Informed Consent

Giving Birth is a natural experience but it has become a little more medical than it needs to be at times. Having an obstetrician does not automatically mean that your choices will be taken away, you just need to stand up for your rights and remember you’re still in control. We lose a sense of control with fear and lack of information, while birth doesn’t always be planned having a plan helps us cope and take away some of the uncertainty.

The first thing I always discuss with clients is using your B.R.A.I.N.! Let’s go over what that acronym means.
Benefits
Risks
Intuition
Alternative
Nothing

No matter what the procedure is you should be asking these questions but we will use one common practice as an example, rupture of the membranes. Often times they want to rupture the amniotic sac, they offer the benefit as it “speeds up labor”. That seems amazing when you’re in the thick of the contractions but there are more things to ask, like what are the risks? Will I be on a time clock once its broken? Next is your intuition, your gut feeling. Do you feel like your labor would benefit from this? The next is the alternative, what can we do besides breaking my water? Can i move more? Use the peanut? Change positions more frequently? Lastly, do nothing. This means to let things progress naturally and without intervention. If mom and baby are okay there is not really much reason to speed things up, labor is a long process so letting the water break naturally is probably the better option.

Always ask questions before your procedure! You should know exactly what is happening and why it is, even down to blood work. We aren’t all in the medical field so having things explained to us is very important. Here are some questions you can ask as an example:

“Why do I need this drug or procedure?”
“Will my baby and I be healthier for taking it/having it done?”
“Is it just routine?”
“What are the known side effects?”

“Will the benefits outweigh the risks? What is the risk to me or the baby if I don’t have it done?”
“Are there alternatives that can be tried before this procedure or drug?”

We also need to discuss the language of consent. This seems to get blurred between healthcare provider and patient. As the healthcare provider they do not automatically get consent for whatever they want to do, it still needs to be asked. Some language that is not consent is:
“I’m going to check your cervix now.”
“It’s protocol.”
“It’s mandatory.”

No. This is not consent. Language of consent looks like this:

“Would it be okay if I check your cervix?”
“Can I check your cervix now?”

This is still your body and your baby, no one else gets the power over you or your body. It’s good to get to know your provider in the beginning to see how they deal with the hard questions. You should be asking questions like:

“What is your induction policy?”
“What are your views on birth plans?’
“What are some of your mandatory tests and procedures?”
“Do you require cervical checks at 36 weeks?”
“What is your pushing protocol?”
“What is your protocol on doulas?”
“What is your protocol on IV use?”

If the answer is anything besides “It is up to you, unless there is an emergency,” run. This is your birth, your baby and your body. Your provider is there incase of emergencies not to tell you how to do things. There are obstetricians that will respect this.

An infamous card they pull while trying to push you into things is something we call the “dead baby” card. This card was pulled on me and I was pushed into a C-section, this card is the one that made me become a doula. They instantly tell you that your baby will die if you don’t do exactly what they say..but the truth is if they aren’t rushing you to the OR while running (I had an emergency section as well, unfortunately and this happened) then you have time to talk about it and try another alternative. A good way to buy time is to say “I need a minute to discuss this with my partner.”

When preparing for a birth you should always check the C-section rates of the hospital as well and take a tour of the hospital. Join your local mom groups as well and ask about their experiences with certain providers. A hospital birth can be just as magical as a birth center birth, I have attended them, you just need to find the place and the doctor that is the right fit for you!