15 Weeks - Prenatal Visit and Plans

Midwife Ina May Gaskin at a prenatal visit.

I keep meaning to blog about my first prenatal visit, and it turns out I have more than that to talk about. Things are coming together, and I'm very excited.

I'll start about prenatal care.

I intentionally waited to schedule my first prenatal visit. Because of my two miscarriages I didn't want to try to find a heart rate at any point when being able to find one would be questionable. For instance, at 10 weeks with a doppler it's possible to get fetal heart tones, but it doesn't always happen. I didn't want to set my hopes up for something that might not work out even if things were still fine. If I hadn't been able to hear a heart beat at that point, it would have only caused more questions and doubts about the viability of my pregnancy, and I couldn't deal with any doubt. I was focusing on the positive and moving forward without fear. There were other factors in choosing to put off my first prenatal visit, but it was mostly that I felt things were OK and I didn't feel a need to have an official visit. I was already consulting with my midwife over the phone, and she had already helped me with some of my needs by offering advice, information, and alternatives I might not have considered myself. That shifted in my 14th week. Out of the blue I felt it was time to call my midwife and schedule a prenatal visit, so I did.

I took all my kids with me to Sherri's house, thinking they'd be happy to play there and that they could all gather around to hear the heart beat when it was time. Not so much. My toddler had just woken from a short nap and was grumpy. The other kids were fine, but the toddler refused to calm down. We didn't know where his pacifier was - I thought we'd left it at home - and he was MAD. Sherri and I were trying to start the prenatal visit and he just screamed at me. About halfway through the visit he found a Spiderman mask, and from that moment on he was Spiderman and he was happy. Phew! I had to laugh when Sherri's 5 year-old (her youngest) who owned the mask kept asking for it back and telling me how "crazy" my toddler was. Yes, welcome to my life.

On to the more important things. My weight was good, and exactly where I knew it was. I had bought a scale when I was thinking I'd have an unassisted pregnancy, so I'd been watching my weight. My blood pressure was nice and low (108/69 - normal for me), and the urinalysis was perfect! When I was pregnant with my youngest I had problems spilling ketones in my urine, meaning I wasn't getting enough nutrition, probably because I was still trying to breastfeed my fourth child at the time and it was such a struggle to meet my body's demands. My midwife counseled me endlessly during that pregnancy about eating more and eating healthier. I was so glad to have avoided that whole conversation this time!

She was able to find the baby's heart rate immediately, and it was 158 beats per minute.

Ina May Gaskin checking FHT with a fetoscope.

I don't remember everything we talked about. She asked if I was taking my nutritional supplements (yes) and how I was feeling. When I told her that I was still fatigued she asked about my sleep schedule and suggested more naps and going to bed earlier. 

Sherri was about to wrap things up and I said "Oh yeah, one more thing!" I told her about how I'd originally wanted to plan an unassisted birth for this baby, and how my husband hadn't felt comfortable about that and we'd decided to hire her again. I explained my reasons for wanting a UC and she listened and promised me that she would be as hands off as I want her to be. At the end of the visit she reminded me of her fees and asked me to talk with my husband and figure out how we would be able to pay her. I told her we would and thanked her, and we scheduled the next visit in 4 weeks. Then I gathered my kids and cleaned up the mess they'd made, and we went home.

I was happy about how the visit had gone, with the exception of the angry toddler. I was grateful for my midwife's support and felt very reassured that all was well with both me and the baby.

And here's where there's more.

About a week after the prenatal visit Sherri called me. She said she'd been thinking about what I told her about wanting an unassisted birth, and about our financial situation. She's a dear friend to us, and she knows our circumstances and has always been willing to work with us. She told me she thought that part of my motivation for wanting a UC was because of finances. She was right, but I had been afraid to admit that to myself until she pointed it out. She agreed that I have a lot of knowledge and understanding about pregnancy and birth and understood that I felt comfortable moving forward without outside support. She also pointed out that at my home birth there was a lot happening behind the scenes that I wasn't aware of. I had thought about that before and realized it was wonderful to just focus and be in labor la la land without worrying about setting up, cleaning up, and all the nitty gritty.

