I was recently told that a senior obstetric doctor said in a hospital meeting that if we stopped routinely inducing women for ‘post-dates’ then the stillbirth rate would go up. I’d like to say here what would have said to his face had I been there:
“Dear Doctor, we could argue all afternoon about the evidence behind that statement but I fear that would be a pointless waste of both our times. Neither of us are going to change our views any time soon.
What I would like you to contemplate though, is a dangerous assumption behind your words. An assumption that it is not the woman’s choice. It doesn’t matter how bogged down we get in statistics, risk factors and hospital guidelines, the fact is, it’s none of your business what the mother chooses to do with her body. Whether you agree, support her choice or think she’s a lunatic is frankly irrelevant.
Paying lip service to ‘woman centred care’ and ‘informed decision-making’ is not enough. If we believe as a society that a woman has autonomy over her own body and the right to make decisions for her unborn child, then we have to put our hearts and our money where our mouths are.
Making a choice means being given enough information on the pros and cons and the risks and benefits, in an atmosphere that is free from coercion or persuasive language. It means the parents being given information that is, as far as possible, objective, as evidence-based as possible and up to date. It means the practitioner understanding that mothers don’t make decisions purely based on cold, hard facts.
How do you know that part of the way she feels about a certain course of action is based on her concerns for other children left at home, or for her relationship with the baby’s father, or trauma from a previous birth experience. All of these concerns, and more, are just as valid parts of her decision-making process.
If we are to give mothers true freedom of choice, you, Dear Doctor, have a responsibility to swallow hard, give her the benefit of your considered clinical opinion and then shut up.
So if you have a woman in your office who is making choices you don’t agree with. Please stop and think for a minute: this is not your story, not your body, not your baby and not your family. Suck it up. You’d be surprised how often the women are the experts on their own pregnancies, if you’d just stop and listen once in a while.”
And for those of you who are reading this, here’s your call to action. This month, in the UK, we are undergoing yet another radical shake up of the NHS. Clinical Commissioning Groups are now commissioning services. These groups have been told that User Involvement in decisions will be at the heart of the health services and the way those services are delivered. If you want choice, control and loving, individualised care in pregnancy, birth and beyond, speak up. Here are a list of organisations that are campaigning for maternity services that offer respectful care; care that does not treat pregnant women like children. There are ways to get involved, large and small. Together we can make a difference and shape the future of maternity care.