Find out your legal rights during pregnancy & childbirth - new Mumsnet & Birthrights factsheet

[MylinhMumsnet]

Hello

Judging from countless MN threads over the years, it's clear that many mothers are unsure of what their legal rights are during pregnancy and childbirth, and how they exercise those rights. Questions range from "Can I have a home birth?" and "Can I refuse an antenatal check-up?" to "Can I request an elective caesarean after a vaginal birth?"

We've been working with a new charity, Birthrights, to bring you this Factsheet on your legal rights during pregnancy and childbirth. We hope that you'll find the factsheet useful and, for new mothers especially, empowering.

We also think that, if pregnant women are clearer about their rights, it will make working life easier for hard-pressed midwives and obstetricians. So this is by no means anti-midwives, in fact Birthrights works closely with midwives and doctors as well as with patients to provide them with support and information.

Take a look at the factsheet now or post your thoughts/feedback below.

Thanks
MNHQ

It's ok - but how is this information going to be given to women? If it's just on the website, then IMO it's next to useless as this information is ALREADY all available on the net to women who search for it.

Many women assume there's no choice, so don't search for it. To be really useful, it would be better if it was included in those bloody Bounty packs that you get at your booking in appointment.

Also, the 'can I have a homebirth if I'm high risk' bit is very woolly. It needs to be clearer 'yes - you CAN book a homebirth even if you are high risk, but it would be sensible to educate yourself about the risks specific to you'. To me, it still sort of dances round the edges of 'well, the consultants will advise you to give birth in hospital, but they can't really tell you what to do' - I say that as a woman who planned a home birth despite being high risk.

Perhaps mention there's no obligation to see a consultant either, some women are referred as standard and have no idea that they don't have to go.

I also think the word 'decline' is preferable to 'refuse', and that the bit about syntocinon/syntometrine for delivering the placenta is OTT - it's pretty unusual for declining this injection in preference for a physiological 3rd stage to 'lead to her death and/or the death of her baby.' (exception being in case of PPH but even then she can of course decline it and there are other non-pharmacological methods of treating PPH).

It's a good start.

Any chance of getting maternity service websites (hospitals, birth centres etc) to have a link to it?

Like Fliss said, the infirmation is out there if women will look for it. Those who are looking for alternatives, information and choice will find it.

What we need to do is ensure all women are able to access it. Including those who don't know they gave options and choices.

(in fact I'd say declining third stage drugs never leads to the death of the baby. What with it being already born by then and everything!)

It could do with a bit about consenting to intervention or treatment in labour. Can a woman in established labour give informed consent? Who gets to make decisions then?

Can a woman in established labour give informed consent?

Yes, of course she can . Women don't lose mental capacity in labour. You probably need to wait till between contractions but a labouring women is perfectly able to make decisions about her care. Of course, it's best if she's considered all the possible decisions she might be asked to make and done all the relevant research antenatally so she's as well informed as possible before labour, but she can change her mind and give or withdraw consent at any time at all, and for any reason at all.

Yes. But usually only if she has had the information beforehand. And then if she is given the information at the right time, in an appropriate manner. Does that happen?

Having been to the launch of Birthrights - I think it is the "missing link" which all pregnant women can tap into if they are unhappy with how their pregnancy and birth is being managed on the NHS. The big question "But Am I Allowed?" or even not wishing to make a fuss (in case they suffer worse treatment on the day) should not come in to the decisions women make over their own bodies. Birthrights has shown, by taking the country Hungary to the European Court of Human Rights that pregnant mothers and their unborn are ONE, there are no "foetal rights", and that any doctor that tries to coerce a mother into a course of treatment they are unhappy with is ignoring those rights.

This is important stuff. We in Britain, through the work of lay charities such as AIMS, have more maternity rights than any other country in the world - and we should use them!

Midwives agree that positive change in maternity services has to be lead by the mothers - and this is a big step forward to achieve that. Birthrights is even offering Pro-bono work for women who want to challenge the medical establishment with just cause.

emma That's all well and good, and I am support anything that educates women about their choices.

My issue is with how this information is going to get to women. If it's just another website, then it's only there for the women who LOOK for it - those women who think there is no choice won't look as they don't know there's anything to look for.

We can have the most amazing maternity services and rights in the universe but if women don't KNOW about their options, then they're wasted. You can have the snazziest, most informative website in the world and all the online factsheets you could shake a stick at - but how are you going to direct women to them?

Whilst I think any information is useful, it has to be disseminated in a way that is going to reach ALL women, otherwise you're effectively preaching to the converted.

Teggie But usually only if she has had the information beforehand. And then if she is given the information at the right time, in an appropriate manner. Does that happen?

No - and that's appalling. That's where stuff like this factsheet COULD be really useful, but it's only ever going to be useful if it's given to all women and not just left on the internet where only a small proportion of women will find it. Even so, that doesn't, and shouldn't, remove a woman's right to decline any kind of action or treatment during labour.

