Collusion and Negligence in Hospitals
by Judy Slome Cohain

[Editor’s note: This is an excerpt of an article which appears in Midwifery Today, Issue 104, Winter 2012. View other great articles and columns in the table of contents. To read the rest of this article, order your copy of Midwifery Today, Issue 104.]

One predominant problem with planned hospital birth stems from the requirement of collusion among hospital workers. Hospitals are living organisms whose drive for self-preservation takes precedence over the goals and needs of the patient. Each individual worker and patient enters with needs and hungers of their own. In order for the hospital to survive, the patient’s needs are sublimated to the needs of the staff and hospital. Ensuring the survival of the hospital takes precedence over the individual needs of a patient. Those in positions of power within hospitals often display intimidating behavior, which is often difficult to challenge, especially for a patient. Authority almost by definition is accompanied by intimidating behavior. The following stories are examples of collusion and negligence within hospitals.

Story #1: A hospital head midwife with 30 years of experience routinely approaches each woman in labor offering in a high-pitched, childish voice what she calls, “happy-durals.”

“Do you want your happy-dural now?” she cheeps.

During my two months working closely with this hospital, I did not hear any other health practitioner, doctor, nurse or cleaning lady correct this head midwife by telling her that it is misleading to use the term “happy-durals” for epidurals since epidurals can have dangerous side effects, such as slowing down labor, week-long migraines or permanent paralysis. I heard no other doctor or midwife use this term for epidurals when offering them, so I am assuming that at least some are not in agreement with her use of the word, yet no one stood up to correct her. Hospitals are set up in such a way that midwives must pretend collusion with the other midwives and not with the women in labor.


Judy Slome Cohain is devoted to empowering women and midwives with knowledge, enabling them to have the birth of their dreams.


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