Advocating for Informed Birth Choice

Advocating for Informed Birth Choices: A Case Study

Ms. Mama wants a natural birth that is not interfered with, unless there is an emergency.

Today, one of my clients faced a challenging and disempowering experience at her OB appointment.

She's been under the care of a providing office, but she's not seen the same provider twice. It is always someone different. Today was no exception. She missed the standard 38 week biophysical profile ultrasound two weeks ago. They didn't bother with rescheduling because well, that's allowed, ultrasounds are optional.

They made it to their regularly scheduled OB appointment, and ya'll.... You'd have thought ultrasounds are mandatory for someone wanting a natural birth.

Doc recommended inducing labor immediately. He explained that without the ultrasound, they couldn’t confirm if the placenta was functioning properly and warned that if the placenta failed, the baby could die. Without providing any further diagnostic options. Doc even called labor and delivery to prepare for the induction.

 WHY would he not recommend she go get the ultrasound?

WHY would he make the decision to induce for them?

He didn't explain the benefits, risks, or alternatives.

He spent 10 minutes with them and told them the baby might be dead because they missed the last ultrasound. He didn't even touch her belly! I doubt he looked at her in the face! Who can relate to that?!

This situation is a prime example of why advocating for informed birth choices is so critical. Let’s unpack what happened and how we can empower parents to navigate these moments with confidence.

What Went Wrong?

1. Lack of Diagnostic Evaluation

   • The doctor did not suggest an ultrasound or other assessments like a biophysical profile (BPP) or non-stress test (NST) to evaluate the placenta and baby’s wellbeing. These tests could provide valuable information without jumping straight to induction.

2. Fear-Based Counseling

   • Statements like “the baby will die” without providing evidence or discussing alternatives can be overwhelming and unnecessarily frightening. Fear-based tactics often leave parents feeling they have no choice.

3. Coercion and Assumptions

   • Calling labor and delivery ahead to prepare for an induction before the client had time to process or consent to the recommendation takes away their autonomy.

4. Failure to Respect Patient Autonomy

   • Every parent deserves to make informed decisions about their care. This includes understanding the risks and benefits of all options and being given time to weigh them.

     
     

Lessons and Takeaways

1. You Have a Right to Ask Questions

   • Parents should feel empowered to ask for clarification and explore alternatives. For example:

     • What specific risks are involved in waiting?

     • Can additional testing be done to confirm the need for induction?

     • What are the potential risks of induction at this stage of pregnancy?

2. Informed Consent is Key

   • Induction is a significant medical intervention that comes with risks and benefits. Ensuring parents have all the information is critical to making the best choice for themselves and their baby.

3. Second Opinions are Valuable

   • When in doubt, consulting another provider can offer fresh perspectives and additional options.

4. Advocacy and Support Make a Difference

   • Having a doula, partner, or trusted friend present during appointments can provide emotional support and ensure all questions are asked.

How to Advocate for Yourself

If you ever find yourself in a similar situation, here are some steps you can take:

• Request Further Testing: Ask for an ultrasound, BPP, or NST to gather more information about your baby’s condition.

• Ask for Time: You are allowed to take time to consider your options unless there’s an immediate, life-threatening situation.

• Seek a Second Opinion: Don’t hesitate to consult another provider for advice.

• Bring a Support Person: Having someone with you can help you stay grounded and ensure your voice is heard.

Conclusion

This story highlights the importance of informed decision-making in birth. As a parent, you are the expert on your body and your baby. While healthcare providers offer invaluable guidance, the ultimate decisions should always rest with you. By asking questions, seeking clarity, and advocating for your rights, you can take charge of your birth journey.

Your birth. Your body. Your choice.