Q: How do I know if I really need a medical procedure?

medical interventionsinformed choicebirthbrain questionsDoulas

Mar 26

Question:

How do I know if I really need a medical procedure? I’m worried about being subjected to unnecessary procedures, but also worried about refusing something I might actually need. How do we make these decisions?

Answer:

Sometimes medical interventions are necessary during pregnancy, labour, or birth, to improve outcomes for mother or baby. When necessary, medical interventions can be life-saving, or can reduce the risks of harm from pre-existing conditions or specific circumstances. But when performed routinely, or without any particular indication, or when performed for the wrong reason, some medical interventions can add risks that may not have been present otherwise. As well as each procedure having its own inherent risks, many medical interventions increase the risk that you will require other interventions to temper the effects of the first, each subsequent intervention associated with its own list of risks. Therefore many interventions carry risks by proxy, as well as directly.

It may seem like common sense to only employ a medical intervention if it is specifically justified—if there is a clear cause for it. But during labour and birth, this kind of clarity can often be cloudy if not downright opaque. There are many different perspectives on when and if certain interventions are beneficial. Not all medical experts agree on their best timing and usage. And in the end, the decision is always that of the birther herself. While there are certainly protocols, the final say is ultimately your own.

So how do you decide if an intervention is in your best interest, if it would encourage or hinder your labour, or if it would help or harm your baby?

It is useful to consider some of the possible “what if’s” in advance. This allows you to research your options, and reflect on your preferences ahead of time, when you have the luxury of zero pressure and mental clarity. Discussing your options and beliefs with your partner or birth attendant ahead of time, will allow that person to better represent you in any discussions that arise while you focus on your labour. It can be useful to avail yourself of the weeks leading up to labour to figure out how you feel about different interventions, and to reflect on what circumstances might lead you to seek or accept them.

When faced with proposed interventions during labour, many families have found that asking questions helps them better understand their options. Keep asking questions until you feel satisfied that you are equipped to make an informed decision. After asking enough questions, you might decide that the intervention makes sense for you and your baby, and you can accept or welcome its inclusion in your birth wholeheartedly. If you understand the medical procedure to be something that will help your labour, or ensure the safety of your baby, you can embrace it as a positive part of your birth experience. Or you might decide that the intervention would not be beneficial for you, in which case you can turn it down. If you believe the procedure would pose unwarranted risks, or is not something you want to do—for any reason—then you can decline with confidence, trusting that you are making the best decision for you and your family.

Certainty over whether a medical procedure is justified is ideal, but just as often, it is up to you to make the final decision that best suits your own beliefs, your own philosophies, your own goals, and your own assessment of the benefits versus risks of the intervention in that moment. If it is a medical emergency, trust your caregiver and shelve those questions! But most often, there is no clear answer, only choices. And ultimately, yours is the one that counts.