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Welcoming a baby is exciting, but labor and birth can provoke sticky medical and legal situations sometimes. Here, we explore patient rights and the meaning of informed consent.

As already mentioned, issues surrounding informed consent and childbirth mainly focus on women who wish to have a natural labor and birth, while the hospital and medical staff see medical management of childbirth as preferable. In this section, I'd like to address how to avoid disagreements with medical professionals during labor. Being a mother who had two low-risk pregnancies followed by homebirths, I certainly understand an expectant mother's wish to be in control of her medical situation.

I am not, here, talking about situations that are obviously dangerous. Instead, I am talking about situations in which doctors simply prefer to follow their usual course of action and have an irrational skepticism toward natural or physiological childbirth. Labor and birth can turn into emergency situations — something that can happen rather quickly in some cases — and there are births during which “natural” would equal “fatal”.

If you would like a natural birth in normal circumstances, you are most likely to achieve this by finding a midwife or OBGYN who has similar views on childbirth as you do — in a hospital that is supportive. You can assess healthcare providers' attitudes toward maternity care in various ways:

  • Checking the hospital's rates of common interventions that you would prefer to avoid, such as c-sections, inductions and augmentations of labor, episiotomy and epidural anesthesia.
  • Asking whether relatively controversial points are welcomed in a given hospital or with a given healthcare provider. Think walking around during labor, waiting for the natural delivery of the placenta, or having showers during labor.
  • Talking about interventions with your healthcare provider. What do they think about episiotiomy and when it is necessary? How about vaginal breech delivery? How about no vaginal exams during labor?
  • Making a birth plan and discussing it with your healthcare provider. If your healthcare provider welcomes your suggestions, they are likely to be a good partner. Some doctors will sign mothers' birth plans to signify they are able to accommodate their wishes. Some hospitals have “banned” birth plans outright. That is a great signal that the hospital is probably not a good choice for women who want to play a proactive role in their care.

It is also, on the other hand, helpful to remain somewhat flexible. Women who have low-risk pregnancies and wish to have a completely natural birth may be better off at a birth center or at home. If you want to deliver at a hospital, it is only natural to keep in mind that you will end up following at least some of their protocols.

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