Sherri then offered an alternative plan.

She had talked with one of her midwife assistants and had made arrangements for this assistant to work with her in giving me 5 prenatal visits through my pregnancy, attend the birth, and provide one postpartum visit. They would also provide phone consultation throughout the pregnancy. She offered me this for a significantly lower cost than what my midwife normally charges.

The visits would be at the assistant midwife's home, which is closer to my home and a shorter drive than to Sherri's house. They would expect me to be responsible for my own prenatal care between visits, including tracking my own blood pressure and doing my own urinalysis. I was already comfortable with that, because I'd been considering doing it all myself to begin with. She suggested I get an automatic blood pressure cuff that would take the reading for me, since she wasn't sure if taking my own blood pressure would be accurate. She also told me where I could order the urinalysis strips from, and suggested I could also get my own doppler to use for fetal heart tones. She also asked that I commit to come to her monthly forum throughout the pregnancy, which was something I really enjoyed last time and was already planning on doing.

I'm very happy about this plan. I feel it shows trust in me to tune in to my body's needs and stay healthy and take care of myself, with minimal visits to the midwives themselves. I feel it's a really good compromise between an unassisted pregnancy and one with the full 13 prenatal visits that are typical. I feel very comfortable doing most of my prenatal care myself, and I love the idea of having my midwife and one of her assistants available as consultants. I feel this is a good way of utilizing them as valuable resources but not depending on them for everything. I'm really glad I spoke up and told my midwife about my desire to be unassisted, and that she really listened and seriously considered my wishes and my needs. It also takes some financial strain off by offering us a more affordable alternative.

Giving Birth Unassisted: an Option for Me

This is an article I wrote for the Pampers website, but it was rejected because unassisted birth is not considered safe by the medical community. I was encouraged by my readers to share it here instead. Thank you for reading and for your continued support. I hope you enjoy it.
(Also published on The Birthing Site)

Giving Birth Unassisted: An Option for Me

Before I got pregnant I thought birth was inherently dangerous and all women needed to be in the hospital to give birth. I'd never heard of women giving birth unassisted, and even the idea scared me. Through personal experiences and time I've come to reconsider my previous ideas, and I now embrace the idea as an option for expectant women.

As I've come to understand it, the concept of giving birth unassisted is when an expectant mother plans to birth without a professional care provider present, but it's sometimes used to describe a situation when a woman's labor goes so fast that she doesn't get the care she planned for. I've heard stories of women who unexpectedly gave birth at home, in the car, or somewhere else, often on the way to the hospital. A friend of mine recently had an unexpected unassisted birth when her midwife didn't arrive in time for the home birth. My friend had her husband's support and gave birth to a healthy baby.

I have a few friends who planned to give birth unassisted for various reasons. Some of my friends requested the presence and support of family members or friends, and some of them chose only to be supported by their husbands. Their reasons are intensely personal, and none of them made the decision lightly. My friends felt confident in being able to give birth without professional support, but they also took precautions by educating themselves and having supplies available, as well as being close to emergency services. I've read some amazing birth stories of birth transfers under emergency situations which ended well even when quick action was needed.

The idea of giving birth unassisted doesn't scare me like it used to. One thing I've learned through my own birth experiences is that I can give birth with very little support or intervention. When I gave birth without medication in the hospital there was very little the staff did for me. They mostly watched to ensure that all was well, and I did the work myself. These experiences helped me plan a home birth with my fifth child. I knew I could give birth without the machines and other things at the hospital because I'd done it even while in the hospital. I hired a midwife to support me, and I'm glad I did. I had an unexpected breech baby and my midwife helped me through it to have a vaginal breech birth.

