[Missy M]

I honestly didn't know where to post this and in fact wondered IF I should post it , but hopefully someone can steer me in the right direction.
As I've posted before I own and operate a Birthing center, I am one of 3 Midwives there. Recently I had a new patient ( lets call her Nina) come over who happens to be placing in an attorney assisted adoption that is slated to be "fully open" whatever that means. The pbmom is 20 and she's 7 and 1/2 months pregnant with a baby boy. The pa-parents always come to her prenatal visits with her and are in fact paying for her medical care. Initially Nina was being attended by the county hospitals' clinic but transferred to me with the a-parents insisting on having her comfort in mind. My services are not cheap and there are no insurance benefits assigned. Nina has submitted her "birth day plan" and she is asking that they and the pa-moms sisters be in her birth room. She did not ask for any of her own family be present. I have not met her attorney or social worker. Her only system of support that I've met is them, the p-a-parents. The problem: The pa-mom came to my office after an ultra sound and away from Nina asked me some very personal questions about Nina. She asked for the results of her blood work, (she wanted to know if she tested positive for drugs or STD's) and she wanted to know if I felt an open adoption was in Nina's best interest. She asked if closing it after she delivered would help her go on with her own life. She gave me every impression thatSHE certainly felt closed was best. She also asked if there was a way for me to obtain enough DNA information so that should the child need medical services someday he could get it without Nina being notified... ie: if he developes diabetes we can see if Nina had it in her genes without contacting her.
Translation...this has all the earmarks of a sudden closure after the fact! As a b-mom I wonder if I am being overly sensitive or overprotective? By law and out of respect for my patient I didn't answer her questions of course, but the hair on the back of my neck stood up. Also, I don't know what to do with my concerns. I don't want to create tension between them and I don't want to worry Nina unnecessarily but something doesn't feel right. I simply don't know what to do! I am thinking of saying to Nina that I need to meet with HER attorney and perhaps I can give her some bogus reason for doing so and share my concerns privately with that person....I don't know...Any Advice??? MissyM

[dl]

I agree with you that the pamother's attitude does not sound favorable to a "fully open adoption". Could you simply tell "Nina" that you need the attorney's name for the file? Would you be violating any confidentiality law by informing the attorney? I wouldn't think so as the pamother is not your patient.

How sad when people are not honest!

WOW!!! What a position that puts you in...What age is medical adulthood in Texas. I know here in Mass its 18...but do some states have 21 as "the age"? If so, I would think her parents would need to be contacted. As you know you have no responsabiilty to the paparents. Your patient is the pregnant women...with that being said, in order for her to have a safe,delivary both emotionally and phyically..she needs to know all her options...our job as nurses is to educate, along with providing the medical care necessarry. If you were not a birthmom and were able to see it objectivlly how would you respond? I see no problem with you teaching her about what is available in terms of support, open adoption, what ever....I would defininatly give her Bromanchik web site. Then she will be able to make her own decisions in terms of her own child.

It makes me very uncomfortable that these paparents think they own her....this baby is hers until she signs the termination papers.

Do have a legal rep.that you can ask...in terms of protecting this women and the birthing center itself?

I don't envy you in this situation!! Keep us posted

Donna

[Cleopatrick]

Wow Missy, that sounds like a disaster waiting to happen. I can't even imagine how awful it must be for you to be put in such a difficult position. There is no reason she would ever need all that information if she didn't plan on closing this adoption, it just doesn't make sense otherwise. Are you breaking any laws by telling the potential bmom what happened? Any legal laws or moral/ethical laws? I feel so sorry for that girl! Sitting in the hospital for no support other than the people who may be thinking of turning their backs on her once they have the child. Is the attorney being paid for by the PAparents? If so, even though he represents "Nina" his loyalities may be with the PAparents. It's just a crudgy situation all the way around isn't it . You said as a bmom you are worried that you are being overly sensative, but I truly don't think that's the case. I'm an amom and I think this sounds like a really bad situation! I have NEVER felt the urge to go behind any of the bparents back to try and obtain information for ANY reason. I can't even imagine a reason why that would come up.

[lucyjoy]

Do you know any other medical personnell you can go to to ask about the liability? What about a SW you couldask hypothetically? Did you express you concerns to the amom about being honest and open with the agreement? It may be becuase the amom is not your patient that the conversation would not be privledged-but I'd check before I spoke. That bmom has a right to know what she's up against. How sad that people do this with such dishonesty. I certainly don't want to trade places with you. What a tough situation.

[RiverGal]

Reading this post was like being kicked in the stomach. It reeks of betrayal and heartbreak...not to mention the close scrape to my own reality.

Missy, you are in a precarious position; ****ed if you do, ****ed if you don't. No matter which direction you take, should you decide to act on it, somebody loses. I guess one of the questions has to be "which one." It's hard for me to give an unbiased opinion, since I am one of the "jilted" Bmoms, but the pa-mom is way out of line.

If the opportunity arises, is there any tactful way that you could ask her, point blank, if she is planning to close the adoption? If she says she is considering, maybe you could explain some of the possible emotional ramifications that she will be opening the bmom up for. IMO, the bmom has every right to know what she is facing with the adoption. Sounds like there needs to be some further mediation between the parties...but, the issue is how to get them to that point.

If reason doesn't work, perhaps a bedpan up side the head might say a lot...(I'm not serious...well, not really ).

Sorry you are in this horrid position, Missy...and with your sweet spirit, of course you would pick up on it. Thank God for gentle souls like you!!!

Debra

[lucyjoy]

Maybe you could ask the bmom if she's had or will be having any counseling before or after the birth. Maybe you know someone you could suggest who could talk with both parties seperate and together? Just a thought.

