This post came to me on a recent night when I was up at 2 am and couldn’t fall back asleep (sigh, active pregnancy brain). This is one major issue that I’ve picked out through the recent discussions about “how to give birth.” Because ultimately, we’re all going to make different choices, and that’s fine. We’re different people with different circumstances.
But what seems to matter most, out of all the stories I’ve read, is the ability to make a choice, and feel in control…through true informed consent. Why does that matter so much? Keep reading to find out!
I was pondering my first birth experience. It’s no secret that I wasn’t thrilled with it. But when it gets right down to it, the aspect I liked the least was feeling that I had no choices. I wasn’t told what my options were and then helped to pick what was best for me and my baby; I was ordered to simply do certain things. The doctor made no secret of the fact that these choices were made for her convenience, either. She literally said, “This is a hospital, we move things along here.” It wasn’t, “I believe, based on your situation, that this is in your medical best interests.” No, it was we move things along here.
That’s really the key right there. Women need to feel that they can trust their birth attendant; that they have a relationship based on mutual respect; that their doctor will make decisions based on their or their baby’s best interests. Those things must be true. Whatever else happens, happens.
Despite that I love my drug-free home birth, if someone told me, “Based on your current symptoms, we believe the safest course is to do an emergency c-section,” I would do it. And I would not regret it. If I was told, from caregivers I could trust, that the best option was an emergency c-section, then I would accept that it was the right way. Based on symptoms, necessary test results, and the practitioner’s judgment of what was truly medically best for me and my baby. I have absolutely zero problem with that.
I do have a huge problem with caregivers who treat me like an idiot, don’t think I have any right to information or ability to evaluate options, don’t explain to me the real benefits and risks of any given procedure, and think that I have to fully submit to whatever they feel like doing, just to make it easier for them. No.
The ideal situation is this:
1) A woman has a caregiver that she has chosen, and trusts.
2) That caregiver takes the time to fully answer all her questions, and explain all her options. When a woman makes a choice, it is because she knows what she is getting into, and her caregiver has explained what s/he believes is medically the best choice.
3) In a non-emergency situation, the caregiver takes all requests seriously and works with the woman’s desires as much as possible (in an emergency situation, yes, it might all go out the window — but that’s why trust is crucial)
4) The caregiver respects a woman’s right to make her own choices (again, in a non-emergency situation) even if it is not what s/he would prefer.
That is how it should work. Period.
Women have every right to choose anything from a completely natural home birth to a scheduled c-section, and everything in between. But they need to have a doctor or midwife who will honestly and respectfully explain what the options are and what the risks and benefits are for each option. And then they should allow a woman to make her choice as desired.
If more women felt that their doctors treated them as if they were actually in a mutually respected, professional relationship, they might not be so unsatisfied with their births. It really doesn’t (usually) come down to what happened, it comes down to whether or not they felt that their wishes were taken seriously. Women who come in wanting a natural birth and wind up with a c-section because something went wrong are not likely to be overly upset about their situation. They know they did what they had to do to safely have a baby.
But women who come in wanting a natural birth and end up with a c-section because they were pushed along with intervention and intervention “to speed this up,” not because it was medically required, really struggle. They know it didn’t have to be that way. They know that if their doctor had taken them seriously and been willing to leave them alone, things could have been different.
Let’s bring back real informed consent. Some doctors and midwives are great at this already. Others? Not so much. But we are real, independent adults, capable of having an actual conversation with another adult, and understanding. We don’t need a doctor with a God complex handing down the orders. We need informed, experienced, capable doctors who treat us like we actually have brains in our heads, and help us to do what is best.
What do you think? Do we really have informed consent now, or do we need to get back to it (at least in some situations)?
Top image by chimothy27