Control, Choice, & Consent: Megan Davidson & the 3 C’s of Birth
I found Megan Davidson’s “Your Birth Plan: A Guide to Navigating All of Your Choices in Childbirth” while browsing our library catalog of books about pregnancy. I’m still early in the book, but I like Davidson’s clear tone and the way she weaves individual stories into her chapters (not surprising, since she studied anthropology, which is a cousin to my original major, history ;) ). And I absolutely fell in love with a theme she put forth in her introduction. She broke down birth planning into three major categories that are useful for any pregnant woman as she navigates her strategy of care. As she put it, there are things we have control over, things we make choices for, and things we consent to being done.
One of the most important areas most Americans have control over is where we give birth and who our providers are. There might be some limitations (laws about home birth providers, for instance, or a list of in-network providers our insurance companies give us), but the reality is that we often can (and should!) interview multiple providers and tour multiple birthing locations before making a choice. Pregnancy is a long process ~ taking the time to find a provider you love and who has a philosophy of birth that you’re comfortable with will make a huge difference at the end. Research providers in your area, ask friends, ask your doula, ask about policies (what will happen if you go beyond your “due” date? what are their standards for deciding if your labor is progressing or not? etc).
There are things we cannot control; when we will go into labor, for instance, or (if we’re induced) whether an induction will lead to a good labor. We don’t have control over if our labor will be “easy” or “hard,” long or short (although this is the spot where I like to point out that doula assisted births tend to be shorter ;-). We have choices for some of the situations we cannot control. Maybe our labor runs long and we are exhausted; we have choices for pain relief, like an epidural. Even if we hoped pre-birth to not need one, that freedom of choice still remains to us in birth. Maybe labor starts sooner than we expected, but still full term… we have the choice to continue laboring at home or to head to the hospital.
And finally, we have the right to consent. Maybe the birth takes an unexpected turn and something like a c-section becomes the best choice; we can consent to that. The right to consent means the right to refusal; maybe a medical provider suggests an epidural and we know that’s not the right choice for us at the moment; we can say no. Maybe we are coming to terms with a big intervention that is needed due to things outside our control (pre-eclampsia, anyone?). We can ask medical providers to talk with us through the whole process before we give our informed consent.
In every stage of pregnancy, it can be helpful to ask what are things we have control over, what we have choices for, and what we need to give consent. Recognizing that there are areas where we don’t have control can be very freeing; pregnancy & birth are unique physiological events, and they do not always go as planned. That’s okay. The best we can do is be prepared for changes (one of the best ways to prepare for parenting, too!) and look forward to celebrating with baby snuggles at the end!