nzpiper's post about peeing on sticks at MW appointments reminded me of how I stumbled across this alien concept of " http://www.mamamaternity.co.nz/mama-maternity-abc/planning-your-pregnancy-care/informed-choice-and-consent/ - informed choice and consent ", halfway through my second pregnancy.

I was at the Homebirth Aotearoa Conference 2009, listening to a woman talk about how she declined to have any form of monitoring while she was pregnant with her third child.  No peeing on sticks, no scans, no monitoring bubs heartbeat, nothing.  Unless she requested it.  She trusted herself to know when things were going well, and to ask to have something checked if she felt she needed it.  Being a rather paranoid type myself, part of me was horrified at the thought of such an approach - in this day and age !  Yet I was also intrigued and a little in awe of her.  I found myself asking "Why ARE we offered all these tests/monitoring procedures/forms of medical intervention during pregnancy and labour?  Do we HAVE to do everything the midwife tells us?  Can we say no, we don't want to pee on a stick today?".

In NZ the “Code of Health and Disability Services Consumers’ Rights” gives anyone (including a pregnant woman) who is receiving any health or disability service, the right (amongst others) to “receive a service only when you have made an informed choice and given your informed consent”.  The website I linked to above provides a good overview of how this relates to pregnancy, labour and birth.  A must read for every pregnant woman I reckon  . 

As Lynda Williams from the Maternity Services Consumer Council http://www.maternity.org.nz/pdfs/INFORMED%20ConSENT%20&%20ANTENATAL%20SCREENING.pdf - wrote in 2007 :

"Pregnancy has now become a 9-month long medical event in which women are encouraged to subject themselves to frequent testing, data collection, and an increasing amount of technology in order to help guarantee a perfect baby, and a painless and stress-free birth.  What impact does this growing dependence on outside technology to confirm her health and that of her baby have on the woman and her experience of her pregnancy?  How does it impact on the ability of her body to care for her baby before birth, to give birth, and to breastfeed her baby after the birth?"

All thought provoking stuff, huh?    So, did you know about informed consent before reading this post?  Do you think you'll approach pregnancy/labour/birth any differently now?  Have you declined any type of medical intervention you've been offered already?

I knew about informed consent with DD's pregnancy but due to health problems I didn't refuse anything. However, this time I will be picking and choosing a little, but will be having all the scans, vitamin K, testing etc. I have refused some medication for what is best for my baby.

Unless you trust your MW fully, never take medications from them without researching. I was prescribed dangerous medication for breastfeeding newborns and it was only a week after welcoming my new baby so don't presume they know best on everything.

Sorry JadeC - I never intended my post to be insulting!  Please accept my apologies.  I was just genuinely interested to know whether it was common practise for midwives etc to explain what informed consent is to pregnant women, as it wasn't spelt out to me at any stage during my first pregnancy.  But I can see from the posts above that perhaps my experience was more of an exception.  And it's great to see that most people seem very aware of what it is .

In my mind this isnt a debate about whether medical testing / science etc has a place during pregnancy - I think its more interesting to know whether midwives and doctors are actually letting you know that you have a choice.

I was aware of informed consent from working in the health industry and in hospitals for a number of years, but also because (like MamaPickle said) I am a grown up and can make choices....BUT I do wonder how many people are seen that DONT know that they have a choice and are effectively bullied into tests / scans that they dont want or dont need. A lot of places in Auckland charge for scans too, so it would be interesting to know how much of their business is from people who dont know that they have a choice. Its a gross generalisation I am sure, but I have certainly never heard a midwife, GP, Doctor or a nurse explain informed consent to anyone.

melissag wrote: I think a lot of people on this website would do a lot of research into decisions they are making but a lot of people don't so assume doctors know best and that everything is a necessity. So while this question may not apply to people on this website it would to a lot of the general population.

Totally agree with that melissag .... I didn't start using this website until my first baby was 7 months old and had had very little to do with the medical profession prior to that pregnancy.  I was so naive back then and thought my midwife knew best.  So I happily went along with whatever she recommended, assuming everything was a necessity (right down to not eating a small box of chocolates given to me after the birth as she insisted it would affect breastmilk and be bad for baby!).  Luckily for me she was an independent midwife who believed in minimal intervention, so I never felt pressured in to anything I felt uncomfortable with. 

Now I've thought about it, yes there are some things I wanted to refuse but felt pressured into because the MW "knew best". I think it's all about confidence and assertiveness and when in labour or hospital with your first it's hard to do that

cuppatea wrote: I suppose what it boils down to is would you be happy if it was "pee on this stick and you have no choice about it" which seems silly but then imagine if you were admitted to hospital and the OB said "I'm gonna do an internal and you have no choice" or" we're gonna give you a c/s and you have no choice" cos if you don't realise you have one or it's not explained to you that you have one they may as well say that to you.

I dont think its as black and white as that though - its not a case of "we are going to do an internal and you have no choice"....its more of "we are going to do an internal." - without explaining that you have the right to ask why or ask about the risks and refuse if you want to. I think its just assumed that people understand that they have the right to refuse or question, but thats not always the case, and I dont think that the medical profession should be so blase about it.