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Am I Allowed?

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It’s something I hear time and time again. The more women I talk to, the more couples I teach, I hear the same phrase over and over. “Am I allowed to...”, “The midwife said I’m not allowed...”, “they’ve said I have to....”. Now I understand why a woman would think that the decision lies in their healthcare professional. They’re the trained medics. But you don’t know what you don’t know. And unless someone points it out to you, it’s very easy to be steered down a particular (usually very medicalised) route by a consultant or midwife for various reasons without realising the decision lies with you and you may have lots of other options other than the one you’re being told you need to take.

Language is an area I spend some time on discussing in my hypnobirthing classes, as language carries weight and it can have a physical effect on birth. And just like a negative story from a friend can effect birth, so can the use of language by your caregiver. A consultant may say for example “I’m just going to book you in for an induction”, which implies assumed consent, when really they should be saying “I recommend booking you in for an induction, do I have your consent?”, or even better “we could book you in for an induction, these are the reasons why... and these are the alternative options if you decide not to be induced”. What most women don’t realise, is that they’re in the driving seat. The decision is theirs to make. That doesn’t mean blindly do the opposite of what your caregiver is suggesting, but it does mean that you CAN say NO to anything. You can say no to an induction. You can say no to a sweep. You can say no to a vaginal exam. You can say no to an episiotomy. You can say no to monitoring. The list goes on.... the right for a pregnant woman to make decisions on the birth of her baby is enshrined in UK law. Under the Human Rights Act 1998, pregnant women have the right to receive maternity care and to make their own choices about that care. It’s not a case of “I’m not allowed to...” and more a case of “I’m not consenting to...”.

I’m not suggesting that all maternity caregivers are there to bully you in to doing what they say, or that they don’t have your best interests in mind. Far from it. But it’s important to understand that hospitals have guidelines and a certain level of risk they’re willing to take, and those guidelines don’t always align with what’s best for mother and baby. Sometimes they don’t even align with what’s recommended by the world health organisation or NICE guidelines! The medical setting itself is counter productive when it comes to an environment that encourages the release of birth hormones and the progression of a natural labour. So it only stands to reason that further medicalisation and intervention in birth is likely to cascade in to further intervention, on the recommendation of the hospital. So it’s vital that with every intervention, procedure and option in birth, you’ve taken the time to understand what that option is, what the pros and cons are, the risks and benefits, and you make an educated and informed decision based on what you’ve researched, not just because someone told you you had to do it this or that way.

Charity birth rights says:

“Women have the right to make their own choices about how they manage their pregnancy and birth.
 
Article 8 of the European Convention guarantees the right to private life, which the courts have interpreted to include the right to physical autonomy and integrity. 
 
The right to autonomy means that a woman’s consent must always be sought before performing any medical procedure. Failure to obtain consent violates Article 8, and may also violate the prohibition on inhuman and degrading treatment under Article 3. 
 
Failure to provide sufficient, objective and unbiased information for a woman to make an informed choice will also violate Article 8.”

The other issue is that a busy midwife or consultant may not necessarily have the time to sit and explain at length what all your options are, what the risks are, or the benefits, and when option A is the standard route they suggest women take, that’s the one they’re going to present to you. So it’s down to YOU to do the research, educate yourself on your options and advocate for what you believe to be in the best interests of you and your baby. After all, isn’t that what we do after baby is born? How much time and effort do we spend researching car seats, schools, which after school clubs to put them in, whether or not to consent to vaccines. Why is birth the one instance, right at the start of your journey to parenthood, any different? This is also why a hypnobirthing class is so important. I spend a lot of time going through birth plans with my couples, providing them with reliable balanced sources for research and providing them with templates and resources so they can discuss, draft and formulate a birth plan that they feel suits the kind of birth they want.

Remember, YOU provide the consent as to whether something is done to you and your baby or not. So it’s important you understand why something is being suggested, what the evidence says about the proposed procedure, and feel confident to make a decision to either give your consent or not. It’s never ok to be bullied in to a decision, or have the “dead baby card” slapped in your face to coerce you to agree to a procedure or intervention. If you want to know more about your rights in birth, take a look at the recommended reading below.

 

Recommended reading:

https://www.birthrights.org.uk/factsheets/human-rights-in-maternity-care/#choicecare

Give Birth Like a Feminist: Your body. Your baby. Your choices. https://www.amazon.co.uk/dp/0008313105/ref=cm_sw_r_cp_api_i_Q9O2Eb4V77FDT

https://www.aims.org.uk/general/human-rights-law

09 June, 2020