What is Informed Consent in the Birth Process?

Informed consent is one of those hot-button issues…but what does it mean in real terms and how does it differ from just giving permission?

Consider the following real-life example:

Christie was in labor with her first child when she entered a Lower Mainland hospital, birth plan in hand. The labor was progressing normally but she had been in labor for more than 12 hours. She asked for an epidural to ease her pain and allow her to sleep. Christie awoke sometime later to see a nurse inserting Oxytocin into her IV line. Oxytocin greatly increases the strength and frequency of contractions and is often used to induce labor.

What’s wrong with this picture? The drug was ordered by the doctor and administered by the nurse without any discussion with Christie. How can you give consent or permission when you are asleep? Some healthcare providers, unfortunately, presume that by virtue of the fact that you are in the hospital with an IV running, you have given implied permission to receive treatment.

As a result of the Oxytocin, which she would have declined had she been awake, the baby became distressed and a c-section was required. Luckily, both she and her newborn son were fine.

So, what’s the difference between permission and informed consent? Permission is just a yes/no response to administering a treatment. “The doctor would like you to have this medication.” A woman may agree, simply because she’s in too much pain to argue or ask questions, or may feel rushed or intimidated. To follow the rules of informed consent the treatment provider must explain the following:

-Which medical condition they want to treat

-What type of treatment they want to use

-How it may help you

-What the risks of treatment may be

-Other possible treatment options

There is a huge difference in the 2 methods of communication. The second one empowers the woman to fully understand the issue and all the possible options. At that point a woman can then agree, decline, ask for a second opinion, or take some time to consider her options.

What’s really interesting to note is that Informed Consent is actually a legal requirement in the province of BC. The law even specifies that a woman must be respected for her decisions and her right to refuse treatment.

How best to prepare yourself?

It may seem obvious, however, having accurate information is critical. Learn as much as you can about labor & delivery, including all of the options that may be presented to you. Remember that you could be making decisions in a highly emotional state where pain can potentially cloud your judgment. This is a very challenging time to try to absorb new information!

It is often recommended to have a written birth plan that outlines your preferences for the type of birth you want to experience. It is also important that you surround yourself with care providers and family members who respect and support your plan and want to work with you.

Labor and birth is an exciting and intense time in a woman’s life and sometimes things don’t go according to the birth plan. Don’t hesitate to ask how urgently you need to make a decision. If it is not an emergency situation, keep asking questions until you are sure about what you want to do. It is your right to do so and it ensures that you will be fully involved in all aspects of this amazing process.

As a result of her experiences during labor/delivery, Christie Weber trained and certified as a birth doula.  She loves all things birth & baby related and is a passionate advocate for a women’s right to choose her birth experience. Christie is also the producer of Birth Fair, a pregnancy/birth trade show set to take place on March 3 & 4th at the Cloverdale Agriplex. Please visit www.birthfair.com for more information.