Your doctor has years of training and experience and can usually identify issues. However your doctor is usually basing diagnosis and decisions off the “average” or in some cases, what’s easiest for him. He does not know your body, your pain tolerance or the way you communicate or don’t communicate problems. Which means that sometimes, he will make a call which isn’t exactly right for your birth.
Many women forget that they have rights in pregnancy & childbirth. Just like any other situation, no person can touch you or do anything to you without your permission – if they do, they run the chance that you could charge them with assault or sue. Women have been conditioned to believe that the doctor is in charge and they must do what they’re told.
Although doctors, midwives and nurses are trained to do a job which involves keeping you and your child as healthy as possible, not all decisions are made simply based on your personal situation or best interests. Often decisions are based on hospital timelines, policies, or even opening up more patient beds, holidays and the end of shifts.
You have the right to say no to anything or anyone during your birth – a medical professional or trainees. However you also want to develop a relationship with your medical carers so that they are willing to work with you instead of feeling they have to fight with you every step of the way, and simply refusing all the time won’t build that trusting relationship. This article will guide you through the steps of standing up for your rights while still staying on amicable terms with your caregivers.
The Dead Baby Card
This is one of the more common and unscrupulous methods medical staff use to convince a woman that she should make a decision that they’re advocating.
Starting any conversation with “Your baby could/will die if…”
- You don’t have a glucose test.
- You don’t get an induction.
- You don’t have a c/section.
- You want to VBAC.
- You choose midwife or homebirth based care.
- You don’t have an ECV/episiotomy/drugs/other interventions
- Or any other reason.
Is emotional blackmail, plain and simple, unless the sentence is followed by FACTS or anything other than broad generalisations. This is an attempt to make a woman make a decision not based on research, evidence or her own preferences but on fear. The decision may or may not be the right one in the situation, but that is the woman’s choice, based on getting all the facts, not with threats to her child’s life.
Saying No While Still Working Well With Medical Staff
Saying no to a carer who is simply trying to do their job and follow the hospital rules will likely get their back up and make them more difficult to work with. Here are some methods you can use to work with them while still making the best decisions for your own care.
- Plan ahead.
Check with your midwife or obstetrician ahead of time whether your birth plan is manageable. This way you have time to work on either convincing them to let you do what you want, or finding a mutual way of reaching the same goal. If your care providers haven’t seen your birth plan, they can’t tell you if anything in it isn’t supported by the hospital. Here’s a good guide to a natural birth plan. Some common things women want that not all hospitals as yet support, include birthing upright, delayed cord clamping and eating during labor.
- Ask for time to decide.
It’s rare that you’ll be asked to make a decision that can’t wait even a few minutes. As long as it’s not an immediate life and death situation, request that medical staff leave the room while you discuss the decision with your partner and/or support people.
- Ask for a deeper explanation.
If your carer’s reasoning doesn’t make complete sense to you, or you want more information, ask! Make sure you’re informed both of the risks FOR and AGAINST the procedure, and how much having or not having it will cause issues. Ask what happens if the procedure doesn’t work. If you’re worried about what’s involved, ask more questions. Was the answer something neutral like “It’s hospital policy?” Ask to see the hospital policy!
-If I don’t have the procedure, what are the risks?
-If I don’t choose to induce now, and wait a week, what will happen?
-Is this standard hospital practice or specific to my case?
-Do you have any research to back that up?
- Look for a compromise.
Don’t flat out refuse – staff will think you’re not easy to work with and will be less likely to try to accommodate your decisions. Look for a compromise – ask if you can wait an extra hour for the procedure or if you can try a different method.
EXAMPLE: If your doctor wants to do continual monitoring with you laying on your back, ask if you can do intermittent monitoring or use a portable monitor instead, so you can stay upright.
- Acknowledge and explain.
Don’t simply refuse point blank. Acknowledge that you understand why they’re recommending that course of treatment and that you understand the risks. Then explain why you feel you’d rather not make this decision or wait for a later time.
- Get more support.
Having trouble making yourself heard? Feeling passive? Not good at standing up to authority? Get your partner, or a close friend to help you. Or hire a doula who can help support you in what you want and is hired by YOU to support you how YOU want.
- Get a new carer.
If you’ve tried everything but you still feel that every time you refuse to follow the exact steps your carer lays out for you, it’s a huge struggle, look for another carer if it’s at all possible. While many doctors and midwives do their best to support their patients, others care more about their jobs and getting patients in and out of hospital to a timeline. If it’s not working out, do what you need to, to get a carer who makes you feel safe and listened to.