Consent in birth

[Greyhorses]

Hi,
Sorry I am way to early to be asking anything about birth as I am only 13 weeks but I had a conversation with a friend and it's been playing on my mind and I had to ask!

I know I am going to have to give birth, I know it's going to hurt a lot...I have a pretty open mind with this sort of thing however I am struggling with some of the things I have been told regarding consent. I hate not being listened too, I am able to have most medical procedures done knowing if I can't cope I can ask them to stop whatever it is and I know they will. I know you can't stop labour but the feeling of no control is scary!

One friend told me she was cut without permission. She begged not to be and they cut her anyway.

Another told me she had manual removal of placenta and was screaming at them to stop but they wouldn't. She said the doctor literally wouldn't remove his hand despite her screaming in agony.

Someone else told me that she refused forceps but was pressured into it and aggred but they did not use any anaesthetic and she said this was horrific. She suffered post birth injuries due to forceps.

I know every birth is different but it scares me to think I could say no to something or be in lots of pain and they won't stop doing whatever it is they are doing?

How likley is this to happen, is it common or do they listen to women?

Also I really really don't want forceps due to risks of incontinence and injury, can I refuse this alltogether?

Thanks everyone I'm sure you all get sick of people asking over and over

They only use forceps if they really need to. I think it sometimes gets to the stage where they need to use forceps or cut you to keep the baby safe. I didn't do labour as had a section but when it came to it they could have done anything to me as long as I had a baby in my arms in the end,

People love to tell horror stories to pregnant friends. Try not to take too much notice!

As other pp have said people love a horror story so try not to listen. I know that I might get flamed for even suggesting this but make sure that your wishes are written in your birth plan. Also, I agree that at the end of the day the drs and midwives AIM is to keep both mother and baby alive - so if that means cutting or using forceps that is what they have to do... (I stated categorically for my pregnancy - my ds is now 17 days- that they could not use forceps, ventouse or do an episiotomy - but as my consultant said.. Once a baby is in the birth canal if they get distressed they cant be pulled back they can only go forward...

As said, emergencies are a different case, but don't assume that you won't be given a choice when it isn't a life or death scenario. My first labour had a prolonged second stage and the midwife-quite correctly given the protocol they work to-was suggesting forceps but fetched a doctor first. Doctor gave me the option as the baby was fine, and as I wanted to keep pushing I did so until DS came naturally. I tore enough to need stitches in theatre (all healed beautifully) and anaesthetist spent plenty of time ensuring I was OK with a spinal for this. And yes, avoid other people's non-positive reminiscences.

I was really worried about this, especially because the community midwives weren't great at listening to me during pregnancy, but the labour ward staff were fantastic. Everything they did they made sure they were explaining to me what was going to happen and why they wanted to do it, they got my permission before any procedures and before even laying a finger on me, and they did not at any point ignore what I was saying. This was for a birth that included a pretty speedy rush to theatre for a baby in distress, too.

There are certainly bad hospitals and bad staff out there, but I don't think you should expect it to be the norm.

Forceps 3 times and cut once, all without any form of pain relief. Did I want that? Course not, but my babies lives were in danger by that point. After it happened with my first baby, I didnt bother writing a birth plan for the other two.

I've had 3 babies and the most intervention I've had was an internal exam to check dilation.

That is one VE in a total of 3 labours. I don't think they intervene because they want to, but because they need to and time is often of the essence.

You may not need intervention, and if a straightforward pg aim for midwife led unit if you can (or lowest intervention rate setting near you). But if something happens in labour, they will act fast to save you and your baby from harm.

It really angers me to read about stories where women in labour were treated like pieces of meat. Consent should always be sort & a procedure explained even if it's very short notice. I was worried about this with my 2nd so wrote a very detailed birth plan including the kind of birth I really wanted but what I wanted/didn't want in case things didn't go smoothly. I would definitely recommend writing 1 taking into account what interventions you would be ok with if needed. Hopefully you'll get a great mw who will support you.

Am a bit at the number of posts here that seem to be saying that whatever happens in birth is all well and good, so long as the staff are doing it for a good reason.

This:

[b]One friend told me she was cut without permission. She begged not to be and they cut her anyway.[/b]

and this:

[b]had manual removal of placenta and was screaming at them to stop but they wouldn't. She said the doctor literally wouldn't remove his hand[/b]

are [i]not okay[/i]. That is assault. You as the woman giving birth are still a patient, you get rights over your own body, you get to say 'no' and be heard. Consent is not just a luxury we have when everything's going well.

And apparently I feel so strongly about this I messed up the bold and italic tags!

But really, it matters. Good staff know that and they won't ignore you.

