Expectant parents discussing with midwife

Various viewpoints on consent

Some people think of informed consent as a two step process. The care provider tells you the information and you consent. That’s the quick and easy way of doing it and it’s the way some care providers prefer it.

But TRUE informed consent isn’t quick and easy. It involves a conversation, not just a recitation of the form. It involves taking time to ensure all questions are answered and other options are explored. Including the option to refuse what’s being suggested. You cannot freely consent if consent is your only option!

Additionally, some people think of consent on different scales from other people. There are two ends of the scale of consent:

Pregnant person talking with a doctor

“Package Consent”

People who think of consent as a package deal tend to think that when someone has consented to a cesarean, that consent automatically includes consent for: IV fluids, blood pressure monitoring, urinary catheter, antacid medication, antibiotics, and pitocin to guard against excessive bleeding.

In this way of thinking, ideally all those other things that are part and parcel of a cesarean birth are discussed. Unfortunately that does not always happen as staff can assume that “everyone knows you get a catheter with a cesarean” when that isn’t really true.

“Piecemeal consent”

The piecemeal approach is one that I find more patients expect. I often see something like “I plan to stay involved in decision making, please discuss everything with me before using any interventions.” included in people’s birth plans.

Those who follow this viewpoint feel that even when someone has consented to the cesarean, they also need to consent to the IV fluids, blood pressure monitoring, urinary catheter, antacid medication, antibiotics, and pitocin to guard against excessive bleeding.

Where do you draw the line on what is included or not included? And does your care provider see it the same way? A mismatch in your approaches to informed consent can lead to conflict and frustration in labor.

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