Rights- 13 Rights Every Birthing Mom Has

Know Your Rights series part 1 of 4

Do not let your caregiver bully you into giving up your rights for their convenience.

You have rights. It is important in a time where POLICIES are being placed before patient rights to know what your rights are.

Discuss your rights and your birth preferences with your caregiver early on. You may even want to interview potential caregivers before your pregnancy to determine who might be a good fit for you.

Download your free birth plan worksheet here!

**As with all procedures and interventions, please do your own research and decide if the results of the procedure outweigh the associated risks.

1. You have the right to refuse an induction

Induction seems to be one of the fastest rising interventions in the U.S.

From the National Vital Statistics System: The rate of induction of labor more than doubled from 1990 through 2010, from 9.6% to 23.8%

Reasons for induction may include:

• significant growth problems in the baby.
• too little amniotic fluid around the baby.
• uncontrolled gestational diabetes.
• preeclampsia.
• a uterine infection.
• placental separation from the uterus.

Reasons for induction should NOT include:

• Late Term– past 39 weeks with no other risk factors

• Baby is Too Big– (the majority of babies can be birthed naturally, even if they are larger in size.)

• Convenience– Your baby knows when he/she needs to be born. Delivering your baby early because you are tired of being pregnant, so that your doctor doesn’t have to be on-call during the weekend or holidays, or otherwise to fit into someone’s schedule is risky as your body is not prepared for labor, and can lead to other interventions.

I KNOW that you are ready to meet your baby! I understand! However, induction will only increase the risks to yourself and your baby.

Risks of induction

Labor induction carries various risks, including: (from Mayo Clinic)

• Failed induction. Studies show that about 75 percent of first-time mothers who are induced will have a successful vaginal delivery. This means that about 25 percent of these women, who often start with an unripened cervix, might need a C-section. Your health care provider will discuss with you the possibility of a need for a C-section.
• Low heart rate. The medications used to induce labor — oxytocin or a prostaglandin — might cause abnormal or excessive contractions, which can diminish your baby’s oxygen supply and lower your baby’s heart rate.
• Infection. Some methods of labor induction, such as rupturing your membranes, might increase the risk of infection for both mother and baby. Prolonged membrane rupture increases the risk of infection.
• Uterine rupture. This is a rare but serious complication in which your uterus tears open along the scar line from a prior C-section or major uterine surgery. Very rarely, uterine rupture can also occur in women who had never had previous uterine surgery. An emergency C-section will be needed to prevent life-threatening complications. Your uterus might need to be removed.
• Bleeding after delivery. Labor induction increases the risk that your uterine muscles won’t properly contract after you give birth (uterine atony), which can lead to serious bleeding after delivery.

Did you know that seeing a chiropractor during your pregnancy reduces the need for interventions and increases your chances of having a natural labor and birth?

2. You have the right to refuse membrane sweeping/ rupture of membranes

Caregivers commonly perform membrane sweeping and rupturing of membranes during induction.

It is common for medical professionals to routinely strip membranes and/ or rupture membranes during vaginal checks. Caregivers tend to do this in hopes to “move things along”.

If you are having a normal and healthy pregnancy, there is no need to start the induction process.

The stripping of membranes carries the risk of infection, excessive vaginal bleeding, and the unintended rupture of the amniotic sac.

Risks of amniotomy (artificial rupture of membranes) include intrauterine infection and umbilical cord prolapse.

Once your membranes have ruptured, most doctors will put you on a time clock and if you don’t deliver within 24 hours, then you will automatically be a candidate for an emergency caesarian section- even with no other risk factors.

From Medscape: Despite a lack of evidence, there is a widespread impression among providers that when the duration of the rupture of membranes exceeds 24 hours, there is increased danger to mother and baby. Birth within 24 hours is a common management goal when the membranes are ruptured.

3. You have the right to request intermittent monitoring

There are different ways that your caregiver might monitor you and your baby.

Blood Pressure Cuff

Blood pressure is monitored once an hour unless there is a reason to suspect preeclampsia or other blood pressure-related issues.

External Fetal Monitoring

Fetal monitoring is done with a band around your abdomen. This band usually measures both the heart rate of the baby and the strength/timing of your contractions.

The problem with this type of monitoring is that it can easily slip and the readings will then be inaccurate. Another issue with this type of monitoring is that you tend to lose mobility due to all of the cords attaching you to a machine.

Internal Fetal Monitoring

This procedure requires the doctor to rupture your membranes if they have not ruptured on their own. From Healthline: The doctor will then insert the transducer on the baby’s scalp as gently as possible. In some cases, the transducer might cause some injury to your baby. Examples of potential injuries include bruising and scratching.

In some cases, this type of constant monitoring may cause unnecessary concern. When there is a question as to whether or not a baby is in distress, the doctor will typically err on the side of caution. This can lead to further interventions such as:

• a forceps-assisted delivery, which involves using large, curved tongs to gently pull your baby out of the birth canal
• a vacuum-assisted delivery, which involves using a vacuum-like device to help ease your baby out of the birth canal
• a cesarean delivery, which involves making one incision in your abdomen and another in your uterus to deliver your baby

These may be common practice in many hospitals, but as stated before, every procedure and intervention has risks. The risks to the mother for these procedures include:

• heavy bleeding
• tears or wounds in the genital tract
• injuries to the bladder or urethra
• problems urinating
• a temporary loss of bladder control
• a severe infection
• an adverse reaction to anesthesia or medication
• blood clots

The risks to the baby for these interventions include:

• breathing problems
• nicks or cuts
• bruising
• bleeding in the skull
• minor scalp wounds
• jaundice- characterized by a yellowing of the eyes/ skin

According to the American Academy of Nursing, the risks associated with internal fetal monitoring outweigh the benefits in low-risk pregnancies.

Intermittent Fetal Monitoring

This type of monitoring is favored by many midwives. It is non-invasive and allows for free movement. Frequent movement has been proven to reduce interventions in labor and delivery.

The nurse/ midwife/ doctor will use a doppler to check the baby’s heart rate. This can even be done while you are in the tub/ shower.

You have the right to request intermittent monitoring for both yourself and your baby.

PRO TIP: Hire a doula! Doulas reduce the need for many interventions and will help you to stand up for your rights!

Check out these local doulas in our area!

Stay tuned for parts 2 and 3 of this series: Know your rights- 13 Rights That Every Pregnant Mom Has to read about the following:

YOU HAVE THE RIGHT TO

• Request to have pitocin turned off at any point

• Eat and drink whenever you feel hungry and thirsty

• Get out of bed whenever you want

• Labor in any position you want to

• Push in whatever position you want

• Have a vaginal birth after a caesarian section

• Deliver a breech baby vaginally

• Refuse any major surgery- including a c-section

https://www.cdc.gov/nchs/fastats/delivery.htm

• Keep your baby’s cord attached to the placenta and unclamped for as long as you want

• Take your placenta home

Why did I choose birth photography?