Sunday, August 1, 2010

Informed Consent vs. Medical Bullying

One of the biggest things that I have learned thus far is that women have the right to say no to interventions and procedures that they feel are not in their best interests. Before I got "that feeling" that something was not right with what my former OB was saying, I honestly thought that the professionals entrusted with my care had my best interests at heart. I did not realize that some OB's choose to lie and manipulate their patients to back up their "facts" and that I had to be the one to do my homework about everything involved in having a baby in modern America. Every childbearing woman in America has rights, which you can read here.

Most providers, I want to believe, will be open and honest regarding the risks and benefits to all the interventions pushed on birthing mothers today. However, there are some who choose to use their "professional" status to bully the patient. This includes brushing off whole topics, inflating statistics to support their opinion, graphic imagery to make a statement, and threats that are meant to stop the patient from questioning further.  Unfortunately, for women who are trying for a VBAC and even more so, a VBAMC (vaginal birth after multiple cesareans), these "scare tactics" are pretty common. Here is a great list of the tactics OB's and yes, even some midwives, will use to get a woman to "choose" a repeat c-section.

So what can you do if you are being bullied into interventions that you don't believe are medically necessary? The OB wants to induce you at 38 weeks, you are told you HAVE to have an epidural, the nurses won't let you move around, or you are told that you have no choice but to have a repeat cesarean....

1. Do your homework- there are great websites here that will inform you honestly about the risks and benefits to most of the common interventions such as Pitocin, artificially breaking the water, laboring on your back, etc. 
2. Make sure that your partner, doula, midwife, and labor coach know what you want for your birth and even more importantly WHY. When you are concentrating on labor the last thing you need is someone from your labor team pressuring you to go along with whatever suggestions the nurses and such are making! 
3. Ask questions- ask what other options there are, ask for a second opinion, ask for time to decide.
4. Go with your gut and listen to your body- if your body is telling you that you need to move then do it, if there is no medical reason for the intervention then decline.
5. Remember that even if you do decline and give your informed refusal to something, you have the right to change your mind. 

I know from recent experience that the more informed you are prior to giving birth the more prepared you will be to deal with various situations. I have no clue how this birth will go, what kind of support the hospital staff will give me or if I will have to constantly fight to remain in control of what is happening. But I truly feel that the more knowledge I have about the whole process, the better off me and Miss M will be!

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