Interventions I Declined...

Your provider should be giving you options, and leaving room for you to consent or decline.

My provider suggested several interventions in the course of my pregnancy and labor. These were a few that I declined. In each case, my provider unquestioningly accepted my choices.

Keep in mind these decisions were based on my personal risk tolerance, after careful consideration and research on my part. Your risk tolerance may be different than mine.

• Follow-up ultrasounds - At my 20 week anatomy scan, my midwife noted the possibility of a marginal cord insertion. She suggested a follow up ultrasound. I opted to track baby's growth through fundal height measurements instead. I felt that the risks of inaccurate ultrasound readings leading to a cascade of unnecessary interventions later in pregnancy outweighed the benefits, especially when there was a method for tracking another way.

• Antibiotics during labor - I tested positive for GBS early in pregnancy. My provider is required by law to suggest treatment with antibiotics during labor. After careful study, and weighing risks and benefits from all sides, I opted to decline a second test as well as the treatment. I felt that the risks of exposing my newborn to antibiotics at birth was larger than the risk of him being exposed to GBS and the even smaller risk that it would affect him.

• Cervical exams - Guess how many times my midwife checked my effacement and dilation? ZERO TIMES. My provider's standard of care already aligns with my preferences in this, but if it had not I would have verbally declined cervical checks as well. Because dilation and effacement have no bearing on the timing of a baby being born, for me the information serves only to distract and cause unnecessary stress. Not to mention the added risk of infection from a cervical exam after the amniotic sac has broken.

These examples aren't meant to be decisions that you copy in your own pregnancy and birth, but they're merely meant to be food for thought. Many would consider these interventions to be standard non-negotiables. But if you aren't given an option to accept or decline interventions, no matter how standard they are, is that truly informed consent?

Here are some questions to ask yourself if you're working with a care provider and you aren't sure if they're using informed consent properly in their care.

Would your provider "allow" you to opt out of these types of interventions?

Would they even give you the opportunity to consent or decline?

Would they explain risks and benefits and give you the tools to research and make an informed decision on your own?

Would you feel comfortable declining something your provider suggested?

If you answer "no" to any of these questions, it's worth looking further into your relationship with your care provider. No matter how long you've been seeing them, or how faithful you feel you ought to be to their practice, it's never too late to leave and search for the provider who's the right fit for you and your family.