It is very important that in childbirth women have Informed Choice and Informed Consent.
Pregnancy and childbirth are very emotional events, and in a medical setting where informed is not always practiced, it is important that you understand all your options.
It is important to ask questions so you have a clear understanding and knowledge of everything that is going on so you can make an Informed Choice/Refusal. Yes the doctor has been to medical school, but that doesn’t always mean that everything they say or prescribe is based on scientific evidence, or that it is your only option.
It is your care provider’s job to provide, options, information and recommendations about your pregnancy and birth. It is your responsibility to ask question, research your options and make an informed choice or refusals.
Birth is your right, it’s your body, your baby and you choose what will happen with it.
What is Informed Consent during birth?
Medical Dictionary definition: Informed consent in the process by which the treating health care provider discloses appropriate information to a competent patient so that they may make a voluntary choice to accept or refuse treatment.
Layman’s terms: It is the obligation of your doctor or midwife to give you as much information as possible about the proposed care options, so that you can make your own choices about your body/ baby/ labour
BRAIN: BRAIN is an acronym that stands for:
- Benefits: What are the benefits of this procedure? How will this help me/my baby/my labour?
- Risks:- What are the risks of this procedure? How might they negatively affect me/my baby/ my labour?
- Alternatives: Are there alternatives to this procedure? Are there other options?
- Intuitions: What are my gut feeling about this?
- Now/Not Now/Never/Need Time: Is there a time frames for this? What happens if we wait? What happens if we don’t? I need time to think about it/Discuss it with my partner, or Doula.
The BRAIN Acronym and Informed Consent exercise may seem obvious, but for many people, especially laboring woman, it doesn’t always occur.
Many people don’t realize that they have the right to ask these questions or even to refuse certain procedures when they are being told that they “have” to have while a woman is nervous for her and her baby’s health.
Practicing brain during pregnancy.
Questions to ask:
- What are my choices?
- What does the research say?
- What are my options? – get more than one and probe for further options
- What happens if I refuse?
- What are the current statistics? – ask for numbers
- What are the risks and benefits of this recommendation?
- You can also state that you don’t understand
- You can ask them to provide you the research
DON'T ACCEPT vague answers:
Sometimes not always you will get answers like, I only do this when it is absolutely necessary, or that is standard practice. But that leaves us open to what do you think is necessary? Or what is the standard? Don’t accept vague answers. Get statistics, research and numbers.
Some examples of vague answers are:
- You have asked not to receive an episiotomy and your care provider in turn responds “I do not provide episiotomies unless it becomes necessary.
- Now imagine your care provider’s rate of episiotomy is at 90%, this tells us that their definition of necessary is different than yours or other providers.
- Another example would be, you go to your care provider and say: "I would like delayed cord clamping by at least 15 minutes. Your care provider in turn responds: “It is standard practice.”
Current standard practice is 2-5 minutes, not the 15 you would like. So asking what their numbers are is very important and then clearly stating what your wishes are.
Practicing brain during birthing
Questions to ask.
- Is this an emergency?
- Do we have time to think about or talk it over?
- What are the benefits of this procedure?
- What are the risks of this procedure?
- Is there anything I can try first? Or other options instead of?
- What would happen if I wait?
- What would happen if we choose not too?
- What does the research say?
- Ask for numbers
Don’t accept manipulations that use fear, nerves or excitement as answers. Answers like “you want a healthy baby”, plays the fear card. “You can meet your baby sooner.” This answer plays on your excitement to meet baby.
It is important know that: YOU HAVE A RIGHT TO CONSENT TOO AND REFUSE ANYTHING THAT INTERFERES WITH YOUR BODY OR THE BODY OF YOUR CHILD.
- You have the right to give or refuse consent.
- You have the right to disagree.
- You have the right to ask questions and gain answers
- You have the right to gain a second opinion
- You have the right to choose a particular form of medical care.
- You have the right to revoke consent.
- You have the right to have your answer respected and supported, from Doctor, Midwife, Doula and Nurse.
- No one can force you to do anything with your body and baby that you do not want to do.
- You have the right to change medical care at any point in pregnancy if you feel unsafe or unsupported
- You have the right to feel safe and secure during pregnancy, labour and childbirth.
- You have the right to have a birth plan that enhances your experience, not protect you from your care provider.
Sometimes we can feel that we have no choice or we can feel that we need to make a certain choice for the safety of ourselves and/of our baby. Make sure as much as possible to ask the questions, ask for numbers, and take the time you need to talk to your partner and doula.