MNHQ here: are you interested in the issue of medical consent during childbirth?

[RowanMumsnet]

Hello

One of the charities we work with, MASIC, is holding an event in London (sorry!) on Thursday 29 November to discuss the issue of medical consent in childbirth, and how that issue ties in to obstetric anal sphincter injuries (third or fourth degree tears that damage your anus, with often life-changing consequences) and the provision of elective caesarian sections.

It's a day-long event (9.15 to 4.30) with panels and debates on topics including:

an explanation of the Montgomery vs Lanarkshire ruling (a landmark case that established a legal standard for women's right to information about risk in childbirth);
a panel on anal injuries in childbirth and what the risk factors are (and what might be the effect of offering more caesarian sections by maternal request);
a panel entitled 'How much do we inform mothers beforehand without scaring?' [imagine there will be some strong MN views on this one...]; and
a panel called 'does consent mean anything when you're exhausted and in pain?'

Throughout the day, people who come along will be able to contribute and ask questions and generally make their views known.

Tickets are £40, or £25 for students or women with obstetric anal sphincter injuries. You can book tickets and see more info here.

We thought this would be of interest to some of you - and of course the issues being discussed are likely to interest lots of you whether you can attend or not - we at MNHQ are thinking about doing something in this area (what does it mean to give meaningful consent to procedures in childbirth, and what's the best way to ensure that women have all the information that they need to give meaningful consent) - so as ever please let us know what you think.

A member of MNHQ will be going along to represent your views, so give us a shout if you buy tickets and would like to have a coffee on the day.

Thanks
MNHQ

Tbf with the budget you have you could go to footballer and wag land.

I wouldn't but it's personal taste. I much prefer the smaller character properties of Hawarden.

Plus I've found nhs services a lot quicker than my friends who need the same services over the border.

A lot of women choose ELCS to avoid a potential emergency c-section as well. I find this is often ignored and the narrative is ‘choosing c-section over a vaginal birth’ when a lot of women may have looked at their hospital statistics and seen that, in their situation, they have a 50% chance of an emergency c-section if they attempt a VB so instead decide to have an ELCS to avoid this, rather than avoiding a ‘natural birth’

@Triskelion

I think your posts conflate two distinct issues - the first is whether women have capacity to give informed consent whilst in labour. The second is choosing an ELCS over attempting labour and vaginal birth.

I absolutely agree (as lots of people have said on the thread) that many women simply aren’t capable of giving informed consent in labour. I certainly wasn’t - there was a point during mine when I probably would have consented to having my arm removed if it would have stopped the pain. I remember being given a card to read which explained the risks of epidurals. I couldn’t get past the first line. (Couldn’t get an epidural either - like you, nature took its course).

The issue of women choosing Caesarean sections is an entirely different one and I really disagree with your remarks about that. I really don’t think many women choose sections because they think it’s the ‘easier option’. It’s a subjective assessment of risk. For example, a women who only wants only only child might attach greatest weight to the risks of brain damage to the baby from a botched vaginal delivery and to the risks of a third or fourth degree tear from a vaginal delivery. But a women who wants four or five children might attach greater weight to the risks posed by repeat Caesarean sections, and prefer to attempt vaginal delivery.

I wondered about this when I was asked if I wanted an internal when I was 5 in 10 with a back to back baby. It was my 'choice' but no pain relief allowed until 4cm dilation confirmed by an internal.

They were the single most painful experience of my life and my care was made dependent on my consent to them which still makes me wonder if it was consent at all.

I “consented” to an emergency CS. At that point I was so out of it that I would have signed absolutely anything, there is no way my consent could be described as informed in any way.

Yes, same here.

I would like some awareness raising on the idea that medics will 'allow' or decide on birth methods. For my second birth I was far, far better informed, and ended up explaining to a (junior) doctor that it wasn't up to her how I gave birth (I'm sure she hated me for it, but doctors should be completely aware that procedures require the consent of the patient and aren't their choice).

Some women might even elect for a c-section just to avoid natural birth. That's not really sensible

It is sensible when it halves the risk of stillbirth and that's your top priority

I'll be attending. Looking forward to it. Will be wearing Posie Parker's Mother T-shirt.