I agree with Fliss, unless this sheet is given to every woman at her booking in it is only going to reach those seeking information about their rights i.e women who already know they must have some.

I completely agree Fliss.

Well if it's any help, I should be a qualified midwife this summer (if I ever stop procrastinating on MN and avoiding my dissertation ) and I absolutely will make it a central part of my practice to ensure that women have truly informed choice, and are aware that everything we offer is a recommendation only and the final decision is theirs. I've already made myself unpopular with mentors by butting in when they talk about what women are 'allowed' to do to point out that it's entirely up to them what they choose to do. It's something our cohort of students (c.25 of us) feel very strongly about and frequently discuss. So hopefully things are slowly changing, but we're up against a very paternalistic system and old habits die hard.

I think there is alot we can do to make women informed of their rights and choices; by talking about it on here, by sharing to facebook,Twitter or anyother media, by using this information in our everyday lives.. and as Hellsbells has said to stop the damaging language of "let" or "allowed" being used when healthcare professionals, women themselves or others use it to talk about a pregnant women's body, and degrade through language, that women's right to herself.

It might be a good idea to clarify that the factsheet is for people in England. For example, in Scotland NICE guidelines are not applicable.

I did not know that!

Well, NICE isn't a Scottish organisation, but it's not strictly true that NICE guidelines aren't applicable - they are highly respected and used alongside SIGN (Scottish Intercollegiate Guidelines Network) guidance, RCOG guidance, Health Improvement Scotland guidance etc - the various bodies feed into each other's work.

But yes, NHS Scotland is a separate organisation with separate governance and structure and it would be nice if people would be clear when a campaign is UK or England, or applicable to both.

Thank you for the correction, sleepyhead, I did wonder about my post before I posted it, but yours is much clearer :)

Fuckwitter. Look at the RCOG green top VBAC guidelines. No more increased risk of scar rupture after 2 cs.

I'm a midwife, who had to fight fellow midwives for my right to a 'higher risk' homebirth, and expectant management when I got to 42 weeks.

I don't know what the answer is any more. :(

I love it when I get a woman who isn't afraid to say what she wants. She will always get it from me.

I'm only 9 weeks pregnant with DC1, so I've by done loads of research into this yet. So I found it a helpful sheet to look at in one place.

It did leave me with some questions though - what is that injection mentioned for, and under what circumstances might I want to refuse it? By including the question it made me think it must be suspicious in some way, or not always for the best, but I don't have any idea why! Most of the others I could at least guess why people would choose to refuse.

Hello

Thanks for all your posts. We've been following the discussion with interest and Birthrights has kindly sent us answers to some of your questions.

Q: How is Birthrights going to raise awareness of women's rights offline; are you working with patient or midwife groups to disseminate the information in future? (flisspaps)
Q: Are you also working with maternity services websites or the NHS to get this info up? (teggie)

A: Birthrights is very aware of the need to reach out to women and those who provide their care offline and in a way that ensures everyone is well aware of the rights in advance of giving birth. We share your frustrations that it's only those with the time and resources to research that come across this information and changing that i a large part of our plan. We are a very new organisation, run entirely voluntarily at the moment and with small budgets, but we do have big ambitions. Our website is a starting point and is currently the only place with definitive, accurate advice on pregnancy, birth and human rights written by legal experts.

Now that this is up and running we are reaching out through partnerships such as this one with Mumsnet to make ourselves more visible and more women aware of the issues. Behind the scenes we are working with midwives and doctors too and have great relationships with organisations such as the Royal College of Midwives.

Later this year we will launch our first campaign. We can't tell you too much at the moment as we are currently planning and fundraising, but the broad idea is to work with service users and those who care for them to research, brainstorm and pilot a scheme to tackle these issues. We hope it's a scheme that will ensure in time that all women in the UK have this information given to them in a way they can understand, and in good time by their care providers and that midwives and doctors are well trained and supported in these issues. We'll keep you posted.

We will also be planning work directly with particularly vulnerable groups of women looking at the difficulties they encounter and as ever our legal advice service will provide help free of charge to those who get in touch.

If you feel passionately about these issues, please consider donating to our work and we'll keep you well informed about how we are using your donation.

Q: Can you clarify if the advice is UK-wide or for English law only? (jolly & sleepy)

A: The vast majority of our advice relates to human rights law and human rights remain the same throughout the UK, as all countries within it are bound by the Human Rights Act and the decisions of the European Court of Human Rights.

Where advice refers to non-human rights structures such as NICE, this is specific to England, but Birthrights is in contact with lawyers qualified in Scotland and Northern Ireland to ensure we can give advice specifically to women in these countries should they need it.

Thanks
MHNQ