Childbirth rights- are you pro-choice?

[Feminist5]

I am sure majority of the ladies who post on the women's rights forum are pro-choice, and support a woman's right to terminate a pregnancy.

My question is more about the woman's rights when she chooses to continue with the pregnancy. Should she have full control over how she gives birth?

I'm not talking about outrageous requests like demanding that a doctor perform IVF and get you pregnant with sextuplets or that a doctor perform an appendectomy or chop off a limb during pregnancy just because the woman wants it.

However, childbirth is a slightly different situation because the baby will come out somehow and I feel liken the woman should have a voice in how and where that happens. It is also quite common for doctors to be biased towards fetal rights and override what the woman feels more comfortable with.

So I am therefore referring to a woman's right to choose how she should give birth, as I happen to think this is a feminist issue.

Do you think women should be able to choose the following (as long as they are fully informed about the pros and cons)?

A home birth?

An elective cesarean?

An epidural?

An elective induction?

Or do you think that a doctor should be able to force a woman to give birth in a way that she doesn't feel comfortable?

Despite the NICE guidelines saying that it is ultimately the woman's choice if she wants an elective cesarean or a home birth, women are still having to fight for these unconventional choices.

Just as it can be disempowering to be forced to stay pregnant against your will, it can also be disempowering to give birth in a way that you don't want

In America women as incubators is more of a reality. www.motherjones.com/politics/2013/05/buckhalter-mississippi-stillbirth-manslaughter

actually no the woman doesn't just have to live with it whatever happens
trained staff are accountable,have professional regulatory bodies who investigate poor practice
your grasp of health care,resource and risk,and professional responsibilities is woeful

badguider Exactly. I struggle to answer the same question myself. The situation with regards to abortion is very similar in many American states. Abortion is legal, but since their is no willing provider women who can't pay to have it done elsewhere have no choice but to continue with the pregnancy. And this, unfortunately, does reduce them to incubators.

scottishmummy

So let's say I am refused a repeat cesarean and effectively forced into a VBAC. The VBAC results in uterine rupture and my baby dies. Will I not be the one to live with it?

Let's say I am tokophobic and I am refused an elective cesarean. If I suffer PTSD and a fourth degree tear, will I not be the one to live with it or will it be someone else?

The health risks of any mode of delivery are faced by the woman at the end of the day, not the person treating her. So obviously she is the one who will have to live with what happens.

In the above two scenarios an investigation into the matter after the fact will be little consolation to the woman.

I know of a really, really high risk woman who had a home birth against advice. She was about as high risk as it gets. Drs told her she was risking the life of her baby and possibly her own.....they weren't exaggerating.

She had a home birth.....it's the one thing a dr can't stop. The woman can just decline to come to hospital. She was well supported my midwives in her decision, once it was realised that's she was sticking by her decision. At the end of the day it was her choice.

scottishmummy Your grasp of reality is woeful.

Viva But at least she was supported by midwives. Imagine if they had refused to attend the home birth! As long as it was an educated choice, it was her decision and I support it.

Is she alright though?

Yes, I'm very glad she was supported by midwives. And she had a lovely home birth!

Yay!

I had an induction at just over 33 weeks actually. I had a risk of a complication from a previous pregnancy recurring, which ultimately could have lead to still birth or severe disability as a result of hypoxic brain damage.

The obstetrician was very against this, wanted me to go full term, and I had to fight to be allowed to do this. The likelihood of the recurrence was very small, but the outcome much worse than problems associated with late prematurity. I preferred the higher risk of a less serious outcome.

The obstetrician thought I was bonkers; should I have been denied the right to make this decision because she disagreed with my logic? Rational adults can come to two different but equally rational and valid conclusions on the same set of facts.

Cost not an issue as I would have been induced at 39 weeks anyway, the disagreement was only about timing.

jedward I am glad you made the choice you felt was best. :)

As I said, you are the one who has to live with the outcome so how can it be someone else's decision?

Clinicians have to make decisions all the time -in all areas of health not just childbirth- the consequences of which other people have to live with! To question that is at best faintly ridiculous. Any operation etc would normally be on the basis of informed consent- as in informed by the expert clinician not google/some half-baked pressure group

no.its not only the woman in the clinical decision making,she'll be supported by team
this is most definitely not a singular decision.its a health decision facilitated by info hcp provides
of course the decision is shared as its assisted health intervention.the mother,the staff,the institution

If a woman asked a Dr for a procedure/operation which wasn't the safest choice and he agreed to do it as she was making an informed choice, if there was a bad outcome the Dr would still be held accountable and could potentially get Into trouble.

hcp,drs are accountable for interventions.this isn't a case mum singularly bear consequence
health interventions outcome affect the individual,the staff,the child
I think op grasp of health,and decision making is woeful,but she's got a line she's sticking too

Jedward I'm glad it went well but cost would come in to it if your baby needed special care.

Some babies don't get the care they need due to lack of cots. If a woman's right to choose means some one ele's baby suffers is that not a feminist issue?

This is a very interesting thread. I'm still in two minds, having read all of your comments.

I think part of the dilemma comes from birth being both medical (complications) and non-medical (normal low risk birth). And disagreements about where the line is. I don't think there is enough evidence about risk in pregnancy for anyone to be categorical about many situations (although some are clearer) - as people have pointed out the policy on VBACs has changed recently.

So, it's a grey area. And also a sensitive area, with new life involved. And also the only major involvement with the healthcare system many people will have until old age. So 'healthy' people are rightly resentful of being 'medicalised' when they may not feel it's warranted.