Because of my growing comfort level with the process of giving birth, I'm personally open to the option of giving birth unassisted in the future. My friends who gave birth unassisted had prenatal care and prepared by doing research and learning what to have ready and what to watch for. They have wonderful stories to tell about the births of their babies.

Pampers Articles Covering a Wide Array of Birth Topics

I've gotten a little behind posting the links to my articles that have been published on Pampers. Here are the articles that have been published since my last update:

A Baby's Date of Birth: Not Always When you Expect it - About due dates and my preference of waiting for spontaneous labor.

A Birth Ball is a Wonderful Labor Tool - Why I love my birth ball!

My Fetal Monitor Journey - My experiences with fetal monitoring and why I choose not to be constantly monitored during labor.

What Can I Expect After Birth? - Many women don't think about postpartum when they're preparing for childbirth. This article talks about some of the things I wish I'd been more prepared for.

Childbirth Preparation: Being Prepared Makes all the Difference - This article outlines my personal childbirth experiences, emphasizing the need for good birth preparation.

Natural Birth Stories: Essential to my Childbirth Preparation - How natural birth stories can be instrumental in preparing one for labor and birth.

Breastfeeding: Not a Matter of Success or Failure - Similar to a blog post I wrote on here, this discusses my widening view of infant feeding and the importance of loving support and understanding.

T-shirt Diapering

No diapers? No problem!

This tutorial shows how to diaper your baby with a t-shirt! 

I love that it's a dad doing the tutorial.

Articles About Breastfeeding and VBAC

Here are my four latest articles published on Pampers:

Breastfeeding While Pregnant - My personal struggle with this, and what I learned.

Thinking About Stopping Breastfeeding? - Common breastfeeding pitfalls and how I got through them.

Breast Pumps: Different Options for Different Situations - Personal observations about breast pumps.

Vaginal Birth After Cesarean (VBAC) - The beautiful option that many aren't aware of.

Ectopic Pregnancy, Epidural Childbirth, and Doulas

I'd like to share three of my recent articles published on the Pampers website:


Ectopic Pregnancy Signs and Symptoms - My experience with an ectopic pregnancy scare.


Considering Natural and Epidural Childbirth - Personal observations and suggestions for when considering pain relief options for childbirth.


What are Doulas and What Do They Do? - How my doula transformed my birth experiences.


Please read and pass these articles on to those whom you feel might benefit from them. It's about empowering women to make informed choice in pregnancy and birth.

Planning and Meditating on Birth - Part 2

If you missed Part 1, click here to read it.


There is no magic recipe for a perfect birth. 

We have ingredients, or options, and each of us is in charge of writing the recipe that's best for us.  Why must we write our own? Why can't we just take an existing recipe and hope for the best? The Feminist Breeder writes on her blog why she won't leave her births up to chance. When you follow someone else's plan without serious consideration you are essentially leaving everything up to chance. I've done it myself, twice. Sometimes this works and things still turn out OK, as it did for me. You survive and your baby survives... oh, but I've gone over this already.

1. The first thing to do is become an informed consumer.  I've talked about this many times. It's one of the main reasons I have this blog. I believe every expectant parent should do their research and become an informed consumer. Know your rights and your options, and know that you are the one in charge. As a consumer everyone else serves to please you. Doctors, nurses, midwives, doulas, hospitals, birth centers, clinics... ALL of them are there to serve you. They have training and expertise in their various specialties, and can act as consultants in helping you make choices. Their place is not to dictate what will happen or make choices for you. Uninformed consumers must have choices made for them. It's your choice who will control your baby's birth.

How do you know if your birth will be like mine, better off at home away from medical intervention and unnecessary surgery, or like the other mother I mentioned whose baby needed to be in the hospital where he could get the immediate care he needed?

