February 2, 2011

Photography in the delivery room — parents feel like they have a right...

... and the doctors and hospital staff don't like doing their work on camera.
Many hospitals allow and even encourage recording because modern cameras, particularly those taking video, are so unobtrusive. But that same technology has introduced a wild card into a fraught scene that could shock a jury — with the mother screaming and staff responding (or not) to what may look like an emergency — all of which can be edited to misrepresent what actually took place....
“When we had people videotaping, it got to be a bit of a media circus,” Dr. Tracy said, adding that the banning of cameras evolved through general practice rather than a written policy. “I want to be 100 percent focused on the medical care, and in this litigious atmosphere, where ads are on TV every 30 seconds about suing, it makes physicians gun shy.”...

Dr. Elliott Main, chairman of obstetrics and gynecology at California Pacific Medical Center in San Francisco, which also allows filming of births, said, “The modern approach is not to ban cameras but to do drills and practice.”

“Where you get into trouble is where people panic or don’t know what to do next and have blank looks on their faces,” he said. Videotaping simulated births, he said, can help the medical staff adjust their behavior.
Now, part of medical training is: Acting!

Look like you're doing the right thing, even when you're confused and you know you're hurting someone. That would be a good approach even without the cameras, but medical personnel — like politicians — need to adjust their demeanor and expression for the world of YouTube.

44 comments:

James said...

I'm a professional photographer and I was recently surprised to learn of an entire genre of photography called "birth photography." Newborn photography I understand as a subset of portraiture, but "birth photography" is entirely different.

This was the story that highlighted it:
Facebook Apologizes For Censoring Birth Photographer Laura Eckert

Sixty Grit said...
This comment has been removed by the author.
edutcher said...

The Blonde tells me most malpractice suits involve birth and the complications thereof.

I love Ann's line, "Now, part of medical training is: Acting!".

Master Thespian!

And then she gives us one that sounds like it came out of a heist movie.

"Look like you're doing the right thing, even when you're confused and you know you're hurting someone."

WV "unslyc" What I'd better do to the side steps.

peter hoh said...

Sometimes, doing nothing is the best thing. But we live in a culture that insists that something must be done.

And if anything goes wrong, someone has to be at fault.

I bet this drives up the C-section rate.

While I have been present at two deliveries, I haven't seen a C-section, so I'm ready to be corrected. My guess is that a C-section is all business. No standing around and letting nature takes its course.

peter hoh said...

A John Edwards-type lawyer to the jury: It's clear that the mother is asking the medical staff to make it stop. Do they? No, they continue to allow the contractions and the childbirth to proceed.

TMink said...

I have been there for four births. One doctor found out my father was an OB-GYN and kept gesturing and encouraging me to leave my wife's shoulder to come see something that she assured me was amazing.

My wife needed my support, so I declined.

Having that sort of thing on video would be as important to me as the video of my knee surgery. Not very.

Trey

traditionalguy said...

We have been meaning to warn you that your impish smiles on Bloggingheads could be cut and pasted with other clips to show you as a Rothlesberger loving Steelers fan. This is serious stuff. Little Johnnie Edwards could then convince a Wisconsin jury that your free speech is the proximate cause of all cheese curd defects. Let's hope Chip Ahoy is not hired by the other side first.

Phil 3:14 said...

Loved the comments in the article about the doctors and nurses privacy. While that may be an issue, we all know THE issue is malpractice. I hate to make a difficult parallel but this is reminiscent of all the police actions towards individuals videotaping them.

What's that legal phrase for:
it speaks for itself?

al said...

When my daughter was born it was a planned C-section. My wife decided she wanted it on tape so we asked my sister (a OB/GYN) to record the delivery. My sister was on staff at the same hospital we were using so the nurses were used to seeing her in the O.R. The DR who was doing the delivery was surprised to see her (he had gotten her fired from her former practice) and asked why she was there. My sister smiled and said she was there to watch her niece be delivered and record it on tape for my wife. The other DR was less than thrilled. The delivery went perfectly and the nurses, who all seemed to really like my sister, gave my daughter awesome care.

