There are often situations in a birth space where snap decisions must be made, where deviations from ‘the plan’ are recommended and interventions take place. Usually these situations feel highly fraught, the care team can appear extremely concerned and you are swept into agreeing to all of the recommendations for the sake of you, your partner or your baby.
In rarer cases people may be left feeling they have no say, no option, no control. Their care team are either incorrectly telling them what they must do or they are coercing interventions which a birthing person may not want or fully understand.
In either situation you have a wonderful tool you can use:
Ask “Am I / Is my partner or is our baby in immediate danger?”
This question is an effective way of assessing exactly how much of an emergency the situation at hand is.
There are, of course, two potential answers. Lets take the first:
In this instance its pretty clear that the health care provider deems you, your partner or your baby to be in a highly risky situation. Their medical opinion is that immediate intervention is suitable.
Regardless, you deserve to understand exactly what their concern is, why, what they are advising you do, why and what the risks & benefits are. This can be a very swift conversation but understand that you have every right to this information and that the ultimate decision on how to proceed is STILL YOURS.
Only with the appropriate information can you and your partner make an informed decision. Make no apologies for asking.
I would also suggest asking that they immediately note down the discussion which has taken place and they they sign their recommendation. You may wish to read this over to ensure it sums up the conversation. If you are unhappy with their opinion, notes or anything else you can ALWAYS request a second opinion.
The alternative is of course - No.
Feel the urgency & tension lift from your body as you realise that this situation is not the ‘life or death’ it may have felt seconds ago.
From here you can breath a little slower, feel yourself settle back down. You have time to consider all options and discuss them fully with your care team and then again with your partner.
I recommend using the acronym BRAIN to assist you in these conversations.
B - Benefits
What are you suggesting & what are the benefits to this.
R - Risks
What are ALL the risks to what you are suggesting? (Dont let them only tell you about the risks of NOT following their advice). Most interventions carry some level of risk, I would be very sceptical if my care provider were telling me something is risk free. (Consider doing your own research or calling the AIMs helpline - they’re open late and will happily chat to you even if you’re in labour).
A - Alternatives
What are all the alternatives to what you are suggesting. There are usually other pathways (e.g. Intermittent monitoring as opposed to continual. Observing maternal behaviour rather than multiple vaginal examinations) the most commonly used method isn’t always the evidence based one.
I - Intuition
What does your intuition tell you? Do you feel that all is well? Or are you concerned about something and you dont feel youre being listened to? Take time to check in with yourself and make your voice heard. Your decision is final.
N - Nothing
Is doing absolutely nothing a reasonable option? Is giving yourself a little more time with no interference, fuss, pressure something you’d welcome? If so, youre more than entitled to decline all of the offered care and proceed.
I also suggest you ask for time alone (with your own partner/s) to come to your decision on how best to proceed without any pressure or coercion.
Having the presence of a doula with you in these situations can make the communication must clearer, calmer and less tense. You have an advocate there who can communicate your decision, ask relevant questions and encourage you to speak your wishes with confidence. Usually doulas have enough knowledge in where to access reliable evidence based information that they can support you as you research your care too. You will feel the benefit of an independent professional by you and your teams side.
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