2.  Assess your feelings and follow where they lead you.  Ultimately you must make a choice, based on both knowledge and your personal feelings. Some people have paralyzing fear of hospitals and doctors and would be most comfortable elsewhere. Others have paralyzing fear of NOT being in the hospital where there is ready access to all the medical technology you could ask for. Whether that's a good thing or a bad thing is really up to you. I have an almost paralyzing fear of surgery, and I would do anything in my power to prevent an unnecessary surgery. That fear definitely plays into the decisions I make for birth, and so far it has served me well. Even if you don't have a paralyzing fear of anything, you will likely have some kind of feeling that will help guide you in the right direction.

3. Honor yourself and tune out the outside noise.  Pregnancy is a time when unsolicited advice seems to come at you from every direction. Whether you want it or not, everyone seems to know what they think is best for you and your baby. Everyone has a story to tell, and they love to tell it. Whether you plan to go to the hospital or have your baby at home or in a birthing center, someone will always have a horror story or opinion to tell you.

I was due to have my fourth baby in January. A very nice lady at church asked me about my due date and I told her that I was focusing on getting through the holidays and then I would feel ready to have my baby. She told me about her daughter who wasn't due until January, but the baby came unexpectedly a month early and she had nothing ready for Christmas. It may have seemed like a harmless story to her, but it stressed me out!

Hypnobabies teaches women to use a "bubble of peace" to help them stay connected with their own feelings and not allow outside advice or stories to upset their emotional balance. Essentially, you imagine a bubble that surrounds your body and keeps in all the happy, good feelings and blocks out all the unwanted stuff that invades you from other people. This is a good way to stay focused on your own feelings, whatever they may be. If there is fear within you then address that fear. Figure out where it's coming from and whether it's valid. Is there anything you can do to allay that fear? Do you have any control over what you're afraid of? If you have control over it, then take care of it. If it's beyond your control then you've done what you can and you can let it go.  Understanding the truth about power and control may help you be able to let go of what you can't control.

4. Continue to check in.  If there's a persistent nagging concern or fear that you just can't shake, then take it seriously and consider changing your plans. Just like the mother I met who never felt comfortable planning a home birth, there could be something you're unaware of that needs you to make a different choice.

In my case, I prayed. I felt I should consider home birth, even though I'd never considered it before. I felt peace about it, and peace as I chose my midwife and moved forward with my plans. I didn't ever feel a need to change my plans, and I never felt the need to prepare for a possible transfer to the hospital. Even as the due date approached, my midwife prayed about who to ask to provide support at the birth, and a specific person came to her mind. That person was a midwife with extensive vaginal breech experience. I feel God knew my baby would be breech, even though none of us did, and He helped me to prepare for it all along the way. I was blessed, I feel, because I knew my options. I had learned as much as I could and then I followed my feelings. I was blessed to avoid surgery which would likely have been traumatic for me. I had the desired experience and the desired outcome, without having to choose between the two.

Planning and Meditating on Birth - Part 1

I was talking with my sister recently about birth choices, and I started wondering how much the decision of where to labor and give birth has an impact on the experience and the outcome. I told my sister that if I'd been in the hospital with my breech baby I probably still would have had the outcome of a healthy baby, but the experience would've been altogether different. The labor itself would have been different and I wouldn't have been so relaxed and comfortable. And then there's the issue of the surprise breech, which would have led to an emergency cesarean. Instead of recovering from a vaginal birth at home, I would have been recovering from abdominal surgery with 4 small children and a newborn. My fear of c-sections in general would have left me scarred emotionally, and I would've had a lot more to heal from than just the physical trauma from the surgery. I also would have ended up with a uterine scar that could impact future births.