I think as long as the photographer stays out of the way they should be allowed.

@Trey - I wish I had thought to bring a tape when I had my knee cleaned out. The images I say were cool. Then again - I have CDs from my MRIs.

traditionalguy said...

There are enough amateurs allowed into the delivery rooms now. The photographers should at least be retired MD's, such as Kermit Gosnell, who needs a new career.But always search him for surgical scissors.

Matt said...

Video cameras in the delivery room = more potential for lawsuits. Do we need more? Lawyers say yes.

Ann Althouse said...

Frankly, I don't understand why a woman would accept having a camera pointed straight at her crotch. Suddenly, it's a proscenium!

I mean... porn actresses aside. They get lots of money, because they're allowing the world into their extra-private zone.

I wouldn't want my husband to remember me that way. Don't they change the name from "vagina" to "birth canal" to create a separation between baby and vagina. You don't want that association, do you?

I remember some comedian going on about how horrible it was to see a baby's head *there.* That wasn't the way he wanted to think of his wife's crotch.

I don't get why people want this photography.

Disclosure: I've had 2 babies, but I adhered to strict baby-vagina separation. I had C-sections. My husband was kicked out of the room, and a sheet was set up to block my view. No video was shot, and I'm not sorry. I don't spend any time thinking, hey, I wonder what my internal organs would look like if they were exposed and pulsating in the bright light of an operating room.

peter hoh said...

By the way, acting has always been a key to the successful practice of medicine.

I assume that it is the same with the practice of law.

traditionalguy said...

Peter hoh...You are correct. All the courthouse and the parking lots, halls and elevators are a stage for a trial lawyer. It really is first impressions uber alles, and Jurors are very alert from the moment they drive up to the courthouse looking for clues about what is going on. My favorite Jimmy Stewart movie, Anatomy of a Murder, is a very true display of lawyering as acting.

Pogo said...

I have started to refuse patients who want to audiotape our visit. I find the recording device makes me start talking in a overly careful and vague way, like a politician. That is, more bullshit.

And those patients suddenly look like Linda Tripp.

Deb said...

I did not want to watch while it was happening. Nor would I want to relive either experience. I really don't get why anyone would.

wv: moomids. We'll have these moomids to remember. Ha!

Coketown said...

Births? Ewww. It's obscene. And just like blessings always wear disguises, miracles always seem to show up looking hideous and vile. Ewww-w-w-w.

k*thy said...

My one birth was a C-section, as well. My husband was present, but also behind the curtain, with me. He seemed perfectly happy not to have to look. No video was shot, either, but now 23 some years later, I kinda wouldn't mind seeing it. I mean, I absolutely couldn't feel or see anything (beyond the curtain) at the time. In a sense, it's kind of like I wasn't there.

As for doctors acting, I think that's helpful for the patient.

Ann Althouse said...

"I absolutely couldn't feel or see anything (beyond the curtain) at the time."

I could feel it. Just not any pain. The pressure is there. It's pretty freaky! And I could hear. They described things. I was awake and in the moment at a level that was appropriate — ie, non-disturbing.

Hagar said...

I understand that in the old days, the doctor would tell the father to go boil some water or something to get him out from underfoot.

It is good for the survival of the species that women have this compulsion to have babies, but no way do I wish to witness the event!

Freeman Hunt said...

I have two children. Both were born at the same hospital. The hospital does not allow photography of births. Neither do I, so I didn't mind the rule.

William said...

It is my shaky understanding that in physics observing an event changes the nature of the event. I suppose with or without cameras babies are going to be born, but the photography of such an event will move it from the mythic to the banal. We will no longer enter the world trailing streams of glory but streams of gory.

Phil 3:14 said...

If we didn't allow video cameras we'd miss scenes like this

knox said...

I wouldn't want my husband to remember me that way. Don't they change the name from "vagina" to "birth canal" to create a separation between baby and vagina. You don't want that association, do you?

