Changing Hospital Birth Policies One Letter at a Time

“Dear Hospital Administrator,
 I had my baby at your hospital on 01-30-2010 and,
overall, I had a [sic] unacceptable experience.”

A mother wrote this with the help of The Letters Project, an online program that birth doula Tracy Hartley designed to help mothers and mothers-to-be exert greater control during the hospital births of their babies. (Read the full letter here.)

A birth doula is certified to provide non-medical support (as opposed to a midwife or physician) to a mother before, during and just after birth. She helps the mother craft a birth plan, assists the mother and partner during birth and is a labor coach.

Hartley has attended the births of 445 babies over the past 15 years. She started the Letters Project to encourage women to put their concerns in writing and send them to their local hospital. Users enter their concerns and experiences into an online form that takes about 10 minutes to complete. The program composes the user’s answers into paragraph form, then churns out the completed letter, which the user can add to and edit. When finished, the user sends the letter to her hospital.

“The hospitals know, like any business, if you get a letter, there are at least eight people out there thinking the same thing,” Hartley says. “If the hospital gets 10 letters saying ‘I wish there were a tub to labor in,’ they’re going to seriously consider putting in a tub. … They’re going to change their policy.”

Since its launch this fall, the project has generated about 30 letters.

Hartley is based in East Los Angeles, and has created a dropdown menu of area hospitals with addresses. But, she says, it’s not location dependent. Anyone can use the form and manually enter their hospital’s name and address.

“I don’t care what choices women make,” she says. “But I want them to make some choices and to make the hospitals be aware of what the choices are.”

Postscript:

The Letters Project is just one of many new things I’ve found while reporting on the birth industry for an upcoming radio story. For example, public health officials, safety advocates and even private insurers are starting to pressure hospitals to reduce the number of scheduled early C-sections and induced labors. For patient safety and cost savings. Some hospitals in Massachusetts are already there. I’ve also been fascinated by the discussions that have arisen from Ricki Lake and Abby Epstein’s The Business of Being Born, a documentary film about the birth industry and birth options in the US. Their sequel, More Business of Being Born, premiered in Los Angeles last month.