Let me make this clear, just because you are about to have a baby does not remove the autonomy you have over your body; you still get to decide who can touch it, when and how.
I’m even guessing that most of you would think “duh” to this statement. But is this expectation truly being upheld by your doctor, midwife, nurses, or anyone one else on your healthcare team?
For example, these things are not ok:
· Someone walking in your room and announcing, “I’m going to check your cervix now.”
· An OB cutting an episiotomy without asking for permission or even telling you what’s about to be done.
· A provider stripping your membranes or breaking your water mid-vaginal exam without explaining the additional procedure.
· Anyone’s fingers or hands touching your vulva or vagina at any point in the process unless they’ve explicitly communicated with you and received your permission.
You signing a general consent upon walking into a hospital does not excuse any of these misbehaviors.
Instead, true consent goes more like this:
Your nurse or provider should always explain what they would like to do, the benefit of performing this step, the risks that might be involved, any alternative options available, and what might happen if nothing is done at this time. Then – and this is key – you as the birthing person must be given the opportunity to give them permission to do whatever step you mutually agree on. AND if you choose something they don’t agree is best (including doing nothing at this time), they must respect the decision you make even if it’s not the one they think you should make.
At the end of the day, only you have to live in your body, and you will be the parent to your baby not your provider or birth team. Your healthcare team is (almost always) acting in what they believe to be you and baby’s best interest, but their priorities and values might not always align with yours. As a result, it’s very easy for a healthcare worker to walk away from a birth and call it “beautiful” or “easy” but unknowingly leave a birthing person quite traumatized and dealing with long term physical or emotional consequences. You are the one to live with the decisions made during your pregnancy and birth. It’s time for you to accept responsibility for your body and choices, and hold your birth team to a standard that respects and supports role.
So let’s practice!
Imagine yourself laboring in a hospital room, your nurse walks in and says, “It’s time to check your cervix!” (Notttttt okkkk. But how do you redirect this?)
You then say, “Can you please tell me how the information from a cervical check will change our next step? And are there any risks of repeated cervical checks? Are there any alternatives or what happens if we do nothing at this time?” (Nice work! You’re really getting this!)
They might then tell you, “Knowing your cervical status will help us decide if we should start Pitocin to augment your labor and make contractions stronger. The main drawback is that a check in early labor without an epidural can be quite uncomfortable. You might get some spotting afterwards. There’s always the risk your water might break during a cervical check, but there’s a good chance it would break on its own soon anyway if that happened. If your water is broken, the risk of infection inside your uterus increases. The primary alternative would be to just not check your cervix now – which could delay starting Pitocin and delay your labor and birth. Or your body could do all the work without additional medications.” (If your nurse or doctor doesn’t answer your questions fully, just ask again! Sometimes, it’s easy for us healthcare workers to forget that the birthing person doesn’t have the breadth of understanding about all the things we take for granted! Keep asking until you feel comfortable with whatever decision you make!)
“But what about an emergency?” you might be thinking. I’m here to tell you there is *almost always* time for at least an abbreviated consent conversation. At the very least your provider should say something like, “Baby’s heart rate is dangerously low, I would like to do a vaginal exam to further assess if birth is imminent or if there is something else we could do to help correct this. Is that ok?”
When it comes down to it, I want you the birthing person to remember to use your B.R.A.I.N. – ask for the Benefits, Risks, and Alternatives, trust your Intuition, and ask what happens if Nothing is done.
If you’re really uncomfortable with the options presented, don’t be afraid to ask to discuss privately with your partner or doula and/or ask to reassess the situation in another hour. If a true emergency exists, you will be able to tell in how they respond to your request for more time.
Best wishes birthing! I hope and pray that your birth team provides supportive, evidence-based care that makes you feel empowered and loved regardless of the twists and turns your birth journey takes!
Comments