The great debate: Cameras in the delivery room

For most parents, few things can match the wonder of photos and video capturing the arrival of a new child into the world.

But at some hospitals, families who bring a camera into the delivery room will be informed that picture-taking is off limits. This is the policy at several hospitals in Maryland and at least one in Massachusetts, where neither photos nor video are allowed until after the baby is safely delivered and the medical team has given permission for pictures.

It’s a substantial reversal to the long-standing practice of encouraging families to be involved and engaged in the birth of their child, and it has sparked some passionate debate about the pros and cons of allowing cameras in the delivery room. The New York Times led the pack with a recent story and online discussion about the issue.

Here’s some background from the Times article, which includes the story of a Maryland mom who was so upset about the camera restrictions that she started an online petition:

For the hospital, the issue is not about rights but about the health and safety of the baby and mother and about protecting the privacy of the medical staff, many of whom have no desire to become instant celebrities on Facebook or YouTube.

Their concerns come against a backdrop of medical malpractice suits in which video is playing a role. A typical case is one settled in 2007 that involved a baby born at the University of Illinois Hospital with shoulder complications and permanent injury; video taken by the father in the delivery room showed the nurse-midwife using excessive force and led to a payment to the family of $2.3 million.

Nationwide, photography and videography have been allowed in many delivery rooms for decades. But in recent years, technology creep has forced some hospitals to rethink their policies as they seek to balance safety and legal protection against the desire by some new mothers to document all aspects of their lives, including the entire birth process.

It’s seems there’s plenty to argue about. At the Times’ “Room for Debate” opinion section, an obstetrician-gynecologist questions how far parents should go in capturing and sharing the birth experience. “The first time I saw a camera lens creeping into my field of view while delivering a baby, I thought the biggest issue was the appropriateness of exposing others to really intimate videos,” wrote Dr. Amy Tuteur. “Our vacation videos are bad enough. Are we really going to force friends and relatives to watch such a personal event?”

Photographing or videotaping a live birth is a decision that ought to be negotiated between the parents and the OB team, she concluded.

Jennifer Margulis, a contributing editor with Mothering magazine had a completely different take: “Anytime you’re told you may not record what happens to you, be very wary of the people you are dealing with… Hospitals don’t want you taking pictures because they fear you might record their mistakes.”

At a deeper level, the whole debate raises issues about how we experience major life events when there’s a camera involved, says Raymond DeVries, a professor with the Center for Bioethics and Social Sciences in Medicine at the University of Michigan Medical School. If you’re going to bring a camera into the delivery room, think twice, he wrote. “Birth is an intimate moment to be experienced and cherished. Women in labor should not be thinking ‘I’m not decent for Facebook.’ When the camera is calling the shots we have lost something precious about human experience.”

The delivery room seems to be the flashpoint for a larger shift in how we view privacy and patients’ expectations of participating in their health care. Several months ago I blogged about allowing family members in the room when someone is being resuscitated. Do families have the right to be present, even when what they’re witnessing is bound to be disturbing and might invade the patient’s privacy? Many would argue that they do, but it has made for considerable tension between patients and health care professionals.

Health care workers often are ambivalent about the lengths to which they can accommodate the wishes of patients and families. What if a family member wielding a video camera gets in the way at a crucial moment? What if the family’s presence becomes disruptive?

The privacy boundaries can sometimes be exceeded for health care workers as well as for patients. Consider a 2007 incident at Children’s Hospital in Boston, where the family of a young cancer patient installed a webcam in the child’s hospital room so a favorite relative could see what was happening – but staff didn’t know the webcam was there until it was accidentally discovered by a nurse.

Judging from the online discussion at the New York Times, it’s a volatile topic. An anesthesiologist who attends C-sections wrote that “the focus needs to be on the patient and not rescuing a visitor from the floor after they have fainted (yes, it happens a lot).” From someone else: “It’s a medical procedure, not a fraternity kegger, for Pete’s sake. Why do people treat everything like it’s primarily some sort of photo op?”

A mother wrote:

I expressly forbade family members from videotaping me during labor and delivery. It’s not a pretty process in the best of circumstances, and still snapshots of me holding the baby after arrival suffice for commemorating the occasion. I don’t comprehend the sort of exhibitionism that would drive someone to want their delivery posted on Facebook.

Someone else argued that cameras are everywhere and we need to get used to it. “Cameras are documenting many facets of our lives and medical people should not be treated any different than other people,” he wrote.

Another commenter wondered whatever happened to pleasing the customer: “I’m not spending $10,000 a year on insurance to have my service providers dictate chapter and verse of how I experience the care I pay them to provide.”

It seems reasonable for hospitals to have some basic rules about the presence of cameras in the delivery room, if for no other reason than to make it clear what’s expected of families and to prevent the picture-taking from becoming disruptive. How far a hospital’s policy should go is less clear. Should there be an outright ban on photos and videos during the actual delivery? Should this be negotiated on a case-by-case basis between families and the OB team? What do readers think?

Photo courtesy of Brent and Gretchen Schlosser