No. And any guy who wants a front row seat... well, that would worry me.

Mary said...

As a lawyer who defends doctors and hospitals in this type of litigation, these home videos are inherently unfair and prejudicial. The professional videographers are trained to record events without emphasizing certain aspects of them or ignoring others. With a family member or friend recording these events, the recorder naturally follows the events that he or she deems important rather than the event itself. Additionally, the behavior of the doctors and nurses becomes atypical because they are constantly aware of the fact that they are being filmed.

Even in the very liberal jurisdiction in which I work, we have been successful in keeping these tapes out so far, although the plaintiff's bar has tried. Phil is correct that the only issue is whether there was malpractice, but these videotapes do not constitute proof of malpractice but only of selective events that the individual with the recording device choses to focus on.

Hagar said...

In this country, common sense goes out the window as soon as "rights" are mentioned!

Tibore said...

Digression...:
"He stopped delivering babies in the 60s when malpractice insurance reached $1000 a month. I assume it is much higher now."

It's way more than that now. One of our family friends kids just a year younger than me is an OB/GYN. And last we talked about malpractice he complained about it being 6 figures!! I think he said $175,000 per year, but I need to ask again if that was his personal slice, or the overall bill for the group (clinic, practice, whatever you want to call it) he belongs to. Regardless, it was a jaw-dropping figure. I remember the rest of us being silent for a moment when we heard that.

Jennifer said...

I don't even know what the rules were at either of the hospitals in which our kids were born. The topic of birth photography never even came up, between the man and I. I didn't think about it, not interested. I guess he wasn't either.

lol @ Acting! Ah, YouTube. Fascinating how it's changed the world.

Methadras said...

Personally, if there does need to be a camera in the birthing room, then there should be a security camera that is positioned in all parts of the room for the best vantage points. Outside of the mother maybe the only other person in there should be the father and of course medical staff. Other family members no. Actually, I wonder if maybe in the old days the father should just wait outside until the birth occurs and then he can go in and be with everyone.

traditionalguy said...

During the conscious C-Section procedure the bad part is hearing a scramble of Stat orders about loss of blood pressure followed by a long needled atropine injection made directly through the chest wall into the heart. And would the testimony of that patient who says she remembers seeing the whole thing from floating above it in the room be admissible? That sounds like a good response team rather than Mal-practice.

holdfast said...

Peter:

For us the C-Section was all business. I was there for my wife's emergency C-Section, seated on a stool by her head, kept away from the ickey bits by a curtain. When I tried to stand up once - the Dr. exclaimed something, and so I naturally stood to look - a nurse barked at me to sit back down.

I was allowed to bring a still camera to take a couple of pics before the little dude was all tubed and wired up for the NICU. Excellent bokeh if I do say so myself - I wanted to blur the look of the operating room.

I'm generally pro-freedom of photography, but as to why anyone would want a tape of that, I cannot imagine. I'll be blunt - the good part about the C-Section was knowing that my wife's crotch was 100% baby free and unstretched (and she feels the same way).

ironrailsironweights said...

How about conception photography?

Peter

Michael K said...

I was one of the first surgeons in my area doing laparoscopic gall bladder surgery, in 1988. For a while I was getting doctors' relatives from all over. It was also a technique that was totally patient driven. It didn't hurt as much, in fact it hurt very little.

Anyway, from very early, I began to videotape the procedure. Since the surgeon sees what he or she is doing on a TV screen, it is very easy to tape that view. The viewer of the tape sees exactly what I saw. I kept the tapes for a month in case there was a complication. Thank God there wasn't, so I would then offer the tape to the patient. About 1/3 wanted them.

Later, I began to do other procedures with the scope, including appendectomy and hernia repair. We gave one kid his tape and he took it to school to share. That was a bit of a local sensation. By the time I retired (after back surgery), I had done about 1,000 gall bladders and 500 appendectomies, all on tape. I am now told by a friend that the hospital no longer allows taping, a very short sighted policy. I wanted the tape to show that I had done nothing wrong.

