When it comes to feminism, advocating for our rights in pregnancy and birth choices (because birth is a feminist issue, no matter what ‘branch’ of feminism you believe in’), nothing, NOTHING, makes me sadder (or angrier) to hear than
‘I wasn’t allowed…..’
Before we go any further, let me tell you one thing
The only person you can allow or disallow you from doing anything, is YOU.
You have choices. From the moment you learn you are pregnant, you are in control of what happens to you and your body. There is not one appointment, test or scan that is compulsory – heck, by law you don’t even need to see a midwife during your pregnancy if you don’t want too. Most people will want to though, and that’s great – they are there to help monitor your health and the health of your baby, and the majority of the work they do is invaluable.
Of course, not all choices we make hold such huge weight, but they are your choices to make all the same. If you are informed in your decisions, then it doesn’t matter whether you opt in or out of an appointment, test or scan. What matters is that you were presented with fair, unbiased information and given time to think about what you wanted to do. Can our health professionals honestly say this happens? Unfortunately, we are in a culture where health care professionals are forgetting they have a duty of care to present us with all the available options (and not just the ones most convenient to them), with women being too scared to deviate from the norm (or not being aware that they can). Never mind when an educated, well researched and informed decision is belittled by the health ‘professionals’ and scare tactics are used to try to coerce women to comply.
Induction of labour is the most obvious case in point here. NICE guidelines state that women should be offered an induction of labour at 41-42 weeks OR expectant management (scans, daily monitoring etc) – this very rarely happens. Locally, women are now being offered induction when they reach 41 weeks. Those who do opt for expectant management will be counselled on the risks of declinining induction. For some, the risk is too much and they will choose to be induced, for others, the many risks of induction outweigh the counter statistics and they choose to continue with their plans. If you were offered induction, were the risks adequately explained to you? Was it explained that if induction failed you would have to have a caesarean? Were you offered expectant management as an option?
You may find you are denied birth options due to your weight or previous pregnancy issues. A BMI that may deny you access to the midwife led unit in your nhs trust, may not even register as a problem for another – how does a postcode change make you higher or lower risk? The answer is, it doesn’t. Women with high bmi’s and those who are having a vaginal birth after caesarean can (and do) birth at home – yet would often be admitted to the high risk labour ward if they were to go in to hospital. Often, the interventions put in place in these ‘high risk’ labours, often end up causing more issues (constant monitoring leading to lack of mobility, reduction in pain relief options, leading to lack of progress, leading to caesarean) than if they were to be treated as low risk. But these women won’t have been told they have options, or they will have been denied permission for a home birth. You don’t need permission. Health professionals can advise, but the decision is yours and yours alone to make about where and how you birth.
Even if you choose to birth in the hospital or midwife led unit, you are still in control. You don’t ‘have to’ lay on the bed or have vaginal exams or not have anything to eat or drink. They can’t arrest you for not doing what you are ‘told’! As well as making informed decisions about your care, you also have the right to give or withhold informed consent – not one person should be touching or examining you without your expressed consent. And no means no – if you ask a health professional to stop, they must stop that very instant. A wise old midwife called Mary Cronk created some good phrases to be used with health professionals if you feel you are being railroaded in to making a decision, or that your wishes aren’t being respected.
Another great acronym to remember is BRAIN
Ask your care providers the following to help you make an informed choice about what they are suggesting as a course of action – whether it be in pregnancy or in labour
Benefits – What are the benefits of this procedure? How will this help me/my baby/my labor?
Risks – What are the risks of this procedure? How might this negatively affect me/baby/labor?
Alternatives – Are there alternatives to this procedure? Are there other options?
Intuition – What is my gut feeling about this?
Need Time, or Nothing – Can I delay this procedure and take some time to think about it/Discuss it with my partner? What will happen if I choose to do nothing for now?
They should be more than happy to answer your questions. It may well be that you decide to go along with their suggested plan – but it will be on your terms. Being listened to, having your wishes and choices respected, and being an involved participant in your care will help you feel in control, and therefore more able to deal with your feelings afterwards, whatever the outcome. If you only read one book in your entire pregnancy, make it Am I Allowed? by Beverley Beech. AIMS is a fantastic organisation who advocate for the rights of pregnant women tirelessly – they are the people you need to contact should you ever be faced with your human rights being breached during the duration of your care.
“Under the Human Rights Act, pregnant women have the right to receive maternity care and to make their own choices about that care. The standards of care they are given must respect their dignity
The Human Rights Act protects dignity, privacy, equality and autonomy and requires all public bodies, including hospitals and Social Services, to treat pregnant women with dignity, to obtain their informed consent and to respect their decisions.
The UK has also ratified the Convention on the Elimination of Discrimination against Women. This prohibits pregnancy-related discrimination and requires the provision of healthcare for pregnant and lactating women.
AIMS works with women on many issues that are covered by Human Rights legislation.
- the provision of adequate maternity care
- the invasion of privacy
- coerced consent
- unnecessary or unexplained medical interventions
- a disregard of a woman’s choice of
- how or where her birth takes place
- her birth partner
- her medical care giver
- her right for unassisted birth
- a lack of respect for women’s dignity
- procedures carried out without consent
These and many other situations may violate human rights and do lead to women being degraded and disempowered.
AIMS works closely with Birthrights, a charity dedicated to promoting respect for human rights from the legal perspective – www.birthrights.org.uk“
We shouldn’t have to fight to have our human rights respected while we transition through one of the most magical, yet bewildering experiences in our lives. We should be able to trust our care providers implicitly that they are allowing us the opportunity to walk our own path, to make our own decisions surrounding our birth choices, and not leading us blindly down one that suits them best. Without a doubt there will be times when we need their intervention, where their intervention will save you or the babies life – but this doesn’t mean we need to follow blindly, never questioning why or how. For any other major health ‘event’, we would want to know what was happening, when, how and why – when did we get so institutionalised when it comes to pregnancy and birth?
I’d love to hear about your experiences – were your wishes respected? Were you told you weren’t allowed but were never really told why? Were your wishes ignored, or consent not obtained for procedures? Please leave me a comment!Your body, your pregnancy, your labour, your birth, your baby – make the right choices for YOU – don’t be afraid to stand up and ask a question, ask it again if they can’t answer to your satisfaction, and ask it to someone else if you need too. You AREN’T being a pest, you AREN’T going to annoy anyone, and your care WON’T be compromised by wanting to know the facts.
*You may have seen this post previously, but after reading this post yesterday, I was inspired to share it again!