I shared my home breech birth story with a group of my midwife's clients at her home. At the very same meeting another mother shared her hospital birth story, and it was a striking contrast to mine. She had a natural labor without interventions in the hospital and everything went smoothly. However, after the birth she noticed her baby was twitching. The doctors and nurses hadn't noticed it. It took the mother's eye and intuition to see that something was wrong. They determined that the baby had suffered a stroke sometime after the birth. Because they were in the hospital, the infant was able to immediately receive the medical care he needed. What was even more interesting to me was when she told us that she had considered planning a home birth, but whenever she thought about it she felt uneasy. She didn't know why she felt uneasy, but she followed her feelings and planned to have the baby in the hospital. She was exactly where she needed to be, and it was because she followed her feelings. I, on the other hand, had felt nothing but peace when I planned my home birth, and I was exactly where I needed to be.

I believe there are times when no matter which choice we make, we'll still have a positive outcome. Almost all babies would survive whether they were born at home or in the hospital, whether born vaginally or by c-section. Almost all mothers will survive birth regardless of where it takes place or under what circumstances. But the outcome is not the whole picture.

Rixa from Stand and Deliver has a great commentary post on her blog about the way people say that all that matters is a healthy mom and baby. "Health" in this sense usually means "alive".  

We all know that health is all-encompassing, and it doesn't simply imply survival alone. Health is physical, mental and emotional. When a woman has a traumatic birth experience under any circumstances, she is emotionally unhealthy. Trauma can lead to Post Traumatic Stress Disorder, and while it's not commonly associated with postpartum women, if the mother suffered trauma during the birth she is more prone to this state of disease. Trauma is not associated with specific birth events, but rather the woman's interpretation of them and her feelings of either being in control and respected or being out of control and disrespected. By definition the CDC considers cesarean section a "morbidity", which would imply that any woman who's recently had a c-section is physically unhealthy. We can see that there are many different situations under which a mother and baby can survive birth but still be unhealthy afterward.  Heather Armstrong wrote a beautiful, yet heart-wrenching post on The Unnecesarean about her own experiences with emotional and physical trauma regarding birth.

The outcome matters. The experience matters. The emotional, mental and physical well-being of mother and baby matter. How can expectant parents plan for birth with all of these variables in mind? How can they make decisions about their baby's upcoming birth hoping for the best experience and the best outcomes?  


Click here for part 2...

Great Post on Group B Strep

Sheridan at Enjoy Birth has written a great blog post about Group B Strep: Group B Strep - Why Should I Care? It's full of resources so you can educate yourself and make an informed choice in your prenatal care.

The Real Risks of Pitocin

This article has been going around the internet like wildfire! I've read a lot about pitocin, but I never realized everything that was involved with its routine use, or the real risks. All expectant parents need this information.

"Pitocin – a very useful drug that improved obstetrics and gave us options to help women in ways we weren’t able to before!

"Pitocin – a very seductive drug that changed obstetrics, increasing risks to mothers and babies in ways that are often not even taken into consideration.

"Both of these statements are true – how can that be? I will do my best to explain this complex issue in a simple and straight forward way. Be warned…much of what you are about to read will probably be new to you because these are the things that aren’t being talked about!"

"Pitocin is a drug used to induce or augment labors here in the US. It is most often given via IV infusion, although immediately postpartum if an IV isn’t already in place it may be given as an intramuscular injection. It was created for the first time in 1953 and became available just 2 years later. Mothering magazine writes, “A survey by Robbie Davis-Floyd, a cultural anthropologist at the University of Texas, found that 81 percent of women in US hospitals receive Pitocin either to induce or augment their labors.” It has been said that only 3% medically require it." (emphasis mine)

I could copy the entire article into this post, but it would be better for you to read it at the source. Please read this important article about the real risks of pitocin:

Pit of Despair

Thoughts About Labor Support and Unassisted Birth

I've been thinking a lot lately about unassisted childbirth. I must admit that the idea is becoming more appealing to me the more I think about it, and I'm starting to consider this as an option for my next baby's birth.

Don't worry, I'm not pregnant again... yet. We want another baby, but we're not trying to conceive at this time. I'm always thinking and planning for the future.

My childbirth experiences have been a journey. I feel I've been on this road, and I keep growing and learning as I go. My journey from fully medicated birth to unmedicated birth in the hospital, then to birth at home, has been a progression for me. I'm always wanting to find something better and more fulfilling, and possibly more challenging as I go.

