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After Mom's Troubling Words, A Maternity Ward Inquisition

Woozy from pain medication after a Caesarean section, swinging from joy over her newborn boy to exhaustion from the strain of delivering him, Karen Piper mentioned to her doctor that she'd been hoping for a girl. She would come to regret those words.

There she was at Washington Hospital Center on an early spring afternoon, three days after giving birth. She'd be taking Luke home to the room she had lovingly prepared, to a time she'd dreamed about for years, just the two of them getting to know each other, reveling in the miracle of new life.

When nurses finally told Piper she was free to leave, no discharge papers for her son were brought out. Instead, she faced a parade of inquisitive official visitors, including uniformed police, a social worker, a psychiatrist, and assorted doctors and nurses. Her baby had been placed on medical hold while government investigators considered whether Piper was fit to take Luke home to Prince George's County, the authorities said. She had failed to bond with her baby, a nurse told Piper.

For three days, Piper fought through a bewildering nightmare of lawyers, investigators from the District and Prince George's, and hospital officials. A night nurse reported that Piper had declined an opportunity to breast-feed her baby, according to the mother and her lawyer. "I was so groggy, I don't even remember that incident," Piper says.

A psychiatric intern asked Piper to spell "world" backward. A nurse-practitioner told Piper that it was awful that a new mother could be disappointed not to have had a girl. "She told me the burden was on me to prove that I should be allowed to take my baby home," says Piper, a lawyer who works at the U.S. Department of the Interior.

Like too many parents before her, Piper had fallen into the rigid, overlawyered maw of a child protection system that substitutes mandatory reporting for the judgment and human sensitivity medical professionals should exercise.

Washington Hospital Center spokeswoman Paula Faria says medical personnel "have a legal obligation to report to local agencies any concerns staff have about discharge of a patient, and especially little newborns." She says it was the medical staff's "professional recommendation that we had to take steps to make sure the best interests of the baby were protected. We really believe we did do the right thing."

Mindy Good, spokeswoman for the D.C. Child and Family Services Agency, says her agency got involved after hospital personnel reported their concern. "Mandated reporters often err on the side of being cautious," she says.

The Prince George's and D.C. agencies eventually found no cause to keep mother and child apart, but for the better part of a week, it seemed to Piper, her family and her attorney that the hospital's care was being used against her. The hospital gave her pain meds that made her woozy, the hospital took her son to be circumcised, and then investigators wanted to know why Piper hadn't spent more hours with her baby.

When a social worker asked for details of Luke's conception -- Piper is a single mother and, at 50, an unusually old one -- Piper concedes she blew up. "My attitude with her was confrontational because I was getting scared they would take my son from me," she says.

When uniformed officers came to take Luke, she yelled at them: "This is my child, in my custody." Piper says one D.C. police officer dug her fingernails into Piper's palm "to make me let go of Luke's crib," then blocked her way when she tried to visit her son in the nursery. Citing privacy rules, hospital officials won't comment on the incident.

"I've been practicing family law for 31 years, and I've seen many abuse cases, but this is unique," says Joel Anders, who represented Piper. "To accuse Mom of neglect as a result of her not spending adequate time with the child in the hospital is just extraordinary, especially since Ms. Piper was postoperative and highly medicated."

The Prince George's child welfare agency refused to comment. A social services source familiar with the case says that "the issue is, Ms. Piper really believed she was going to have a girl and made some comments that caused concern." A hospital spokesman says putting a medical hold on a newborn is a rare move.

Anders says child protective services personnel "embraced the complaint no differently than if they had seen bruises on a child. Don't they have an obligation to sort out what they do and don't investigate?"

Astonishingly, that's a matter of debate. When I wrote about a similar case of overzealous child protection last year, D.C. Attorney General Peter Nickles argued that "this is a very law-driven process that can have very unsatisfying results. . . . The law is skewed properly toward the protection of the child." But in that same case, Roque Gerald, then deputy chief of the city's child protection agency and now its head, criticized "defensive child welfare. In our attempt to protect, we have also lost the ability of balance for fear of retribution."

That's welcome honesty; if only the authorities would act on it.

Join me at noon today for "Potomac Confidential" at http://www.washingtonpost.com/discussions.

By Marc Fisher |  April 23, 2009; 8:36 AM ET  | Category:  Children , Prince George's , Social services , The District
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Comments

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I'd hate to think my wife's extreme exhaustion after a C-section childbirth could trigger intense scrutiny. How silly this is. They should rethink that whole process

Posted by: Solnoir | April 23, 2009 11:21 AM

What a bunch of pinheads. And if she had fallen asleep in the hospital while holding the baby, because she was exhausted from L&D and juiced on pain meds, they would have held that against her too.

I'm surprised they would want her to breasfeed while on pain medication, actually. Can't most narcotics pass into breast milk?