Hi I recently came off my contraceptive patch on the 18th October according to the leaflet and where I was in the patch cycle I wasn’t covered from the next day being the 19th at around 3pm (24hours) I had a withdrawal bleed around 3rd till 7th November and light pale when wiping once yesterday I’m just wondering the chances of me being pregnant and when would you ladies test

I find it so sad to read these stories of lack of consent.

When I gave birth to my son, it was a long process with every intervention under the son other than a csection. I managed to get him out with a final push, forceps and a spinal in theatre

Prior to them making the plan for me to go to theatre, a consultant came to see me and insisted on putting my legs in stirrups for an external examination. I was in so much pain and she refused to believe it. She insisted I wasn’t in pain because of the epidural I had had. This was despite warnings the epidural may not ‘take’ becuase I have scoliosis and also the fact that it had been inserted while my husband and the doctor had been swatting away wasps from a wasps nest while it was being inserted!

I got into a real argument with the consultant where it was like she saw it as a battle of wills.

“It hurts, stop.”
“It doesn’t hurt. You’ve had an epidural.”
“It does hurt, a lot. Ouch”
“It can’t hurt. I need to do this”.

It went on until I gave my husband a bewildered ‘help me’ look and he knew I was deadly serious and he told the doctor very forcefully that she was to stop. Things were very heated at this point. She left the room with the midwife, regrouped, came back in and told me they were going to prep me for theatre.

In theatre, after I had given birth to my son, the same doctor was stitching me up. I apologised for kicking up a fuss. 😡 It makes me angry to think that her attitude made me think I was the one in the wrong.

I gave birth to my daughter at home after a planned home birth. It took 2.5 hours from start to finish, I used hypnobirthing. The midwives were completely respectful. I didn’t have a single internal examination. I lifted my daughter out of the water, my husband held her, we snuggled now on the sofa and my 22 month old son held her. We stayed there for two hours before the midwives came in and asked if it was OK to weigh her. It was a completely different experience. I completely trusted the home birth team. Had they told me I needed a particular treatment I would have trusted them 100%.

I’m pregnant with child number three. I still get very upset about birth one. At the end of the day I got my beautiful, healthy baby boy but the whole experience was so stressful. I feel robbed. I dread the thought of having to give birth in a hospital and worry that for some reason my plan for a home birth will have to change. If it starts at home then I get to keep the homebirth team midwives for the duration and I trust that they will advocate for me along side my husband (who was bloody fantastic in birth one).

I have only read page 1 and have to say that my experience was very similar to @dinosauratemydaffodils.
I remember being induced and things happening very quickly. DS was stuck and his heart rate was faltering. I couldn't feel to push after having an epidural. I was rushed to theatre and remember someone forcing me to sign a form there and then. Had no idea what it said. I was shaking all over and away with the fairies. It could have said that i will not pursue legal proceedings if anything really bad was to happen. As it was, DS was pulled out and survived it. I had a very nasty 3rd degree tear, lost nearly 2 litres of blood and had to be stitched back up afterwards which took hours. I vowed never again and meant it. We were lucky.

I actually can’t face typing out fully my experience with midwives with my first but needless to say it involved being laughed at when my waters broke (induction), not listening countless times when I said it was moving along, begging the trainee student with the for help with the TENS machine and then haemorrhaging in the pool which wasn’t noticed. I had a third degree tear, needed several transfusions and was offered no support. The only reason I didn’t take it further was because my child was unwell.

Hi a bit off topic. But has anyone experienced this yet or is it just me? Had my baby Wednesday morning back home Thursday afternoon. My partner (babies dad) its almost like he's scared to touch him or pick him up. He hasn't held him yet. He wanted a baby and he Is being helpful on his own way he had all the baby's baskets clothes monitor grow egg night light etc set up for him coming home and he goes and gets things I need for the baby when ever I ask no issues. Just wonderd if this is slightly normal with a man that's had nothing to do with a baby before? Cheers

I saw the midwife at 37 weeks who sat in front of me and told me if I went more than 10 days over I 'had' to be induced. She then picked up the phone and booked me in for it at 41 odd weeks when I was sat there saying no, that wont be happening.

