A number of bloggers and birth educators have been discussing (and applauding) a recent commentary by Nicette Jukelevics, MA, ICCE, called 'Putting Mothers and Babies at Risk: Promoting the Elusive ‘Cesarean Delivery on Maternal Request’'.
In it, Nicette Jukelevics asks questions including 'Maternal Choice or Physician Choice Cesareans?', and I completely understand that this is a genuine concern for women whose first choice is a vaginal delivery.
However, for me, the most important aspect of her commentary is its 'suggested Patient Information Form', which Jukelevics would like every pregnant women to read, answer the questions and then sign, in order to 'accurately demonstrate that she is choosing a cesarean section that is based on informed consent.'
Patient Information Form
(Surely this is needed for cesarean AND vaginal delivery?)
I actually like the idea of such a form, and while I would like to see some modifications in the set of questions proposed here for maternal request cesarean delivery, what I am even more interested in seeing is the proposed Patient Information Form for pregnant women to read prior to choosing a planned vaginal delivery (primary and VBAC) - in order to ensure that this too is based on informed consent.
I appreciate that my request for equality in aiding informed decisions of both cesarean and vaginal deliveries will strike many birth educators as unnecessary - they may believe that the decision to plan a vaginal delivery is the norm or given, and it is only cesarean delivery 'pushed on women by obstetricians' that requires informed consent.
I believe that the risks associated with planned vaginal delivery - whether spontaneous, instrumental or eventual emergency cesarean delivery in its outcome - are often underestimated or ignored by birth educators, and that women are not consistently informed of the potential negative health implications (physical and psychological) for their babies or themselves.
ALL BIRTH PLANS HAVE ASSOCIATED RISKS - AND WOMEN'S INFORMED CONSENT TO TAKE THESE RISKS IS NECESSARY WITH BOTH CESAREAN AND VAGINAL DELIVERY.