Your friends' descriptions of childbirth are so very far from mine... I may just have been lucky, but with my first (complex) hospital delivery, and my second (easy) home delivery, I felt that I was listened to and treated as an individual with bodily autonomy. With both DC I had a birth plan which I hoped to stick to. I also thought about the various ways it could go wrong, and had various alternative plans. With DC1, I ended up on about plan F! However, my midwives explained things at all times, and they helped guide me to make the decision which would give me and the baby the best outcome at that point... not all health professionals are out to undermine you :(

It can and does happen, and I had a lot of the same fears as you OP. I don't agree at all that it is ok to ignore and potentially brutalise a pregnant women in the interest of getting baby out. I included in my first birth plan that I would not consent to an instrumental delivery and was told it wasn't my decision to make!
Luckily DC1's problems in delivery led to an EMC and not a battle over consent. That comment meant I didn't even chance it with DC2 and opted for an ELCS.

53rd Yes! It's not right at all that consent is not always obtained. It's illegal to actually perform a procedure without consent, but you don't usually get anywhere with that as in your notes it'll just say 'consent given' anyway, when you didn't.

I'm sorry if no one agrees with what I put, but if I was the old pregnant me again, I would want to know that sometimes it's not okay. And be told that so I didn't feel like a failure, like a lot of women do...

"Horror stories"? These stories actually happened to women, why dismiss it? I have heard some horrendous things happen, but you need to understand they are worse case scenario. If nothing goes wrong and you are given the right information, you should be fine. But I don't like to tell people they'll be fine, because they might not, sorry. I was told by everyone throughout my pregnancy I would be fine. I was absolutely shitting myself over intervention being used! Started with an easy going labour, about to birth my baby, thought all was fine, I got away with it then it ended in an emergency that left me with injuries without an explanation, episiotomy that I didn't want but consented to because of the panic on her face (she didn't tell me why!) and PTSD for 3+ years (and I didn't know)

It sounds like what you need though is a rock solid advocate, someone that knows your wishes inside out! They don't read birth plans. Things like "EMCS rather than forceps (depending how far baby is down), don't cut me I prefer to tear, tell me what's happening, inform me, talk to me! If there's no time, explain WTF happened afterwards PLEASE".

The only thing that helped me come to terms with my son's birth, traumatised from the rushed decisions, was knowing that his heart rate dropped, twice, and didn't recover, so had they not been quick and rushing and panicking my son may have needed to be resuscitated. Which is what I thought they were about to do! Sometimes it's not picked up on the monitor...

I second having a strong advocate with you during the birth - I had DH for DC1, and a doula for DC2 (DH was at home looking after DC1!) Both times they just checked and questioned what was happening, and then checked with me that I understood (because my ability to grasp reality seemed to slip a bit when in labour).

If it helps, in my birth plan for DC1 I'd said no forceps, no episiotomy. I ended up with both, to save DC's life (not that I really appreciated that at the time). In each case the medic down at the business end came scurrying up to my head and and said "terribly sorry, we know your birth plan says no to x, but we think we really need to do it because y". I vaguely remember replying "JUST FUCKING DO IT, AND GET THIS FUCKING THING OUT OF ME!"

First up, if you say no, no means no it doesnt matter if the reason behind it is seen as valid by a doctor!!

Writing a clear birth plan is really helpful.

Birth does not have to be awful and painful and in hospital. I had ds at home using hypnobirthing and had no interventions of any kind, inc VE for dilation. My mw just let me get on with it.

Stop listening to people, as so many people have bad expereinces, a good birth experience doesnt make for good gossip....

Can I just second topsy's post - good birth experiences don't make good gossip. But can I also add that a good birth experience can actually be any kind of birth? I count both of my births - highly medicalised, intervention births - as good ones, because I was listened to and kept informed, and my wishes (such as they were) were respected.

I'm sorry. I think my post was a bit..
But you need to prepare yourself for things to not go to "plan" - they don't stress that enough I think. If it doesn't, it's not your fault. Really you should be working with the staff to delivery your baby, not them vs you.

It was my first and I had no idea that I'd have a bad time, no one I knew had. One thing that could have changed my experience, and maybe made it positive for me (despite fretting over intervention during pregnancy), is knowing what was happening and why. Even a brief couple of words is all I needed, but didn't get.

zzzz You sound angry like I aimed it at you? I didn't at all, just in general. I didn't say you did dismiss anything. I think I got a bit offended by Double's sentence 'try not to listen'. Sorry if you took it the wrong way because you mentioned them words in your post. A lot of people just say 'don't listen to it' when really we should. Sorry.

And Clobbered actually. I saw them and got annoyed. I realise my post is under yours and you assumed..?

I think from other women's bad experiences others can learn how to protect themselves when confronted with a similar situation. Had I been told a similar story to my first birth when I was pregnant, I would have been able to get the right support and get the right explanations that I needed. But I wasn't told that from the woman's perspective, there is a whole lot more that goes into intervention than it just... being done. The information is out there for the women that have straight forward births but not for the women that end up having a traumatic birth.

If no one listened to these women that don't have a good experience, who will help them overcome their emotions and even birth trauma?

Sorry, I'm a bit touchy about that as I got nothing from anyone when I was suffering in silence on my own. The help isn't out there, it's not put in place. There's no safety net to catch these women that end up with PTSD.