She said it will. You wont have a choice, she said. Wtf

@Louise2111.. Congratulations on your beautifull DS! . So my DH had no choice with DS as i was being stitched up he held him for ages and that helped him bond
When we got home it was awful but we got used to it and my maternal instinct which was missing in hosp, soon kicked in. I think it can be such a shock at first that you feel kind of numb and like wtf do i do now?! You're suddenly responsible for this tiny being and even holding him can feel terrifying! I think that's what your DP is doing thru. It is a massive life changer! He just needs time. He sounds like a great support. Just keep talking and you'll be fine. Good luck x

In my mind there are two separate but obviously very intertwined issues here - being informed and consenting.

I was horribly uninformed about induction and I do place a lot of the blame there on the NHS midwife who led the antenatal classes. She said nothing about induction, her whole schtick was that intervention should be avoided at all costs. All she said was that it just meant bringing on labour, nothing about the processes or why all these magical breathing techniques might suddenly be rendered useless (in my case because there was no break between contractions). If I had had a bit more of an idea about what to expect and how it might differ from the ‘normal’ labour that was all anyone talked about, I might not have felt like such a fucking failure when asking for an epidural as they put the induction drip in, after 48 straight hours of those fucking pessaries. I had obstetric cholestasis so I wasn’t going to refuse my induction but I wish I’d known that I wasn’t just a wimp.

I ended up with forceps and again knew nothing about them or the risks they entailed. The midwife giggled as she declined to show us the forceps in the antenatal class because they’d given us nightmares.’ So when I was still shitting myself a fortnight after delivery I was terrified that this would be me for life.

WRT consent, I was asked for my consent re forceps when I was in a great deal of pain after the epidural had worn off and I can’t remember signing anything but at least I was asked. One thing I absolutely did not consent to was some random arsehole midwife/nurse/whatever turning up my drip until I was screaming, without asking. Thankfully the very kind midwife who was actually looking after me turned it back down.

@Triskelion I'm curious as to where the evidence is that there are women choosing to avoid vaginal birth for the sake of it - do you have any sources to back up that claim?

I'd also like to know why it matters if a woman chooses CS over vaginal for no reason other than she feels that's best for her and baby? Given the amount of information women take in about birth throughout their lifetime until they are pregnant themselves, e.g., stories about their own birth, sex education, biology lessons, stories from family/friends, cultural expectations, religious expectations, TV/movie storylines, documentary programmes, news stories, etc.

There's so much information that 'for the sake of it' is very likely to have been influenced by many sources, even if the woman herself cannot articulate it, rather than just a whim.

* I'm just going to cut you now, Roly.' In what universe is that an acceptable thing to say? *

In a hospital. Where they are medical professionals and dealing with life, death, sickness on an hour by hour basis. Yes there will be mistakes made but I was also “told” that I was going to be cut. It didn’t cross my mind to argue. I was trusting them to help me bring my baby in to the work. Not something I had experience of whereas something they’d done multiple multiple times.

I've got a scan on Wednesday to determine how my baby is born, it's breech at the moment and they say they might want to induce me first week of Dec. I really do not want that, my last birth was horrific and I'm getting panic attacks so bad I'm throwing up, me and son almost died and I'm terrified of another vaginal delivery, yet they seem reluctant to give me a c section

* I'd also like to know why it matters if a woman chooses CS over vaginal for no reason other than she feels that's best for her and baby?*

Because a CS is surgery, which comes with risks, and so the decision most should not be simply a case of “I want therefore I get”

Being 'told' is not consent lovemenorca. My elderly relative had a minor fall. She was told in hospital she needed a catheter. She didn't think to argue. There was no justification for it. She hadn't broken any bones and could walk with help. It was for nursing convenience. She developed a serious catheter-acquired infection and nearly died. She's also now incontinent and has to spend a fortune on tena products. 😡

Do you not think women are clever enough or to be trusted enough, to have researched the operation they're asking for and weighed up the risks?

That was to love.

* Do you not think women are clever enough or to be trusted enough, to have researched the operation they're asking for and weighed up the risks?*

A few hours googling puts you on the same level as a doctor, even the most junior of which will have studied for 7 years?

Love why do you assume women haven't thought about it first? Why do you assume they aren't aware of surgical risks? Why do you assume those risks outweigh the risks of vaginal delivery for the women involved? What's wrong with 'I want' when it has been well considered? And, if the experiences on all these threads are anything to go by, even being well considered and researched and aware of the risks, you still often have a fight on your hands.

Education, informed consent and the right to choose the risks we're willing to take. That's what women should be given but are all too often denied.