Independence Day-Medical Freedom
Today’s blogpost is a guest post by my daughter, who is writing over at thereviewmirror.com She’s passionate about small government, medical (and all other) freedom, and since her mother is a midwife and has been in the birth world nearly half of her life, Ashlyn has a lot of exposure to challenges childbearing women have to a physiological birth.
There are many reasons to be grateful as we celebrate the 4th of July weekend-we are blessed to live in America, tumultuous as it may be. The nation is blessed with men and women who give their lives to protect our liberty-if you’re one of them, thank you.
Freedom as a right is never far from the headlines, as astounding as that seems; shouldn’t everyone have it, as long as it does no harm to others? The answer you’d expect is much different than the answer we have, unfortunately. To put this in perspective, I ask that you imagine that you sustained a serious laceration to your finger - some sutures, a round of antibiotics and some painkillers and you’ll be set. Before you’re even to the hospital, however, you’re informed that the surgeon believes an amputation is a safer alternative, as it’s too dangerous to leave the hand.
Seem unrealistic? OBs do it to women when they insist that a Cesarean section is safer than a vaginal birth. (Hint-it’s usually not. Know what is true about a c-section? It brings more money in for the hospital for a fraction of the time most vaginal births take.)
Throughout history there are many examples of those in positions of power and leadership taking freedom of choice away from those in their care. The Nuremberg Code was created in August of 1947 in response to the horrific experiments committed by Nazi doctors on those in concentration camps. The first part of the Code states
The voluntary consent of the human subject is absolutely essential.
This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject matter involved, as to enable him to make an understanding and enlightened decision. This latter element requires that, before the acceptance of an affirmative decision by the experimental subject, there should be made known to him the nature, duration, and purpose of the experiment; the method and means by which it is to be conducted; all inconveniences and hazards reasonably to be expected; and the effects upon his health or person, which may possibly come from his participation in the experiment.
The duty and responsibility for ascertaining the quality of the consent rests upon each individual who initiates, directs or engages in the experiment. It is a personal duty and responsibility which may not be delegated to another with impunity.
I’d like to draw your attention to the first few sentences-specifically “...without the intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion…” If this doesn’t ring a bell, then you haven’t been paying close enough attention. If you’re presented with an experimental medicine and given a choice, that’s one thing. However, having your access to school, church, work, or the grocery store limited by whether or not you receive that experimental medicine… is coercion. When facts are only partially given and mostly hidden behind inflated and unbalanced statistics, this is fraud.
In an age of such medical slavery, it’s important to know your rights regarding healthcare-especially birth. Informed consent is a basic, fundamental right. Mandated medicine and one-size-fits-all healthcare is counterintuitive to personal well-being. What is right for one person is not necessarily right for the next, even if their problems are identical. There are many things that contribute to an individual’s decisions regarding their own body. Past experiences may change the way they are able to address the situation. Personal values, religious beliefs, family history and intuitive mind-body connection all contribute to an individual’s decision. To pretend that any amount of medical school or practice time can prepare a doctor to make the best decision for their patient without first having a transparent conversation (informed consent time!) is to choose willful ignorance over critical thinking. Informed consent says that a patient is a whole individual with personal autonomy, capable of making decisions about their own health-including whether or not to take their doctor’s advice.
An example is a patient’s basic right to refuse surgery. ACOG says a planned vaginal breech birth should be an option for women yet there are very few hospitals that currently allow it and medical schools have stopped teaching breech. A woman facing the choice between a vaginal breech birth and a Cesarean section actually has no choice if the system won’t train providers to conduct a breech birth and/or the hospital won’t allow it. The woman has lost her medical freedom. Some of these women feel so strongly about a vaginal birth they’re willing to birth at home, without a skilled provider of any kind.
Another example is the very real story of an OB who told a woman at her due date that since the baby was not yet engaged in her pelvis, it was time for a C-section. The truth is, it was time for nothing but to wait the normal amount of time for baby to show he was ready. Though still not appropriate, if an intervention were needed, it would be an induction, not a C-section. Yet this mother trusted that her doctor was the expert and since he said it needed to happen, he must know what he’s talking about. A moment taken to give informed consent, including the pros and cons of waiting for baby to engage and telling her it was not abnormal that her baby wasn’t engaged would have blown his plans to get this woman “delivered” and have her off his roster of possible 2am calls.
Maternity care is not one-size-fits-all. Postpartum is not one-size-fits-all. Motherhood will look different for every woman and vary with each child. Assembly line healthcare fails to address individuals and the root of their concerns, further dividing doctors and patients into opposing sides where neither really understands what the other is playing at. When we choose transparency and insist on informed consent in ALL aspects of healthcare, we take a step toward unity. A system that doesn’t see its clients as people is not a system that will function well. Offering true and thorough informed consent is a step forward. A system that allows you to ask questions without becoming “that patient” is a great step forward. Standing for health freedom and medical choice is a vital action. Be informed. Make decisions for yourself. If you and your OB (or midwife!) don’t mesh, find one who does. Vigorously defend your medical freedom, your right to make decisions regarding your birth, and your right to informed consent. After all, isn’t that the world you want your child to have some day?
Happy Independence Day.
Next week starts a three part series about Ashlyn’s experience with a tongue tie release as a 24 year old. See you then! -Wen