What is Informed Consent?
And how does a doula advocate for you?
When you choose to give birth within the system (through a public or private hospital or one of the homebirth programs), you must be aware that Obstetricians and Midwives will treat you according to the policies of their hospital and state. In South Australia, these are the Perinatal Practice Guidelines, and you can find a link to them at the end of this blog.
The government website states that "The statewide guidelines do not address all the elements of clinical practice and assume that clinicians are responsible for discussing care with consumers in an environment that is culturally appropriate to ensure informed decision-making and individualised care for pregnant women, mothers and their babies.
The emphasis on specific terms is mine. Because although the health departments mention this in their documents, women rarely receive wholly culturally appropriate, individualised care with a real opportunity for informed decision-making.
Let me share some examples.
Is it culturally appropriate care to tell a woman she can not have her placenta straight away for burial because part of a policy says that the hospital must stick it in a fridge for seven days, along with every other placenta born there that week? No.
Is it individualised care for a midwife to tell a woman that the last person she saw with higher blood pressure was induced straight away, so that is what she will need to do also? No.
Has the opportunity for informed decision making been given when a midwife performs a stretch and sweep while doing a cervical exam without asking the woman first? Just because the midwife wanted to "razz things up a bit" No.
Is a decision free from coercion when the unit manager storms into a woman's birth space without introduction, demanding to know why the labouring woman isn't consenting to a suggested course of action? No.
Is it individualised care for a midwife to tell a woman that she will not attend her birth if she doesn't consent to cervical checks, despite knowing the woman has a history of sexual abuse? No.
Has a woman given legally valid consent to have continuous monitoring if the OB only tells her that if she refuses, her baby could suffocate and they won't know about it until it is too late? No.
These aren't made-up scenarios.
My clients have disappointingly experienced them all and I have witnessed the majority of them.
So as your doula, what do I do in these types of situations? How do I advocate for you? It's a question I often get asked.
I know that these are all stressful situations which can interrupt the labour process, so my first action is to remind my client that she isn't alone in this - reassuring her with a touch, eye contact or even a smile to help her settle her nervous system as much as possible.
Depending on the situation and timing of the event, I might also do any of the following:
If you would like to learn more about what informed consent and refusal looks like, you can download the free handout below. Click on the picture to get your pdf and print it out. Hey, you could even take it with you to your appointments if your health professional needs a little reminder =)
My approach to birth-planning with clients draws inspiration from different areas. One of them is goal-planning. Setting goals can be fun, exciting and also stretch you to consider different areas of your birth you might not have previously thought of.
Through my Clarity Sessions, you (and your partner) get up to four hours of one-to-one time with me. What do we go through:
1. Your previous pregnancies and births. Let's see what worked for you and what didn't.
2. The power of emotion - how do you want to feel during your labour, birth and immediate postnatal period?
3. Defining your biggest, juiciest goals.
WARNING: you might be surprised that these are different to what you originally believed.
4. A reality check - are your current actions in-line with your goals and circumstances?
5. Action steps - finally we will nut out specific actions you can start taking straight away and make achieving your goals one step closer.
How do you make your birth-plan unique to your circumstances, powerful yet flexible?
In this infographic I share 5 tips to help you to develop a fabulous, meaningful birth plan. If you'd like to delve deeper with me and get crystal clear on what you want from you birth, book in a Clarity Session asap.
Which of these 5 tips most INSPIRES you?
Let me know in the comments below.
Make the best choices for your birth
We are faced with making a lot of decisions for ourselves and our child during pregnancy and birth. Some couples prefer to let their obstetrician call the shots but many want to feel in control and confident of the decisions around their care.
How can you know if you are getting all the information you need to make an informed choice?
Do you understand what you have been told?
What if you feel uncomfortable with what the doctor or midwife is telling you to do?
As your doula I will find out what your preferences are for childbirth and how you feel about communicating these to your care provider. We can role-play different styles of communication with you and your partner so that when you are faced with making a decision, you feel more confident to do so. I will also talk about various decision making tools to assist you with the myriad of choices available to you.
Here are 10 handy questions to get you started.
Freebies for your birth
Free Birth Affirmations To Print At Home
Birth Affirmations can act as reminders of your birth philosophies, help set a positive frame of mind, relax you and make your birth environment your own.
Print them out, hang them around your home or hospital room as reminders to you and your care providers. Share them with friends
Click on each picture to be taken to the pdf download. Enjoy and have a positive birth
PS If you're local to Adelaide you might like to also join our free antenatal classes through the Positive Birth Movement.
More information is available in our Facebook group www.facebook.com/groups/1394215413942214/
Prepare for an easier fourth trimester with these 25 Secrets From A Postnatal Doula!
Kelly Harper is the owner of Elemental Beginnings Doula & Placenta Services in Adelaide. She provides sleep consultancy, placenta encapsulation and doula services to families during pregnancy, birth and in their fourth trimester.
PREGNANCY, BIRTH & POSTNATAL SUPPORT DELIVERED WITH  ❤  THROUGHOUT ADELAIDE & SURROUNDS