Posted by: northgs | April 23, 2009 11:53 AM

Here's what I think happened: the mom probably used donor eggs, which means an amniocentesis wasn't necessary (it's the age of the eggs, not the age of the mother that dictates this). Mom was likely told on the basis of an ultrasound that she was having a girl (or she asked not to know the sex, but it doesn't sound like that's the case). But ultrasound isn't a totally reliable way of determining a fetus' sex, though the techs are usually right.

So mom was genuinely surprised that she had a boy. The hospital staff probably encounters few new moms who don't know the sex of their babies in advance these days. So when poor, groggy mom expressed her surprise, the hospital nurses became alarmed. Add on to this the freight of Octomom anxiety plus our societal squeamishness at older motherhood, and mom entered a perfect storm of ignorance and misguided vigilance.

I'm a layperson, and if what I'm speculating is the case, it would not have taken a medical genius to figure out what was going on. This hospital and social services need to have several new orifices ripped and be required to apologize -- profusely.

Posted by: WhiskyGalore | April 23, 2009 11:55 AM

In general I am adverse to lawsuits, and there may be more to the story than we're getting here, but based simply on what has been posted above I hope this woman sues the hell out of anyone and everyone responsible for this.

Posted by: chibbs2000 | April 23, 2009 12:01 PM

Six years ago I gave birth to my daughter in Columbia MD and had an experience similar to Ms. Piper's. I had severe pre-eclampsia and my obstetrician started me on magnesium sulfate during my labor, 6 hours before a c-section was performed. I slept through the birth and was not allowed to see my baby, who was whisked immediately to the NICU. Next came pain medications and another 30 hours of magnesium sulfate, which made me so out of it I was saying anything that came into my head, including whether I had actually had a baby and if the baby was mine. A nurse finally took pity and wheeled me to the NICU on a stretcher so I could see my daughter for the first time; I was far too drowsy and disoriented to walk.

Soon after the hospital's psychologist came into my room. He accused me of failing to bond with my baby. I did my best to talk with him but couldn't focus my words. For the rest of my time in the hospital I felt the staff watching me. The only reason I probably escaped Ms. Piper's fate was that my husband was with me the entire time, even sleeping at the hospital, flabbergasted by the psychologist's behavior. He held and fed our daughter when I wasn't able to.

I had my baby by donor egg, and was 46 years old. Maybe hospitals think donor egg mothers don't bond with their babies, but if so they don't know how much love and effort goes into conceiving a baby that way.

After the incident with the psychologist I brooded so much over what he had said that I eventually had to be treated for postpartum depression.

I've never told my story before, but I want Ms. Piper to know she's not alone in having this kind of experience, though hers was so much more painful and extreme. Ms. Piper, when you feel well enough maybe you should sue everyone involved. I wish you and your son much joy in the years to come. Hopefully your memories of this misery will fade and all you will remember is the joy of becoming his mother.

Posted by: singer4ever | April 24, 2009 4:36 AM

I think it is extremely dangerous to pass judgement on these medical professionals. Many of these doctors/nurses have worked with new mothers for DECADES. Their skills, abilities, and expertise is what we rely on. They were clearly alarmed by the actions of this mother, or they wouldn't have reported her behavior. Just because she went to a lawyer and the Post doesn't mean that she's telling the truth. Readers musn't be too quick to pass judgement. I find it hard to believe that this many doctors/nurses were so off base with their assesments. WHC is a reputable hospital with excellent patient care and it is disturbing that this woman can slander an entire nursing/medical staff.

Posted by: maestra2 | April 26, 2009 12:09 AM

I think it is extremely dangerous to pass judgement on these medical professionals. Many of these doctors/nurses have worked with new mothers for DECADES. Their skills, abilities, and expertise is what we rely on. They were clearly alarmed by the actions of this mother, or they wouldn't have reported her behavior. Just because she went to a lawyer and the Post doesn't mean that she's telling the truth. Readers musn't be too quick to pass judgement. I find it hard to believe that this many doctors/nurses were so off base with their assesments. WHC is a reputable hospital with excellent patient care and it is disturbing that this woman can slander an entire nursing/medical staff.

Posted by: maestra2 | April 26, 2009 12:09 AM

I agree with those counseling caution here. What if the statements of the patient and her actions that led directly to the response by the medical and social services staff are true, and evidence of a deeper problem that should be investigated? Shouldn't they err on the side of protecting an innocent child? Just in case? Maybe the Post should look into this patient's history before it criticizes the medical and social professionals involved. What if she has a history of mental instability (god forbid) and a history of claim filing (god forbid)?? The point is, don't assume, or condemn too quickly.

Posted by: objective2 | April 26, 2009 7:27 PM

I had the same kind of thing happen to me at WHC. They are power mad. Just consider the comment that the burden is on the mother to prove that the child can come home with her-- what right does the hospital have to say that?? Do you people defending the hospital or advising caution think that is true-- the burden is on the parent to prove they can take the child home. The whole thing made home birth more appealing to me for the birth of my second child.

Posted by: captiolhillmom | April 29, 2009 3:55 PM

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