Clearly, where the intervention of medical professionals is required they must be allowed to follow clinical procedure - they're trained after all and those procedures are designed to keep us safe. However, the standard rules of informed consent apply just as they would for any other medical intervention.

But I think the above circumstances have to be taken into account - it's unreasonable to expect women to go along with medical advice blindly, a higher level of information is required. It's not like breaking your leg, which is more clear cut. And with that goes greater choice about the outcome.

Do I think women should have absolute choice? Difficult.

To refuse treatment, yes. That's the right of anyone offered medical treatment.

To be supported in a natural birth in order to avoid medicalisation of birth, if medicalisation is not justified? Yes.

To demand treatment? No, as that goes over the line into the medical sphere where I think we need to live by the rules of healthcare provision (unless by exercising the choice to go against medical advice, we waive the right to complain/seek compensation if something goes wrong). There's obviously also a cost lens, funds are not infinite for healthcare.

However, all risk factors being relatively equal, women should certainly have a choice between medical options. And much more needs to be done to take the wishes of women more seriously - there are too many stories of women not being heard when they say their pain is unbearable, or they feel that something is wrong with their labour, or that they are terrified of birth.

I think it's an important debate, because approximately half the population will experience this at least once in their lives and it does have a lot of undercurrents about the wider position of women in society. I don't think the current situation is ideal, so I think we need to keep poking things to improve the situation.

I've only scanned the thread, and this is my first time on the woman's rights boards!

Women should be able to make an informed decision. They should be given the knowledge to make their choice. None of this 'c-section is twice as likely... '4 times more likely to die'. Proper facts, with proper statistical numbers. PPs have already shown that by using the 'twice as likely' statement, the actual facts can get twisted, when in reality, it's only 0.4% more risky.

I don't know about 'demanding' certain things....it's not a very positive word is it? But on the other hand, if a woman has been given all the facts, and decides she would like a c-section, why should she be forced to give birth vaginally just because her dr disagrees?

With Jedward's case as well there was a reason why she could argue the early section was warrented. After fighting the Obs agreed to it and everything went well - good outcome which is great.

But imagine a similar scenario if things hadn't gone well. A woman in such a situation may well have turned round and sued/complained. The Drs could say "oh well its what the woman wanted and we thought about it, told her the risks but in the end agreed as there was a reason"

A good lawyer in court would pull a Dr to bits over such a decision. They'd have expert witnesses lined up to say no way would they have done a section at 33 weeks, too much of a risk, blah, blah. That they'd have waited for more signs of the preveious complication repeating itself. They'd have found research to say that the chance of the medical condition been repeated was lower than the chance of the baby being really poorly, etc.

Obviously I don't know the ins and outs of Jedward's history at all so I'm using her case as a loose example.

I've seen sections done at 38 weeks for SPD where the baby has had respiratory distress and spent a long time in NICU. There's research saying that elective sections shouldn't be done prior to 39 weeks unless medically indicated. Again if something goes wrong a lawyer would argue that SPD isn't a good reason. The woman may then turn round and say the SPD wasn't that bad, they would have been happy with stronger analgesia but the Dr offered a section so she assumed it would be safe, etc.

Actually, my baby did have respiratory distress and spent time in NICU. This risk was explained to me. I chose to accept it as being preferable to the risk of still birth, even though the risk of still birth was much lower.

It can't be right that my choice should have been restricted because of a risk I was prepared to take.

Plus the feminism angle here is that my then unborn baby was not the patient. I was.

Is there not some sort of 'waiver' form that you would have to sign if you wanted to go against the Doctor's advice?

I know I had to sign a waiver when I didn't want me and 3 day old baby to stay at hospital (weight loss/BF not being established). After arguing that I would probably find BF easier at home than on a ward with 13 other women and their babies, and the fact that the hospital was a 120 mile round trip for my bloke - I had to sign a waiver saying I was aware of all the facts and if anything happened to the baby it would be 'my fault'.

No, I didn't sign anything.

It is pointless to argue about whether or not doctors can be forced to perform a procedure because that will never happen.

Should women have absolute control over how they give birth? YES.

I have had a miserable vaginal birth that I was forced into and it killed a part of me emotionally. I felt like I had no control over my body and the health care professionals had stripped me of my autonomy and rights. I felt violated and objectified.

My planned c-section in contrast was a peaceful, calm and empowering experience. It felt amazing to be able to choose how I would bring my baby into the world and to take ownership of that decision.

I don't mind doctors getting women to sign waivers if they aren't fully on board with whatever treatment the woman is requesting. Referring the woman to another doctor is also an option. There are ways to work around disagreements! Denying the lady a choice in such a life-changing event is never an option.

It amuses me when women who are pro-choice about abortion say that there is no right to 'demand' treatment. So women can 'demand' abortions but not epidurals/c-sections/etc? Why? Abortions aren't exactly risk-free and doctors can have medical or moral issues with performing an abortion as well.

I've skimmed through the thread and it seems that some people can't understand that doctors can all have different opinions on the same thing.If every doctor was 100% correct and ethical and unbiased then there would never have started the concept of a second opinion.

Doctors are human-they are not God. They can make mistakes and they can be biased for or against a certain kind of birth.

My SIL wanted a VBAC. The first consultant she asked refused because he felt that the risk of rupture was too serious and shouldn't be taken. She persisted and was referred for a second opinion after much drama. The second consultant agreed without a fight because he believed that VBACs were better.

Does that mean either doctor was unethical/wrong? No ! They just had different perceptions of risk and different interpretations of the existing evidence.