This is a post in my series on Owning your Birth. It is my strong belief that your birth experience profoundly impacts your early days with your new child. The way you feel while birthing your baby can inform how you feel about yourself as a person, parent, and partner. If you feel respected, strong, and supported during pregnancy, labor and delivery, you will improve your chances of beginning your parenting journey with confidence and hope. If you feel disrespected, controlled, or unheard during pregnancy, labor and delivery, you may enter your parenting journey with fear and sadness.
Birth is normal and breathtakingly beautiful. But it is also mysterious and unknown, sometimes overwhelming and scary. With any labor and delivery, you can have an experience that is family-centered. Feeling respected and heard, and experiencing your own strength and power during birth, comes down to owning the experience, even in its uncertainty. And often still, things won’t go as you expected. If you are surprised, overwhelmed, or sad about your birth experience, you will be better able to confront it and work through it if you feel prepared, strong, and confident enough to reach out for support.
You cannot plan your birth. Birth will takes its own course and we do best when we can let birth happen. But birth can happen best when we are physically, mentally, emotionally, and spiritually at our best. In this series, I’ll share ideas about what you can do to own your birth experience.
Own your Birth: Part 10 of 24
Understand Informed Consent
Informed consent is on my short list of things every pregnant person and their partner should understand. It’s right up there with understanding how to choose a supportive care provider and building your perfect birth team. Understanding your rights and understanding the essence of true informed consent will make it possible for you to gather evidence-based information and remain autonomous as you stay in control of the decisions being made during your pregnancy, labor, and birth.
ACOG, (The American Congress of Obstetricians and Gynecologists) states, “The Obstetrician-Gynecologist has an obligation to obtain the informed consent of each patient” (2011). Hermione Hayes-Klein, Human Rights Lawyer and Director of Human Rights in Childbirth, lays out for doctors and midwives what informed consent in birth care should look like. If you want to be sure that your provider is practicing true informed consent, look for these 3 components in your conversations and care.
- Your provider should inform you about what is happening and objectively share all the risks and benefits of all of your options. This part of the conversation should be objective and supported by evidence.
- Next, your provider should advise you. This is when he/she can take into account your personal situation, his/her limits and skills, and give suggestions for what he/she thinks you should do. This part of the conversation can be subjective.
- Finally, your provider should support you. This means that, even if you choose not to follow his/her suggestions, he/she should support your decision, knowing that you have been given all the information.
You should always be the decision-maker in your pregnancy and birth care. You should decide what risks and benefits are tolerable to you because you are the one who will live with the outcome. If you make a choice that is different than your provider’s suggestion, it might help to let him/her know that you understand the responsibilities that accompany your right to choose.
More resources on informed consent:
- Informed consent from Human Rights in Childbirth: http://humanrightsinchildbirth.com/right-to-informed-consent/
- Your right to refuse medical treatment from Human Rights in Childbirth: http://humanrightsinchildbirth.com/right-to-refuse-medical-treatment/
Make sure that you and your partner understand true informed consent and refusal before labor day comes. This information, and your ability to use it, may be crucial in helping you maintain your autonomy and own your birth in the face of tough decisions about you and your baby during the end of pregnancy, labor, birth, and the postpartum period.
Informed consent in action
You can stop reading now, or read ahead for two short stories that demonstrate the difference between consent and true informed consent. I think you’ll be able to tell which one illustrates informed consent!
1. You have been in labor at the hospital for many hours and your contractions are becoming long and challenging. You have been working on all sorts of pain management and coping techniques, but you are tired. You know that you don’t want an epidural, but you decide to ask your doctor if there is anything else she might be able to give you to take the edge off and help you rest for just a little while. She says that she can give you a narcotic called Nubain through an IV tube. It won’t eliminate your pain, she says, but relieve it a bit. As you have done for your entire pregnancy, you ask her about how this drug might help and what the risks are of taking it. She tells you that it won’t immobilize you like an epidural would so you will still feel contractions and be able to push effectively when the time comes. It only lasts an hour or two so your baby will probably be born before the drug is fully metabolized by your body. She assures you that there is no risk involved. You decide to take the Nubain.
2. You have been in labor at the hospital for many hours and your contractions are becoming long and challenging. You have been working on all sorts of pain management and coping techniques, but you are tired. You know that you don’t want an epidural, but you decide to ask your doctor if there is anything else she might be able to give you to take the edge off and help you rest for just a little while. She says that she can give you a narcotic called Nubain through an IV tube. It won’t eliminate your pain, she says, but relieve it a bit. As you have done for your entire pregnancy, you ask her about how this drug might help and what the risks are of taking it. She tells you that it won’t immobilize you like an epidural would so you will still feel contractions and be able to push effectively when the time comes. It only lasts an hour or two so your baby will probably be born before the drug is fully metabolized by your body. She also tells you that narcotics adversely affect fetal heart rate and your baby would be more likely to be born with low blood PH and/or have trouble breathing. She also tells you that the narcotic might make you nauseous and she can give you an antinausea medication as well. She lets you know that you might feel fuzzy-headed and reminds you that your pain won’t be totally eliminated. After sharing this information with you, she advises you to take the Nubain so you can get some relief, but reminds you that she will support whatever decision you make. You talk with your partner and decide to try laboring for another 30-60 minutes and reevaluate then. Your doctor supports you and agrees to come check on you in about 45 minutes to see how you’re feeling. When she returns, you decide to take the Nubain and she sends the nurse in to administer it.
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