Do I have to… ?
I’m writing this post in response to a question I saw posted from a mum-to-be online. But it’s not the first time I’ve heard it, and sadly it wont be the last time. There are so many ends to this sentence. Do I have to have a sweep? Do I have to have an induction? Do I have to have a caesarean? Do I have to have an extra scan? Do I have to be on the labour ward? Do I have to, do I have to?
My short answer to this.. NO.
My long answer.. below..
There’s a little something, all healthcare professionals are legally obliged to obtain from you before they do ANYTHING.. and it’s called ‘informed consent’. Informed consent.. what does that mean? A trusty dictionary would tell us that ‘informed consent’ is ‘permission granted in full knowledge of the possible consequences, including the risks and benefits of the treatment offered’. And therefore, as long as information and advice has been shared with you in a balanced and factual way, then the final decision to accept or decline ANY intervention lies with you.
As healthcare professionals it’s not our responsibility to coerce or steer you into a particular choice. It’s our responsibility to share with you information, and to advise and support you to make your own decisions around what is best for you and your baby. That’s not to say that intervention isn’t sometimes a good idea, a positive choice or a potentially life saving.. it IS to say that actually you can ALWAYS say ‘no’, you never ‘have’ to do anything, and the final decisions should always lie with you.
Ok.. But that’s easier said than done right? What can you do to get BACK that control. And what if it feels like informed consent isn’t happening?
I was in the middle of a somewhat heated, definitely passionate and utterly fascinating debate between two birth workers last week. One side argued that ‘the system is broken, consent isn’t happening, this is the root of the problem and THIS is what needs changing’.. the other argued that ‘telling pregnant women they’re going to try and give birth in a totally broken system isn’t a helpful approach and takes away from all the wonderful supportive work that many, many midwives provide to women every day.’ And there I was, sat in the middle, both passionately agreeing and disagreeing with both of them at the same time. And this is where I share my (temporary) solution!
Ok, so yes, the system is a bit broken, and yes, the vast majority of midwives are UTTERLY incredible humans who deserve a medal every damn day! But this message is a bit like standing outside a restaurant, telling your friend how awful the food is, telling them how they’d likely get food poisoning or at the very least a burnt dinner.. ‘but at least the waitresses are lovely’.. and then telling them you’d booked a table for 8pm!
What we need to know, as potential diners, is WHAT on that menu should we be ordering? And how would we like it cooked?
Metaphors aside, what women need are the TOOLS to navigate the system, to take control and assert their power!
THESE are my top tips for taking control of your birth experience.
1. Use your BRAIN tool! Benefits, Risks, Alternatives, Instinct, Nothing. Gather THIS information- and you can feel like, YES, you ARE informed.
2. WRITE EVERYTHING DOWN. Ahead of an appointment write down ALL the questions you hope to be answered, and do not leave until you are satisfied with the information that has been provided. I don’t know about you, but it takes much less courage to read off a sheet of paper, than to question a healthcare professional sitting behind a desk!
3. NEVER make a decision when you’re asked it. Whether you’re in an antenatal appointment and being offered an induction date, or in labour and being offered augmentation (speeding up of your contractions), ask for the information (the risks, the benefits, the alternatives) and then ask to be left alone (or with your partner) whilst you make up your mind. It’s human nature to nod along when a person of importance stands in front of you and suggests a course of action. Making your decision separately, allows this to happen in a much more rational state of mind!
4. Do your own research. Ask to see the papers a midwife’s recommendations are based on if you want to. Have a look at the NICE guidelines, the clinical research, visit the AIMS or Evidence Based Birth websites. Get YOURSELF informed. DO NOT ASK ON MUMSNET!
5. Know that you can ALWAYS change your mind. If you decide that a sweep doesn’t feel like the right choice now, you can always change your mind in two days. If you feel like pethidine is something you wanted to avoid and then circumstances arise where actually, you’d like to try it, you can always change your mind!
6. Take your TIME. Let’s say you’ve done the above and decided to accept the offer of intervention.. Now ‘time’ might be 30 seconds or a week, but taking a moment to allow a change of plan to ‘settle’ in your mind, can transform an experience from panic to positivity. It might be asking for 2 minutes alone or just 30 seconds of quiet before an instrumental birth, where you can take some breaths together and have a kiss and cuddle; it might be accepting induction and popping home for 30 minutes first to put the washing up away and giving your other kids a big old squeeze.
For me, the TWO things that make a birth positive are CONTROL and SUPPORT of your decisions. This will help you get the control.. this post will help you get that support!
If you are keen to understand what’s happening in your body during labour, and how hypnobirthing can help things moving in the right direction, you can sign up for classes here or read more of our helpful
If you are interested in taking the next step to a positive birth, Positively Birthing Hypnobirthing and Antenatal Classes run throughout Surrey and SW London- areas including Surbiton, Esher, Teddington, Cobham, Twickenham, St Margarets, Thames Ditton, Molesey, Richmond, Wimbledon, Kingston, Sunbury, Epsom, Ewell, and beyond. All bookings can be made here.