I like challenging. It stretches me, helps me grow.

"When you're through changing, you're through." -Bruce Barton

What's the next step? Is it freebirth?

Don't get me wrong. I'm not going to put myself or my baby at risk just because I enjoy a good challenge. I don't make any big decisions without doing my homework and knowing all the ins and outs, exactly what I'm getting myself into.

I also believe in divine personal inspiration, and I'll pray about my options and move forward with what I feel is right and best for my family. I prayed about home birth with my last baby and felt such overwhelming peace that I knew that's what I should do.

Right now I'm researching and considering my options, and I'll pray about them when a decision is needed.

I'm all about labor support. I'm a doula. I DO labor support. I feel it's important to have the right support for birth. But what is the right support? I think it can be different for each birth.

When it comes to unmedicated, natural, spontaneous birth without unnecessary interventions, I've always felt that with the right support and care I can do anything. I love my doula and midwife who each worked with my husband to provide encouragement, comfort measures, and a level head to help me through what's always been for me a somewhat long process of labor and birth.

At one point during active labor with my planned home birth I found myself alone. My midwife was in the other room. She had left my husband and I alone because I was coping well with his support and she was respecting our private space. My husband had to go to the bathroom, and just as he was gone a strong contraction hit.

I had been depending on my husband's support, and it suddenly occurred to me that I was alone! Panic hit, fear set in, and I experienced the worst pain of the entire birth experience. It's the only part of Liam's birth that I consider to have been actually, truly painful. Even transition was nothing compared to the pain I felt at that moment.

I learned two things from that experience:

1. The Fear-Tension-Pain syndrome is REAL. When we experience fear our muscles invariably get tense, which causes pain. This is definitely true in labor and birth, and I experienced it first-hand in stark contrast to the rest of my otherwise relaxed and peaceful labor.
2. I have had the belief that I can only handle natural labor if I have support from others. Whether my belief was true or not, it was real and it affected me completely in that moment.

I've reflected on that experience a lot since then. What about women who experience spontaneous precipitous labor and have no support, but still have an amazing and beautiful birth? What about those who plan unassisted birth and handle it just fine without any outside support (other than that of their partner)? Why would I only be able to handle labor well with support, if others could handle it just as well on their own?

If I plan an unassisted birth I would still have my husband's support so I wouldn't be completely alone. Do I actually need the support of a doula and/or midwife or others in order to have a beautiful birth experience?

Breastfeeding and Skin to Skin in the Operating Room

"With a Cesarean birth the baby can be brought to mom's chest and feed even as the incision is being closed."

Skin to Skin in the OR

The routine is generally to whisk the baby away for weighing, drying, and doing newborn checks while the doctors close the incision and the mother lies on the operating table. As long as the newborn is in stable condition, it can be brought to the mother and held skin to skin just as many would after a vaginal birth.

There are other things that can be done differently to make a cesarean section birth more meaningful. A friend of mine had a positive experience with her cesarean birth. Her midwife gave some really good suggestions to them before going in for surgery. One of those suggestions was for the father to hold the baby and not let the nurses have him back. When the nurses wanted to put the baby in the bassinet to take him to the nursery, the father gently refused and told them he would hold his son. Even after they told him he wasn't allowed to do that, he held tight to his newborn and insisted on carrying him to the nursery himself. He stayed with the baby when the mother couldn't be there.

There are options other than the normal routine, but you must ask for them. You need to know your rights and how to ensure you get them. Do you have any suggestions for expectant parents on what they can do in the event of a cesarean section?

Nitrous Oxide for Labor Relief?

Why haven't I heard of this before?

Consider the Source: An Interview about Nitrous Oxide with Judith Rooks

European countries use nitrous oxide regularly and safely as a form of labor relief, but it's a practically unknown as a labor option in the US. This is possibly because only two hospitals in the United States currently offer nitrous oxide to laboring women. There is a shortage of equipment as more hospitals are trying to acquire them and be able to offer it.

