Consent
If there was one thing, one tool, one gift I could give every family who was about to grow their family, it would be to know, understand and utilize the power of consent. One of the best tools out there to begin to practice this is the BRAIN concept; always asking about the benefits, risks, alternatives, checking in with your intuition and asking if you need to decide now. But to really delve into consent, to really understand its meaning, its process, its implications and how it manifests in the birth space is pretty invaluable.
The best resource I’ve been able to find out there is through Birth Monopoly and there’s a whole buncha links down below that you can explore after the video. Cristina, the founder of Birth Monopoly, is a really great writer and all of the articles are fabulous and relatively short and even the comment section is pretty powerful.
So to summarize the basic idea of what I would like you to know or feel or gather from all of Birth Monopoly’s work and this video is that consent is more than BRAIN. It’s more than your care provider obligingly laying out all your options and you being able to choose the one you’d like. It’s more than that because both language, the physical setting and the power dynamic can wildly affect this exchange.
One of my favourite definitions of consent is that it’s an active, affirmative, conscious, direct, unimpaired and voluntary agreement to engage with and continue with something.
What does all of this imply? Consent is ongoing. You have the right to start something and then stop something if it no longer feels right. You have the right to start with an induction and stop, if you so choose. You have the right to get an IV put in and have it removed, if you so choose. And so forth, with any and all scenarios you can possibly imagine in the birth space.
Consent is not given ahead of time. If you talk about a procedure with your caretaker beforehand and agree to it then but feel uncomfortable or no longer want to when the time comes, you have the right to say no or stop. And this is not you changing your mind because you couldn’t have known then what you feel now. Consent is always given in the moment.
Any sort of coercion always directly impacts whether or not something is truly consensual. Just because you have consented before does not mean your consent continues to be implied. If someone, anyone, in the birth space tries to use force, manipulation or their power or authority to try and convince you to do something you don’t want to do, it no longer becomes about consent but about that person disrespecting your boundaries and rights. If you say ‘yes’ after being coerced, it was not by definition, not a consensual decision. What does this sound like? “If you really ____________, you would __________”.
One of the last and biggest impediments to consent is feeling threatened. This is especially important and tricky in the birth room because it can feel like baby’s always at risk. Birthers are sometimes treated like anything could go wrong at any moment by the way they’re monitored, spoken to and treated. Monitors are placed on “just in case baby’s heart rate dips or crashes”, families are recommended inductions “just because the longer we wait the higher chance that something bad could happen” and eating is restricted or an IV is put in “just in case you need an emergency cesarean”. If you’re afraid that speaking up for what you want and what feels right will result in harm to you or your baby, or will harm or affect the care you receive from your care provider, then you are no longer engaged in a situation where giving your full and true consent is possible. If you are afraid of what will happen, or the consequences or repercussions of saying ‘no’, then your ability and right to freely give your consent has been taken away. There is now an uneven balance of power, someone maybe be using their authority wrongly whether intentionally or unconsciously, and the situation needs to be reset, reevaluated, and reconfigured.
Phew, okay. That got pretty heavy. So how then do we put all of this into practice? I try to remind the families I work with of one big thing:
Which means, you’re allowed to do or not do whatever you like. This is not meant to be a video about anarchy, radical opposition to OBs and midwives, but just a reminder that you *do* have a choice about everything. When your care provider tells you that you need to get an ultrasound, you’re allowed to say no. When they want you to do the test for gestational diabetes, you’re also allowed to say no. When they tell you it’s time for an induction, or that they need to break your bag of water, or that you can’t eat during labour, you’re allowed to say no. And the reason why you’re allowed to say no is also because you’re allowed to say yes; they’re proposing something as your care provider and you have the right to consent and agree, or not give your consent and say no. You are a medical consumer, you are their client, and YOU have the final say.
I absolutely have seen over and over how their suggestions sound more like preferences, or like it’s the only option or sometimes it sounds like a straight-up demand, but it’s your body and your medical care and if you say yes then it was your choice. Think back to all the examples above: “When they tell you that you need to...”, “When they want you to…”, “When they tell you it’s time...”, “When they tell you they need to…” or “When they tell you that you can’t…” none of those are examples of conversation between someone who has authority, your care provider, and someone who is vulnerable or under their care, you. Those sentence-starters are the reason why consensual conversations and thus consensual decisions are, heartbreakingly, not commonplace in some of today’s birth culture here in the GTA.
