It is all about relationship – Informed Decisions and Consent in Maternity
“The right to informed consent is a fundamental principle of medical ethics and human rights law and is particularly relevant to the provision of medical treatment. In addition, our common law starts from the premise that every human body is inviolate and cannot be subject to medical treatment without autonomous, informed consent.” Bashi Hazard.
In discussing informed decisions and consent we need to be mindful of the power inherent in any interaction and the potential for disparity and inequality within any relationship. Acknowledgement by the healthcare practitioner that imposition of their own beliefs may disadvantage the woman receiving maternity care is fundamental to the delivery of informed and safe care.
The need for a birth map has arisen because women are often not included in decision making during pregnancy and birth, denying them their human rights. Birth maps are about informed decision and consent. As Bell* states Birth Maps are about exploring the potential options ahead of time and making decisions in consultation with your care provider. These discussions help to build trusting relationships. Trust is essential as the experience of maternity care will influence the outcomes of birth, the success of a woman’s mothering career, and the long-term wellness of her child.
For trust to develop the woman and her care provider have understand each other, and to do this the very first thing you need is a relationship. When things are tense, the better your relationship is, the more quickly you can understand each other, and the more quickly you can come to a consensus with each other. When you have had a lot of conversations about the possibilities – you can then say, “This is that thing that we talked about.” so that, in those high-stress situations, the decision can be informed and consensual.
Most women birthing in Australia today do not have an opportunity to form a relationship with a single provider, they do not have continuity of care from the beginning of pregnancy to well after. That is why we continue to work to in Australia to achieve Respectful Maternity Care for All Women in a midwife-led continuity of care.
* The ‘birth plan’ is a shortcut to disappointment, time to ditch it – @ https://www.smh.com.au/lifestyle/life-and-relationships/the-birth-plan-is-a-shortcut-to-disappointment-time-to-ditch-it-20191106-p537xq.html