by Julie Snyder
Have you read any of these recent headlines about birthing, midwifery and childbirth coverage?
"The South Australian Deputy Coroner release recommendations regarding midwifery and home birth."
"In Indiana, a former OB-nurse-turned-midwife was arrested on charges of practicing midwifery without a license."
"If your pregnancy care and birth is covered by Medicaid, your options may be limited to hospital birth only."
If a pregnancy doesn't have any pre-determined restrictions or complications, a woman has the right to choose where she can give birth and how. They can also speak up and request to limit interventions and refuse treatments.
When you arrive at the hospital or birthing center, you're liable to hear the following phrases from the staff: "Sign this..." "Wear this..." "Lay here while we get a base-line printout," and "Hold still while I put in an IV."
It's no surprise that many parents don't realize they can be in charge of their baby's birth experience. They can choose the way the labor and birth goes and their baby's care after birth.
"You're paying the doctor's, nurse's and other staff's salaries, and you deserve to get what you want," says Pregnancy.org expert Kerry Tuschhoff, HCHI, CHt. "If there are true complications, that's when the doctor, midwife or nurses step in and help. Just like being a lifeguard at a pool, no one needs to do anything except keep a watchful eye on things. If anyone's in trouble, that's when they jump in to help."
Your Birthing Rights
Expectant mothers have the right to control their medical care and choose to refuse or accept procedures based on solid information. Knowing your birthing rights allows you to feel more in charge of your birth and empowers you to insist on getting the information you need to make important decisions.
Pregnant moms are the decision makers. Healthcare providers can be liable if they fail to obtain sufficiently informed consent.
Informed consent is when you're given the space to make an informed decision. It also means your're free from coercion and outside pressures. It means giving moms facts about interventions and the risks and benefits of the procedures.
Any diagnosis should be fully explained to you. You should also be told of any alternatives for treatment, what could happen with each alternative, including not opting for any treatment at all.
The person explaining the procedure should be familiar with you and your situation. They should use language you can understand.
Many national and international organizations promote the patient's right to informed consent and refusal, including the American College of Obstetricians and Gynecologists.
Informed consent forms: If you give birth at a hospital or birthing facility, you'll be asked to sign a consent form. Read the form carefully. You can cross things off or add things to it.
It's Your Right to Say "No"
You have the right to refuse any treatment. You can make decisions about birth settings, care providers, medical interventions, tests and drugs for yourself and baby. Even though your rights extend to being able to get up and leave the hospital or birthing center at any time, we don't recommend making that decision. You could put you and your baby's health at risk.
Your legal right to informed consent and refusal means that your treatment in the hospital is your decision. Some hospitals may say that their procedures are non-negotiable. Legally, they are negotiable according to the American Hospital Association's "Patient's Bill of Rights." To avoid conflict, check out all the policies and procedures as you're choosing a provider and birthplace.
Even if you sign a "Consent to Treatment" form on admission, you can change your mind at any time by making your wishes known to your caregivers.
There can be repercussions to refusing treatment. Your insurance carrier might not cover complications or care that results from you leaving against medical advice and your provider may decide not to continue on as your provider.
If you decide to decline the treatment recommended by a medical provider, you'll probably be asked to sign a waiver of liability acknowledging that you are taking responsibility for your decisions.
If you or your baby is in danger, your care provider is authorized to provide care without getting informed consent. If you need an emergency c-section, your doctor can go ahead without spending the time to explain the all of the risks to you.
Who's Taking Care of You?
You have the right to know if you're being treated by a trainee or an intern. You can refuse treatment by healthcare providers who are not fully-trained and accredited.
If you're birthing in a teaching hospital, you can choose not to be observed by students, but you have to speak up with your request and preferences. If you don't say anything, your request won't be heard.
Your Birth Plan
Your birth plan isn't a binding contract. Your care provider isn't required to follow it. Think of your birth plan as a summation of your goals or as a guideline. If an emergency situation arises, your midwife or doctor may need to deviate from the birth plan. If that happens, they will make every effort possible to let you know what's going on.
Just because you enter a birthing center or hospital in labor doesn't mean you check your rights at the door. You're a paying healthcare consumer and can expect your provider, birth facility and insurance company to work hard to meet your needs and comply with your requests and requirements.
Were you aware of all the possibilities? Did you have a less than ideal birthing experience because you didn't know about your rights? Share your story!