Gaaaaaaaaaahhhhhhhhhhhhh. A few of the statements my clients have talked about being on the receiving end of this week.
If your waters break, you’ll need to have your labour sped up.
If you have your labour sped up, you’ll need to lay on the bed to be monitored.
If you tested positive for Strep B (early) in your last pregnancy, we will need to give treatment this time, just in case.
No. No, no no no, no and NO. Just NO.
There is just no excuse for this kind of language, unless maybe it’s an emergency situation. When I asked these clients, “and why did they say that this is important?”, they had nothing. No one had bothered to explain.
Now look, I am no crackpot hypnobirthing purist. I don’t believe that a ‘natural’ birth is superior. You know what I do believe in? WOMEN. I believe in their capacity to weigh up the info, and to make intelligent choices that make sense for them.
And what I know for sure, is that women are far more likely to be traumatised by their experience of labour and birth if they have not made fully informed and supported choices.
Aside from this, legally we cannot give consent unless we have understood the risks and benefits of a recommended procedure.
And ethically? It’s crap. It’s oppressive, it’s patronising, it’s unacceptable.
Another of my clients found herself at an unexpected appointment a few weeks ago, and when she persisted with her questioning about what to expect, and what her options might be, she was met with bewilderment. “I don’t know why you’re getting worried about all of this.” She said it was like they couldn’t understand why she would like to know more about the situation- the expectation being that she would blindly go along with their preferred plan. “I’m not worrying”, she replied, “I’m asking for the information I need to make the right decisions for me”. I mean, this should be obvious, right?
It’s like, ‘Let’s not give the women too much information. lest they dare to exercise their human rights and think for themselves. Instead, we will gently suggest that we know best, and that they should keep their pretty little noses out of it.’
It may be the right decision for you to have your labour augmented if your waters break- there are risks if you don’t give birth within a certain period afterwards. There are also risks with augmentation.
You may be happy to accept continuous monitoring. You may feel that the benefits of upright and mobile labour outweigh the benefits of laying still to suit the monitor. If you’re well supported, you’ll know it’s possible to move around AND be monitored, and so you don’t necessarily have to choose.
You may be happy to accept ‘just in case’ treatment for Strep B- there are some serious risks associated with it, for sure. There are also implications that come with the treatment.
This is not about declining intervention for the sake of it in a twisted act of rebellion.
We must have a recognition that birth is about so much more than extracting babies.
Birth is a transformational life event that can make us or break us. We can emerge feeling utterly in awe of ourselves, our capacity, our resilience and power. That feels AMAZING and stands us in good stead for early motherhood. Or, we drag ourselves forward in struggle, in confusion, vulnerability, feeling disrespected, sometimes violated, even traumatised.
The difference is really quite simple. At every stage of the pregnancy, birth and postnatal experience, women must be afforded kindness and respect. They must be treated as competent, intelligent adults, and their bodily autonomy must be protected.
It’s not consent if we are afraid to say no. It’s not consent if we don’t even know it’s possible to say no.
Good questions for you to ask if you find yourself being told what you’ll NEED to do…
Why is that? What is the absolute risk of that? What alternatives can we consider? What if I decline? What evidence is this based on? Where can I read more about this? Is this the case across all Trusts? What do NICE guidelines say about this? What do RCOG guidelines say about this? Could you take me through the risks and benefits of each option? Could you please write down in my notes the specific risks and benefits we have discussed?
When second time parents come to see us following a difficult first birth, things could almost always have been dramatically improved if they had been given more comprehensive, unbiased info, and been empowered to act on it. They deserved better, and we all do. I’m inviting you to DEMAND better, for yourself and for your baby.
If you’d like to go deeper on this stuff, and equip yourselves with the tools to feel calm and confident in asserting your preferences, and to know your own worth in birth, you can find out about our courses here. From Breakfast Birth Prep at £12, we’ve got options for most budgets, and offer one ‘pay what you can afford’ space on each group- get in touch if you really need it.