeting was with me. I sat down with the Chief of Obstetrics and Gynaecology, the Patient Representative and the Director of Family Birthing. So much happened in this meeting and I’ve been trying for days to put the words together. One of the major things I learned in this meeting was:

Metropolitan hospital doesn‘t call surrounding hospitals for intervention on neonates under 24 weeks (22-23 weekers)

^^ THIS was huge for me and it was actually what I was mainly fighting for. Windsor does not have the ability to care for babies under 27 weeks if they are born. I didn’t find this out until I was in labour but the biggest thing is they weren’t even calling surrounding hospitals who DO have the ability to save 22-23 week preemies. Metropolitan Hospitals reason that they don’t call surrounding hospitals was as simple as “well, they told us not to call unless the mom is 24+ weeks.“

In this meeting I had to relive the day I went in labour all over again & PTSD was sure to show her ugly face. As I stared at a picture of the twins on a board and told the story of those 4 terrifying days and how I was treated I found myself sobbing. I was sobbing in fear. It was like my mind wasn’t clicking that my babies were alive, safe and waiting for me at home with their daddy and brother. That’s what PTSD does. It steals all the joy and brings your mind and body right back into the middle of the trauma. At my meeting we discussed the 3 previous meetings and the changes and policies that have now been put into place.

New Policies, Big Changes

After all the meetings were said and done I feel like I am happy with the outcome. I’ll start with the ”smaller” changes first:

1. Guidelines have been put in place for the hospital when dealing with midwife patients. The old guidelines were midwife patients were “hands off” to the hospital and they’re staff so even if a midwife was calling up giving her permission to provide care, it was often getting loss in communication. Now, the hospital will automatically assess midwife patients within half an hour of them arriving if their midwife hasn’t arrived. This guideline could have stopped me from going into full labour as I sat and waited 4 hours to be seen because the hospital “forgot” my midwife called up to give them permission to see me.

2. New coaching has been put in place on how Drs, nurses and staff should be delivering traumatic news to patients.

The BIGGEST change:

Metropolitan Hospital has made it their policy that if requested by the parents & mother and baby are stable enough for transport that they will make the call to surrounding hospitals to request life-saving interventions for 22-23 week premature babies.

Before this policy was put in place, Metropolitan refused to make any calls for babies born under 24 weeks. Just by making this simple phone call, it could save hundreds of babies a year. If this policy was in place when I went in labour, it would have saved me 4 days of trauma, of begging, pleading and fighting for my daughters lives. My prayer is that this new policy will save many families from the pain my family had to endure.

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Do you know your hospital and surrounding hospitals policies on handling premature babies?