When you read the article you may be as stunned as I was to find:

• Nitrous oxide is safe to both mother and baby with none of the ill side effects associated with other forms of pain relief.
• It can be self-administered by the laboring woman, which allows her to use it as-needed and also avoids over exposure.
• The gas is expelled quickly from the mother's and the baby's bodies. A newborn infant expels the gas from its body with its first few breaths and is completely free of it within 5 minutes. This means no NICU admissions from adverse reactions to medication.
• For women who want to avoid an epidural, the use of nitrous oxide can take the edge off in the moment she feels she needs it. Because it's self-administered, she can start it or discontinue it at any time.
• Women wanting an epidural can use nitrous oxide in the early stages of labor and while waiting for the epidural, and avoid the use of opoids (which carry a risk to the baby).

For much more in-depth information, along with scientific evidence, please read the full article linked to above.

For demonstration purposes, please check this video of a woman using nitrous oxide while pushing her baby out. Please ignore the cheesy commentary from the producer.

What do you think?

VBAC Articles

Enjoy Birth blog shared these great articles about VBAC, and I thought I'd pass them along.

Rebirth of the Midwife

A Change of Delivery

Enjoy!

Using Epidural Anesthesia Judiciously

I've blogged about epidurals before:

Epidural: Procedure, Benefits and Potential Risks

The Evidence Says Epidurals Do Impact Newborns

Those two blog posts discuss some of the risks and negative impacts of epidurals, and it's important information to consider when you are deciding which birthing options you will utilize for your baby's birth.

I found a really good blog post on The Unnecesarean about using epidural anesthesia judiciously:

Minimizing the Negative Affects of Epidural Anesthesia

It's written by a Certified Nurse Midwife, and discusses situations in which an epidural might be beneficial to use, and ways of approaching its use to provide the best support for the mother and baby.

Informed Consent

When a woman goes to the hospital to have a baby she is given forms to sign, and is usually immediately placed in a hospital room with a bed and hooked up to all kinds of gadgets and strange machines. In the throes of labor does she read through all of the forms and know exactly what she is agreeing to when she signs them? When a doctor, midwife or hospital staff want to intervene somehow with her labor and birth, do they explain all of the benefits and risks associated with that intervention? By law, physicians are required to provide full disclosure to the patient, and this is called "Informed Consent".

The American Medical Association has laid out requirements for Informed Consent as follows:

“Informed consent is more than simply getting a patient to sign a written consent form. It is a process of communication between a patient and physician that results in the patient's authorization or agreement to undergo a specific medical intervention.

In the communications process, you, as the physician providing or performing the treatment and/or procedure (not a delegated representative), should disclose and discuss with your patient:

• The patient's diagnosis, if known;
• The nature and purpose of a proposed treatment or procedure;
• The risks and benefits of a proposed treatment or procedure;
• Alternatives (regardless of their cost or the extent to which the treatment options are covered by health insurance);
• The risks and benefits of the alternative treatment or procedure; and
• The risks and benefits of not receiving or undergoing a treatment or procedure.

In turn, your patient should have an opportunity to ask questions to elicit a better understanding of the treatment or procedure, so that he or she can make an informed decision to proceed or to refuse a particular course of medical intervention.

This communications process, or a variation thereof, is both an ethical obligation and a legal requirement spelled out in statutes and case law in all 50 states.”

Informed Consent is required by law, yet I don't recall being given informed consent for every intervention done on me or my baby in any of my 4 hospital births. This is of grave concern, as I believe all women should be fully aware of the reasons, risks and benefits of what is being done.

I urge every woman to take charge of her own care and insist on having informed consent. After all, it is her legal right and her doctor's legal obligation.

AMA - Patient Physician Relationship Issues - Informed Consent