What is Informed Consent?
Merriam-Webster's definition is:
"consent to medical treatment by a patient or to participation in a medical experiment by a subject after achieving an understanding of what is involved and especially of the risks."
How does it apply to pregnancy and childbirth?
ACOG states:
"Informed consent is a practical application of the bioethics principle of respect for patient autonomy and self-determination as well as the legal right of a patient to bodily integrity. Although informed consent has legal implications, this Committee Opinion focuses on obstetrician–gynecologists' ethical obligations surrounding informed consent. Respect for patient autonomy is one of the four pillars of principle-based medical ethics (autonomy, beneficence, nonmaleficence, and justice) and is considered by some to be the “first among equals” of these four principles because of the value placed in modern Western society on individualism and liberty."
You can read that entire committee opinion on the ACOG website. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/02/informed-consent-and-shared-decision-making-in-obstetrics-and-gynecology
Why Is Informed Consent Important?
Informed Consent gives the person making the decision the power in the situation. They are not simply following a recommendation, but they are choosing for themselves based off of accurately stated risks and benefits that have been presented to them in an unbiased way. Every woman deserves the power to make her own decisions during pregnancy and childbirth, regardless of someone else's opinions or preferences. Her birth is just that: HER BIRTH. A woman's birth is not her doctor's, nurse's, friend's, or her doula's birth. It is exclusively the Birthing Woman's own experience, and a memory she will hold close to her heart forever, and never forget.
Informed Consent removes the element of being frightened into something for the benefit of someone else besides the Mother. Information is power, and most of the time, facts are not as scary as opinions of someone who knew a cousin's Grandma's Mom that had a terrible experience and almost died because of __________ (fill in the blanks), or old wives tales such as "Redheads always bleed more" that are not evidence-based at all.
If you're feeling pressured into a decision, it's most likely not the best evidence-based decision. Take a moment and ask for an explanation of risks versus benefits and any alternatives that are possible (but maybe not as convenient).
Here's another great article on Informed Consent:
Why Do I Care About Informed Consent?
Because I'm a woman who has given birth.
Let me share a little story of my own that started out as a Facebook post:
This is my story.
This is the reason I became a doula. 💗
I don't talk much about what led me to have homebirths with all 4 of my children, but it is something that I feel very deeply.
It started when I first went to the OB/GYN office to see a CNM after finding out I was pregnant. No one asked me if I wanted things done. They just told me what to do and that they were going to do whatever it was. I was 21 and they treated me like child.
Then I denied the genetic testing. I even signed a paper refusing it. They did it anyway and charged me the $1800 that insurance didn't cover.
After that, I asked about what bloodwork they were doing. I didn't deny it. Just asked. The lab tech was very irritated, and said something about me killing my baby while slamming a piece of paper listing what they would test for into my hand. (From a large stack that was readily available, I might add!)
Then there were the ultrasounds. After 20 weeks, I thought we were done. But they want another one. And another one. With no real response when I asked why.
Then I brought my birth plan to my appointment. The CNM told me ( in other words) that I didn't need one. They were going to do what they wanted to do at my birth.
I left that appointment and decided I would never go back to that care provider.
I switched to a CPM and hired a doula at 32 weeks pregnant. Jonathan and I took out a loan to cover the midwife because we only had 4 weeks to come up with the total amount.
That was the BEST decision ever.
I was compared to a woman who gave birth at a hotel and left her new baby on the floor, placenta and cord attached, for 12 hours before her husband called 911 by someone I know. The baby later died. I guess that's the only baby born outside of a hospital that died that she could recall hearing about.
I have since had 3 (this was written in 2019. Now, 4!) intervention free, medication free births with midwives who answered my questions, addressed my concerns, and respected my wishes. I often wonder what would have happened if I had stayed with my original provider for that first birth. I KNOW I wouldn't have liked it.
So, here's to all the Moms who dare to ask questions, and expect informed consent. We need more of them, and more providers who listen.
I'm not saying that a homebirth is right for everyone, but I am saying that informed consent is.
Informed Consent is your basic right, Momma! Don't be afraid to speak up for it.
Love, Bethany
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