Unless you are a klutz, of course.

Methadras said...

Michael K said...

I was one of the first surgeons in my area doing laparoscopic gall bladder surgery, in 1988.


You didn't happen to use Davis & Geck Laparoscopes for the gall bladder removal procedures did you?

Martha said...

Anne said: Frankly, I don't understand why a woman would accept having a camera pointed straight at her crotch. Suddenly, it's a proscenium!

I agree! A friend's daughter is due to deliver in March and she is drawing up a guest list. Who should she invite to witness the birth? I advised that she keep the event intimate--husband and medical staff only --with the husband seated at her head-- not her crotch.....if she plans on having sex again with the husband.

DADvocate said...

I'm sure that acting is a part of all medical practice, is it is in virtually any profession. The subjuct acts as if he knows what he's doing or is going to do whether he does or not, i.e. makes a display of confidence. Funny an attorney should bring this up, lawyering contains much more acting than many professions.

holdfast said...

@Martha - Damned right.

@Michael K - I think what you were doing is a bit more clinical than childbirth, which is obviously medical, but also more emotional and feelings-driven. If there is a complication during birth you might have to do something rather nasty in order to save the baby and/or the woman. You may have to actually cause extra pain to get the baby out safely. All of that could look awful to a jury, but might still be the right thing to do.

Freeman Hunt said...

Forget photographers.

With my first child, I was constantly asked whether or not my mother would be present in the delivery room. I was surprised that anyone would want a parent in the room. My parents shared the sentiment and found the idea repulsive.

Maybe those are our English roots showing.

Conservatives 4 Better Dental Hygiene said...

That would be a good approach even without the cameras, but medical personnel — like politicians — need to adjust their demeanor and expression for the world of YouTube.

So they can be just like the pundits: Phoney.

Sixty Grit said...
This comment has been removed by the author.
John Burgess said...

I'm with Methadras: If there's to be video of the birth, it should be from several angles and run start to finish. Anything else inject a subjective, even if unconscious, prejudice on the part of the videographer. Attention is paid to what looks interesting, not necessarily something in context. The expression on a nurse's or doctor's face that take up three frames of film does not tell anything near a complete story.

Of course, if all births are to be captured on film or in digits, then there's really no argument to be made about 'modesty' in complaining about TSA security scanners, is there?

Tangentially, I'm a curious person. I would love to see film of any and all medical procedures done upon me. I was absolutely thrilled to watch an angiogram/plasty on an X-ray TV. I was also happy to be with my wife, at her request, at the birth of our son. No curtain, no commands to stay put, but common sense dictated not getting in the way. That, too, was utterly thrilling and utterly humbling.

Fred4Pres said...

Crowning photos really have no place in a family photograph album (or God forbid a facebook or flickr page).

Call me old fashioned on that.

Methadras said...

John Burgess said...

Tangentially, I'm a curious person. I would love to see film of any and all medical procedures done upon me. I was absolutely thrilled to watch an angiogram/plasty on an X-ray TV. I was also happy to be with my wife, at her request, at the birth of our son. No curtain, no commands to stay put, but common sense dictated not getting in the way. That, too, was utterly thrilling and utterly humbling.


I have zero issue with human bodily processes. They fascinate me. Surgeries for me are like going to a carnival, you never know what you are going to get. I love watching them. In fact, I dig them so much, I asked my mom if I could sit in on her knee replacement surgery, she didn't have a problem with it and then I asked her orthopedic surgeon and said it wasn't a problem. I scrubbed in like everyone else, watched my mom go under, get prepped, and the surgeon even let me look closely at the work. It was awesome. My mom told me not to tell her about it and I could certainly understand why. All they have to do is wake up and see the dressings, the sutures, and rehab. They don't want to know the details.

Hal Dall, MD said...

"Now, part of medical training is: Acting!"

Acting is half of the "art of medicine" and the main component of a good "bedside manner". In training I learned from attendings who were masters of the craft, and, well, from the mis-example those who weren't.