Seriously?  When it comes to maternity care the emotional tie of a baby’s health can be used unscrupulously.  Of course a mother doesn’t want to do anything that would hurt her baby, but is the emotional blackmail of responses such as these really necessary?:

“Well, if you don’t care what happens to the baby…” “If you don’t do this your baby could die.” “You can choose that if you’re going to take all of the responsibility for the risks and sign this waiver.” ~ What Are They REALLY Saying?

Natural or ‘normal’ birth advocates and educators are sometimes labeled as rebellious, extreme, etc. with the opponents claiming in the same breath to also being focused on healthy birth outcomes.  Kathy Petersen, IC member, muses more about the same team issue.

There may not be an “I” in ‘team’, but there certainly is a “me.”  The only ‘team’ that exists is the one you put together and at its center is you.  You are the “me” in team.  You are an active participant in your birth and that actually benefits your practitioner because you get to give informed consent or informed refusal.   Are practitioners so afraid of the legal system that it’s easier to just have women go along with what makes a lawsuit least likely to arise?  The truth is most consumers don’t want to have to deal with a lawsuit either.  It may appear to be easier and simpler to just go along but it isn’t.  If Big Baby Bull doesn’t help you see ‘malpractice’ intertwined with emotional tugs perhaps a mother or a baby dying from the misuse of the drug Cytotec for an induction (for the suspected big baby??) will.

Informed refusal gets dicey because a practitioner must be able to prove that their client/patient was aware of the consequences of not following a specific protocol.  Yet when it comes to maternity care, a system so fraught with the overuse of technology that many in the field admit they’ve never seen a natural birth, can practitioners really convey to a mother what will happen if they refuse technology?  We can hear that conversation now: “Well, if we just sit here and wait you will have to have this baby completely on your own!”

A practitioner’s ability to understand normal birth is greatly undermined by their own failure to appreciate the litigious environment they created themselves.  ACOG recently admitted, for example, that the guidelines for external fetal monitoring are left open to interpretation.  What they are not making clear to the consumer though is that it is the obstetricians who have failed to understand and deploy external fetal monitoring prudently but it is the mothers who are shouldering the consequences, the fear of malpractice:

“Our goal with the ACOG guidelines was to define existing terminology and narrow definitions and categories so that everyone is on the same page,” says Dr. Macones. One of the problems with FHR tracings is the variability in how they’re interpreted by different people. The ACOG guidelines highlight a case in which four obstetricians examined 50 FHR tracings; they agreed in only 22% of the cases. Two months later, these four physicians reevaluated the same 50 FHR tracings, and they changed their interpretations on nearly one out of every five tracings. ~ ACOG Refines Fetal Heart Rate Monitoring Guidelines, June 2009

Desirre Andrews, IC member and President of ICAN, shares Alexandra Orchard’s experiences spanning six years of trying to achieve a natural birth.   Again, as Alexandra and her family learned, it is not the VBAC itself that is to be feared but rather fear that the practitioner’s judgement, recommending surgical delivery in the first birth, will be called into question is what drives a practitioner’s loathe to attend a VBAC mother.

Last, the public itself is brought into the drama with irresponsible headlines such as this one from the New York Times blog, Refusing a C-Section, Losing Custody of a Baby.

Contrast Alexandra’s letter to her obstetrician (watch the video to the end!) to this scenario ripped from the headlines today over the mother who supposedly lost custody of her daughter solely because she refused a repeat cesarean.

Independent Childbirth supports the natural birth community through the use of quality and self-earned birth knowledge about natural childbirth.  Mothers are the birth experts.  We share normal birth and because we do, more mothers today recognize medical interventions are sometimes needed but they do not justify today’s rate of surgical deliveries, birth injuries and denying mothers of patient rights.  Let calmer heads prevail, that of a thinking mother (who isn’t?) choosing normal birth experienced practitioners who value a mother’s instincts.

**For more on “informed refusal” visit The Risk Management Handbook for Healthcare Professionals.  For more information on the New Jersey case visit Knitted in the Womb and VBAC Facts.
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