I’m Pregnant… Now What?

Being a Birth Doula by trade, I hear this phrase exclaimed over and over. My response will forever be… “Hire a supportive provider and get EDUCATED on your rights in birth.’

So here are the TOP TWO points you need to know FIRST!

Choosing the Best Care Provider: 

    There are many things you will be thinking on as you enter your place of birth, worrying that you didn’t choose the best OB/Midwife for your desired birth…. SHOULD NOT BE ONE OF THEM. No matter what type of birth you are looking forward to, If they openly share statistics with you and are eager to listen to your desires and concerns, that’s a good sign you’ve chosen a supportive provider for you. Below is a list of questions every maternity care provider should be asked. And based on their answers, you can determine if they will in fact provide you with evidence based care:

1)    What are your vaginal birth, cesarean birth & VBAC rates? - The majority of their practice should be birthing vaginally without major complication. roughly around 80+%

2)    What do you consider a reason for an induction? - You SHOULD hear “preeclampsia, extreme medical problems, IUGR(intro-uterine growth restriction) etc”

3)    Do you support women birthing in alternative positions? - hands & knees, upright(standing or using a squat bar), throne or sidling position. **the answer SHOULD be YES!

4) Are you willing to deviate from a blanket protocol, in order to provide me individualized care if necessary? - Yes!

These are just a few to get your wheels going! If the answers to the above-mentioned questions are not compliant with current evidence based practices,(based on recommendations from the ACOG, NCIB, EBB, APA etc) then you have everything you need to know to make an informed decision on who is the best care provider for your desired birth wishes. Make a list of your own based on your desires and needs! After all, YOU are HIRING them to supply you with the best care imaginable! At one of the most important times in your life!

Informed Consent: 

    The most basic rule of medical care is that the patient has an absolute right to be informed about the proposed treatment before agreeing to it; this is known as “informed consent.” Your care provider must explain the planned care in words that a non-medical person can understand and explain the risks involved as well as all alternatives. He or she must explain why this procedure is deemed necessary and discuss medication with you and tell you about its risks and benefits, as well as its full name. Your provider must also share information about the effect of drugs and treatment on your baby.

Photo of woman and baby seconds after achieving a vaginal birth after a previous cesarean birth with Doulas of Jacksonville Birth Doula

EMERGENCY SITUATIONS: 

    If you or your baby is in danger, your care provider is authorized to treat without getting informed consent. This is in the paperwork you sign at check in. For example, if you need an emergency cesarean, your doctor is going to go ahead without spending the time to explain all of the risks to you. Understanding the risks and benefits are very important reasons to do your own research in advance- just in case.

CONSENT FORMS: 

    When you give birth, you will be asked to sign a list of consent forms. READ EACH FORM CAREFULLY. It is best to grab these when you go in for a tour! Bring them home and take your time to read through them. If necessary, you can cross things out or add things to them. Usually these forms give consent for your health care provider and anyone under his or her supervision or direction to provide care for you. But sometimes these forms may include things like permission for staff to give formula to your baby if they deem it necessary or to provide certain vaccinations that you may desire to postpone. Doing this prior to birth will help you have a smoother and therefore more peaceful transition into the birth place.

REFUSING TREATMENT: 

    You have the right to refuse any treatment. Period. You can even up and walk out of a hospital against medical advice (AMA) if you so choose to do so. But it may come with a steep price. Insurance companies may refuse to cover expenses that are the result of walking out (rarely). As well as your care provider may decide it’s too much of a liability to continue having you in their care. No matter if it’s actually ethical to do so.

    This is why it is so very important to be educated on various birth complications and your options for birth and all of the risks and benefits of those options prior to the onset of labor. So that if the time comes that you are faced with the uncertainty of a complication, you can easily make an educated fully informed decision for care and give a speedy consent.

    You can always change your mind about what treatment you agree to. You can withdraw your consent to a treatment at any time. Obviously not in the middle of a cesarean birth. But you get the point. Additionally, you can change your mind and agree to receive care that you originally declined. You may also choose to switch providers at any time—even during labor if you wish.

In Closing

Pick the provider who best suits your needs concerning the type of birth you are desiring!

Make sure you are supported in giving informed consent or refusal!

If you get these two points right, you will be set on the path to a peaceful, empowering birth experience!