Informed Choice: Your Rights in Pregnancy and Childbirth

Informed Choice: Your Rights in Pregnancy and Childbirth
I was at a workshop yesterday where I met a very successful and strong woman. She is pregnant. 38 weeks pregnant. The nature of her personality was so assertive and determined that it surprised me when she mentioned that her obstetrician had told her that she might be induced and that she had not realised that she had the option to say no! The fact that the OB suggested induction because of the size of the baby is another whole blog post but I’ll attach a link for more about this.


I’ll say now that I am a midwife and it is my job to make sure that women are aware and informed about the procedures involved in pregnancy and birth, in fact I can seriously jeopardise my registration and career if I fail to do this.


I would like to talk with you about the concept of Informed Choice.


Informed Choice is the idea that a health practitioner, a Doctor, a Midwife, a Surgeon is supposed to give the patient/client all the information about the risks and benefits of a certain course of action and the client decides whether or not to take that action, the doctor or midwife then supports the client in that choice, regardless of their personal thoughts.


The National Midwifery Guidelines for Consultation and Referral state that:-


“Midwifery care must be provided in accordance with the principle of informed choice. The midwife must provide the woman with sufficient information to inform the woman’s consent to any procedure and must give the woman the opportunity to consider the advice being offered. The woman is free to accept or reject any procedure or advice.”


Can you see that bit on the third line of that statement that says ‘any procedure”?
That means everything, blood tests, scans, vaginal examinations, medication prescriptions, monitoring of your baby.  Everything is optional. YES everything. Did your GP discuss the risks of ultrasound with you or just give you a referral? Did a hospital midwife say ‘just hop up here on the bed and I’ll put this monitor on’? Did they say there was risk and very little benefit and that you would find it difficult to move around and that you might experience more pain and a more difficult delivery, did you know you could say no thanks?


Did you know that the choices you make during your pregnancy and the preferences you express can make the difference between achieving the birth you want and coming home with a new baby wondering what just happened?


I am often frustrated by the way health practitioners forget their moral and legal obligations to women and their babies and just tell them that they have to have a certain course of action. Practitioners often forget that pregnancy is a vulnerable state, that pregnant women are very suggestible and are much more likely to accept whatever is suggested. When women are pregnant they tend to want to do what is best for their baby and if a professional suggests a course of action, say induction, the majority would agree without argument or even discussion, so there is a professional obligation to offer every intervention as a choice.


In my practice as a midwife I explain the concept of informed choice to my clients at the beginning of our relationship. I make sure they understand that while I have the knowledge and resources they need, I am not going to choose their path for them. The baby is theirs, the body is hers, all the choices are theirs.
I would encourage you to ask you maternity carer if they support the concept of informed choice, if they don’t you might consider changing to a care provider who does.


Ladies, get to know yourself, trust yourself, trust your body.