CASCADE, Md. — When Laurie Shifler was expecting her eighth child, she was so upset about a local hospital’s new policy restricting photographs of births that she started an online petition. Hundreds of people, near and far, signed it, many expressing outrage that a hospital would prevent parents from recording such a momentous occasion, one that could never be recaptured.
The hospital, Meritus Medical Center, in nearby Hagerstown, bars all pictures and videos during birth — cellphones and cameras must be turned off — and allows picture-taking to begin only after the medical team has given permission.
“It’s about our rights,” Ms. Shifler, 36, said the other day at her home here in rural Maryland as she cradled her newborn daughter, Kaelii, in her arms and the rest of her brood roughhoused around her. Her husband, Michael, 37, a police officer, was able to take pictures 30 seconds after Kaelii’s birth last month, but Ms. Shifler is still fighting the hospital to change its policy.
“It’s my child,” she said. “Who can tell me I can take a picture or not take a picture of my own flesh and blood?”
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 take place 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 with the desire by some new mothers to document all aspects of their lives, including the entire birth process.
“Hospitals are struggling with it,” said Dr. Joanne Conroy, chief health care officer for the Association of American Medical Colleges. “Cellphones have exponentially increased the ability to take a picture — a high-quality picture — in a hospital setting.”
Mike Matray, editor of The Medical Liability Monitor, a newsletter based in Chicago, said the issue had been moving up on hospital agendas.
“I have certainly heard this issue discussed more often than I ever have previously,” he said. “And it’s certainly true that some risk managers in hospitals are advising doctors to stop allowing video in the delivery room.”
There are no national standards regarding cameras in the delivery room, so each hospital sets its own rules, creating a patchwork of policies. No national organization, including the American College of Obstetrics and Gynecology and the American Hospital Association, keeps track of how many hospitals allow photography, so it is hard to tell whether restrictions are on the rise.
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.
The restrictions at Meritus went into effect in November, after the hospital began reviewing all of its policies because it was moving to a new facility and learned that six other hospitals in the region had barred photography and videography during births. Georgetown University Hospital in Washington has a similar policy.
“Deliveries are complicated,” Dr. William C. Hamilton, chairman of the department of obstetrics and gynecology at Meritus, said in an interview at the hospital, adding that no one wanted to be distracted. “I’m not a baseball catcher with a mitt, just catching a baby,” he said.
Massachusetts General Hospital in Boston also bans cameras during births, said Dr. Erin E. Tracy, an obstetrician there who also teaches at Harvard Medical School.
“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.”
But many other hospitals are taking the opposite approach and accommodating families (except during Caesareans or if complications arise). St. Luke’s Hospital in Boise, Idaho, which serves a large military population, even uses Skype to connect mothers with soldier-fathers overseas. Brigham and Women’s Hospital, in Boston, began allowing photography and videography of births in 2008.
“Our hope is that the family will film it and it will lead to a closer bonding and a feeling of joy and success,” said Dr. Robert Barbieri, chairman of Brigham’s department of obstetrics and gynecology. He said the mother and clinicians must agree to be filmed and the photographer must use a hand-held camera with an internal light so equipment is not in the way.
“We’re trying to be as transparent as we can,” Dr. Barbieri said. “If something goes wrong, we try to explain immediately what happened. A video is not inconsistent with the goal of trying to be transparent.”
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.
Obstetricians are sued more often than doctors in other specialties and pay among the highest insurance premiums. They can also be more wary than other doctors, whose every move is not recorded.
Video is a particular worry because it picks up actions that a still camera might not catch and the sound can make a situation seem worse than it is.
“The first consideration for a trial attorney is how this plays to a jury,” said Paul Myre, a lawyer in St. Louis who has defended doctors and hospitals in malpractice cases for 25 years.
In one case in which he was involved, a man on the jury fainted when a simple instructional video of a birth was shown. “Just a normal childbirth can look fairly traumatic to a lay person,” Mr. Myre said. He said he defended a doctor in another case in which the video showed that his client “had done everything right,” but the jury still felt “the child needed to be taken care of.”
In a case in which the audio was crucial, mentioned in a 1998 article in the Journal of Family Practice, a father’s recording picked up complaints by nurses that a doctor would not get off the phone to attend to a delivery. It also picked up warning signals from the fetal monitor. Another time, a father taped a complicated delivery and then pretended to be congratulating the staff while recording their responses about the complications, which were later used as evidence against them.
Matthew Dudley, the lawyer who won the $2.3 million settlement in Illinois, said that without the video, he probably would not have won the settlement. He also said that without video, some trial lawyers were less willing to take a case, adding to the reasons for hospitals to ban it. At Meritus, Dr. Hamilton said no particular incident had prompted the new restrictions, adding that the threat of lawsuits was not new.
“I openly admit to my co-workers that I practice defensive medicine,” he said. But he said he “takes offense” that “now I have to be videoed to prove that I’m providing good care.”
Aggravating the situation at Meritus, which prides itself on its new family-friendly obstetrics unit, were statements from officials last month that families had to wait five minutes before taking pictures. Dr. Hamilton said that those statements resulted from “miscommunications” and that “there is no five-minute rule.”
Brittany Saunders, 17, who was sitting upright in her hospital bed at Meritus recently with her newborn daughter, Meliyah, said her mother was able to take video within a couple of minutes of birth. (Ms. Saunders had not seen it yet because her mother “ran off with the phone too quick.”)
Still, Ms. Saunders was disappointed not to have video of the actual birth because her friends had posted their deliveries online and she wanted to do the same.
But some mothers who think they want the whole experience recorded change their minds. Robin Dobbe, 27, was angry when she first learned about the Meritus policy (“It’s my body”), and she signed the petition.
But once she was giving birth to her son, Charlie, she wanted her mother by her side, not taking pictures. Her mother was allowed to start shooting within 30 seconds.
“I look like a complete mess,” Ms. Dobbe said. “I wasn’t decent for Facebook.”
She said she now supported the policy, was glad the staff was focused on the task at hand and that she would never forget the experience.
Andrew Keh contributed reporting from New York.
