Mother-baby friendly hospital

My hospital is trying (oh so slowly) to become a Mother-Baby Friendly hospital. Why are we operating in the dark ages of not being Mother-Baby Friendly? Because the way we do things is the way we have done things. It's so hard to change habits that have been ingrained into so many health professionals over so many years!

It's still like pulling teeth (without anesthesia) to have postpartum/nursery nurses accept -- without pulling a million excuses -- that mothers and babies can room in together without separation. Yes, we're still fighting that fight. The postpartum/nursery nurses will blatently make up reasons why a mother cannot have her newborn in the room with her upon their transfer from L&D to postpartum (we are two different floors of the hospital).

We have specific rules/guidelines of what babies may not transition in their mother's room. It's the truly at-risk babies, basically. Things that make the most sense: post-resuscitation, meconium fluid requiring intubation at birth, babies with cardiac or respiratory anomalies, low apgar score at 5 minutes, maternal narcotic administration within one hour of the birth, etc.

We are eventually going to move to a mother-baby care model that puts every baby with their mother from birth, unless they truly medically cannot - or if the mother requests nursery care for the initial first few hours.

We are also moving towards having totally open 24/7 units (L&D and mother-baby) with no restrictions on the number of visitors or the times that visiting hours occur. We currently are set up on L&D as 24/7 visitation, no more than 3 people in the birth room at one time. Children under age 12 are welcome, as long as they are siblings of the newborn, and are accompanied by another adult to care specifically for that young child (take them out of the birth room if they get scared, etc).

We are going to change to 24/7 open access, unlimited number of visitors per room. Yikes. With how busy our unit is, and the doors being locked (and you need to buzz and have a staff member open the door each time you come and go), this is not going to go over well with our staff. I say, if we go to unlimited access, just get rid of the locked doors. Come one, come all to the sacred event of birth! (Sorry, that was actually some sarcasm. Many "visitors" on L&D are there to gawk and not actually help the birthing woman/family. It's a big pet peeve of mine. If you're here - you need to help support the mom!)

The current visitation on postpartum is such: primary partner (the one with the ID band from the birth, usually the father) is 24/7 access. All other visitors are 12 noon to 8pm ONLY. That will change to all visitors, 24/7 access. Oh my, that will NOT go over well with the mother-baby staff AT ALL.

Let me just let you know some stats about my hospital:
*4500+ births per year
*High poverty demographic population
*High teenage birth demographic
*Very high number of outpatient visits to L&D -- we see EVERYTHING if you are pregnant. We do outpatient NSTs and other testing, as well as outpatient Rhogam injections (no matter how far pregnant you are or were).
*Outpatient visits exceed 1000 each month
*Births are 350-400 per month
*We also have long term antepartum patients with pregnancy complications. Don't know the number offhand per month, but it's a lot.
*Many patients are high risk (preeclampsia, preterm labor, PPROM, multiple drips, unstable diabetics, post-seizure eclamptics)

Needless to say, this is not your average low risk hospital unit.

Yes, we do need to work on becoming more mother-baby friendly. However, I oppose the 24/7 open door unit policy with unlimited numbers of 'visitors'. Apparently the entire hospital (even the ICU & NICU!!!!) is moving towards this same type of 24/7 open unit, unlimited visitor policy. So, technically it's not just the women's health/OB departments.

Your thoughts? Opinions?