As a homebirth midwife, I’ve come to rely on the practicality of what I’ve termed ‘True Informed Consent’ (TIC) TM as the basis for the care I offer to birthing families.
I’ve found over the years that it’s so rare for most people to ever be exposed to the concept of True Informed Choice within their medical experiences that most have no idea what it even means. In fact, I believe our world as a whole is experiencing a crisis around consent. Lack of consent is a violation of each of our inherent and unalienable rights and boundaries. These violations have been coming to light on the world stage more and more often recently, so I have hope for the direction we are heading- and for the potential changes this kind of transparency exposes.
We still have a long way to go to reach consensual practices within our larger community, as well as in the health care community. Has anyone reading this ever gone into a doctor’s visit and left without all of your questions sufficiently answered? Without a clue how common the side effects listed really are? Unsure of whether their practitioner heard your concerns at all? Having been badgered for refusing the treatment or medication proposed by the doctor? Having been touched or examined without being asked for consent first?
So what does the term informed consent mean, and how is it different from True Informed Choice TM
Lets start by breaking it down. I’ve done a bit of alchemy with a few different definitions I found from Internet dictionaries to find the following:
The definition of INFORMED:
“Possessing, or displaying, or based upon reliable information. Knowledgeable or educated.”
So to paraphrase; informed means having ALL the relevant knowledge, education, and facts.
The definition of CONSENT:
“Acceptance or approval of what is planned or done by another. To permit or comply.”
Medical Dictionary Online states that Informed Consent means: 2. consent to medical procedures/treatment given by a patient after the potential risks, hazards, and benefits of the treatment have been explained.
In practical terms in our current health care system Informed Consent documents are considered the paperwork that practitioners have their patients/clients sign after discussing an option/procedure/test/treatment etc. to prove that the patient is indeed informed of the risks. This form allays the practitioner of responsibility for consequences that come about from said treatment. In our high liability and insurance-led healthcare system it’s no wonder that this paperwork is the gold standard for practice. And indeed it is one of the necessary components to informed consent.
What is sorely lacking in the common presentation of IC, in my opinion, is a full overview of ALL possible risks that include all available statistics and studies- both absolute and in the practitioners own lifetime of practice. Try going in to a hospital pregnant and asking your Obstetrician what the hospitals rate of C-sections is? What their own personal rate is? Are we talking 3%, (the 20 year average for the birth center The Farm)? 10%? 30% (The US current national average?), 45%? This information makes a huge difference for someone seeking to avoid unnecessary interventions in their pregnancy and birth experience. There are some practitioners and some facilities that have come a long way in addressing concerns and questions like these in the past 10-20 years- but chances are you’ll be treated like an ungrateful, indigent, and unwelcome nuisance if you begin to ask questions like these in a maternity care setting. And how can a pregnant person determine the actual risks of birthing with a specific practice if basic statistical information such as this is not made readily available? If the person asking is often made to feel that they have no right to do so? This system is not as much based on TIC as it is on CYA liability. And this is bad for everyone.
In my own homebirth practice I take the meaning and the practicality of informed consent to a deepening level, way beyond the signing of a piece of paper. This I call TRUE INFORMED CHOICE (TIC)TM. Please check out the following blog post for a streamlined version of the basic tenets of TIC TM
I feel honored each and every time, to experience the full wisdom and power of a birthing family standing in their own autonomy and choice- and I delight in offering them the widest and most accurate scope of knowledge and experience I have available for them. I find that families often choose to decline quite a few of the options presented to them- when those options aren’t packaged as requirements, and that being a practitioner who offers true choice builds trust and rapport between birthing families and myself. Ultimately this trust allows them to focus on their true work: bringing our next beings to the planet- and not on the stress created by a liability and intervention-based birthing system. And offering TIC TM is better for me as well, I can release the need to be liability-oriented within my practice and focus instead on the unique desires and needs of each family I work with. What a blessings this is!
True informed consent is essential to safe-guarding the passage of our emerging generation through their transition into life (for babies) and their transition into parenthood (for families!) And WE have the ability to shift the trend by standing up for our right to TIC TM. If our current practitioners won’t offer it we can let them know we’ll be finding an alternative care provider, and why. I’ve seen this begin a shift in the hospitals near my midwifery practice here in Boulder, CO. Demand for respectful treatment and the education and autonomy of the Boulder community here have influenced maternity care providers to meet them at least in the middle. Imagine what’s possible as more and more of us assert our rights to navigate maternity care on our own terms!
Here’s to bodily autonomy, true informed consent, and TRUE freedom!