[bromanchik]

You know, I do not see you as stuck in the middle Missy. The prospective adoptive mom is not your patient. Period. You have no confidentiality concerns here at all. It does not matter who is paying for the patient, but who the patient is. If you have information that effects the well being of the patient you do have a responsibility to share it.

This pamom is setting this woman up for a lifetime of heartbreak. I think you know you need to step in.

[Missy M]

Originally posted by bromanchik
You know, I do not see you as stuck in the middle Missy. The prospective adoptive mom is not your patient. Period. You have no confidentiality concerns here at all. It does not matter who is paying for the patient, but who the patient is. If you have information that effects the well being of the patient you do have a responsibility to share it.

This pamom is setting this woman up for a lifetime of heartbreak. I think you know you need to step in.

OK...first of all, thanks for all the advice, I really appreciate hearing the thoughts and concerns all of you posted. Bromanchik, its not that I don't feel that I should "step in" the question is HOW? At this point the pa-mom can deny the conversation ever occured or at best say I misunderstood her entirely. While "Nina" is my patient, technically her adoption issues are not my concern. She will be discharged from my services within 6-12 hours after giving birth. At the time of her discharge SHE will still have complete custody of her son, and must wait at least 36 hours before the papers are signed; therefore I am under no legal obligation to tell her what I sense and I don't want to scare her off with "my" gut feelings. She is so totally smitten with this family that I am not sure she'll even listen to me. The only reason I posted who was paying for her care was to give you some insight into how this story goes. I think this p-amom sought out my clinic BECAUSE she wants the inside story on Nina, and the quick discharge plan. I have decided to give her your web-site info as well as this forum. I know she has a computer at home. I am also asking her on Wednesday for her attorneys name and number. I will be contacting him/her and making sure she has seperate representation and sharing my feelings withthat person. Its never been about my legal obligation, nor is money a factor, my clinic "writes off" 25% of our cases anyway and we have another 25% who write us off after they deliver; its my heart that I'm listening to today and its telling me to get real with Nina.
Again, thanks to all of you for helping...MissyM

[Missy M]

Originally posted by lucyjoy
Maybe you could ask the bmom if she's had or will be having any counseling before or after the birth. Maybe you know someone you could suggest who could talk with both parties seperate and together? Just a thought.

I just had a Sunday evening from home conversation with a social worker from my former job at the county hospital. I gave her the "what if" story...she suggested that I talk with Nina privately and while doing so share my concerns about her adoption remaining open; maybe share that I am a member of a forum where this has occured to several b-moms. I get the impression that like many Nina thinks her open agreements are binding and legal. She advised that if Mr and Mrs P-AP are indeed thinking of closing this adoption after the fact, that my confronting them won't change that and might even make this situation worse. In the best case scenerio they will deny it and in the worse case they will advise Nina to deliver elsewhere, and be careful not to ask questions and make someone else suspious. Its a difficult posistion to be in and to make matters worse Nina is an adorable woman who I'd love to shout my suspisions to! I just ache for her! MissyM

[Jackiejdajda]

What about giving her some literature about open adoption in your state and what is legal and what is not legal..

Are there any books about this?

Jackie

[sspete]

My Vote is talk it over with the attorney!!!! My only concern would be that the attorney might blow it off just for the money type thing!!! You just NEVER know....I do know that these people are not to be trusted, and someone needs to inform this poor girl of this!!! Missy, I feel so bad for you that you are in this position. You could maybe talk to Nina, AND the attorney. Just tell her you are a bmom yourself, and this pamom has approached you on some things that make you feel very uncomfortable with their "OPEN ADOPTION" arrangment. Maybe if you talk to her bmom to pbmom she will trust you???? Just a possibility...I am at a Loss. All you can do is your best to let her know. The rest has to be up to her, as to what kind of decision she makes.

Oh how disgusted this makes me feel for this poor girl!!!! How callous and unnerving!!!!!!

Staci

[bromanchik]

I think you might want to slowly ask her questions about the "post-partum"period. You can let her know the agreements are not binding. If you want information to share with her on the grieving process I have all kinds. If I sent you the pocket guides would you give them to her? I have OB's that give them to their patients considering adoption. Call me.

[Missy M]

Originally posted by bromanchik
I think you might want to slowly ask her questions about the "post-partum"period. You can let her know the agreements are not binding. If you want information to share with her on the grieving process I have all kinds. If I sent you the pocket guides would you give them to her? I have OB's that give them to their patients considering adoption. Call me.

Thanks, Brenda...you will be hearing from me tonight...MissyM

[crick]

As an amom, I too, would want to know if any of the blood work came back positive for std's or drugs etc. That's a possible "change our minds" type of deal for some aparents. I can see also wanting info on the DNA results. I can see playing every possible scenario in my head...."What if we lose contact down the road?" "What if she dies?" and we don't have this information? How do we get this information without the bmom?Never mind that it's inappropriate to ask the midwife for this information, just saying the need to know EVERYTHING about your possible soon to be child is an overpowering one.

The question the pamom asked you regarding closed adoption could be seen as a red flag, but it could also just be her trying to get a line on how Nina really feels about things. If Nina is truly "smitten" with this family as you think, maybe the pamom sees that too and isn't sure if Nina is really dealing with the situation. She could be grasping at straws, who knows? She's also under a lot of stress right now, full of all kinds of emotions going on so she might not be at her mental best.

I'm a big believer in "gut instinct" though, so if your gut says this woman does not have Nina's best interests at heart, then by all means, make sure Nina has all the information on open adoption and possible closure situations etc. I wouldn't hesitate one second to do that.

Just wanted to see if you thought of any other possible reasons why she might be asking you the questions she is....

Crick