When you hear someone say, “I wasn’t allowed to eat during labour,” it was a suggestion that their care provider offered them, and in all fairness it sometimes comes with a side of coercion or threat, but that family agreed to do it. If it involved coercion or threat then it was not a consensual decision but at the end of the day, they had the choice and they chose to not eat. So “I couldn’t eat during labour,” actually should sound like, “The doctors didn’t want me to eat during labour so I didn’t.”
Part of what I want for you is to start using the BRAIN concept to have really good conversations with your care provider to be able to pick up on the can’ts, won’t let’s, and need tos so that you’re able to critically and honestly decide that if that’s what you would choose for yourself. It’s hard to make a decision if it doesn’t seem like there are any other options and knowing the benefits, risks and alternatives opens the door to getting the whole picture. If no other options are presented then it sounds like there are none, and if there’s no conversation at all surrounding a certain procedure, intervention, situation then it’s really hard to engage in any sort of consensual decision-making.
We will go over this a bit more in the prenatal but I’d like you to just start swirling this around in your head and see how you feel about it. If this rings true for you, if this is important to you, then we can delve into it deeper and do some role-playing and talk about different ways all of this can manifest. And if it’s something that you’re not super interested in exploring, that’s okay too. The whole point of consent is that you get to decide for you, and I will always 100% respect all of your decisions.
Check out the resources below if you’re so interested and there’s also a little fun-sheet that has some reflection questions regarding consent and other birth stories you’ve heard or maybe that you’ve experienced yourself.
As always, shoot me a text or give me a call if you want to chat, and I hope to hear from you soon.
If there was one thing, one tool, one gift I could give every family who was about to grow their family, it would be to know, understand and utilize the power of consent. One of the best tools out there to begin to practice this is the BRAIN concept; always asking about the benefits, risks, alternatives, checking in with your intuition and asking if you need to decide now. But to really delve into consent, to really understand its meaning, its process, its implications and how it manifests in the birth space is pretty invaluable.
The best resource I’ve been able to find out there is through Birth Monopoly and there’s a whole buncha links down below that you can explore after the video. Cristina, the founder of Birth Monopoly, is a really great writer and all of the articles are fabulous and relatively short and even the comment section is pretty powerful.
So to summarize the basic idea of what I would like you to know or feel or gather from all of Birth Monopoly’s work and this video is that consent is more than BRAIN. It’s more than your care provider obligingly laying out all your options and you being able to choose the one you’d like. It’s more than that because both language, the physical setting and the power dynamic can wildly affect this exchange.
One of my favourite definitions of consent is that it’s an active, affirmative, conscious, direct, unimpaired and voluntary agreement to engage with and continue with something.
What does all of this imply? Consent is ongoing. You have the right to start something and then stop something if it no longer feels right. You have the right to start with an induction and stop, if you so choose. You have the right to get an IV put in and have it removed, if you so choose. And so forth, with any and all scenarios you can possibly imagine in the birth space.
Consent is not given ahead of time. If you talk about a procedure with your caretaker beforehand and agree to it then but feel uncomfortable or no longer want to when the time comes, you have the right to say no or stop. And this is not you changing your mind because you couldn’t have known then what you feel now. Consent is always given in the moment.
Any sort of coercion always directly impacts whether or not something is truly consensual. Just because you have consented before does not mean your consent continues to be implied. If someone, anyone, in the birth space tries to use force, manipulation or their power or authority to try and convince you to do something you don’t want to do, it no longer becomes about consent but about that person disrespecting your boundaries and rights. If you say ‘yes’ after being coerced, it was not by definition, not a consensual decision. What does this sound like? “If you really ____________, you would __________”.
One of the last and biggest impediments to consent is feeling threatened. This is especially important and tricky in the birth room because it can feel like baby’s always at risk. Birthers are sometimes treated like anything could go wrong at any moment by the way they’re monitored, spoken to and treated. Monitors are placed on “just in case baby’s heart rate dips or crashes”, families are recommended inductions “just because the longer we wait the higher chance that something bad could happen” and eating is restricted or an IV is put in “just in case you need an emergency cesarean”. If you’re afraid that speaking up for what you want and what feels right will result in harm to you or your baby, or will harm or affect the care you receive from your care provider, then you are no longer engaged in a situation where giving your full and true consent is possible. If you are afraid of what will happen, or the consequences or repercussions of saying ‘no’, then your ability and right to freely give your consent has been taken away. There is now an uneven balance of power, someone maybe be using their authority wrongly whether intentionally or unconsciously, and the situation needs to be reset, reevaluated, and reconfigured.
Phew, okay. That got pretty heavy. So how then do we put all of this into practice? I try to remind the families I work with of one big thing:
- They’re not allowed to not let you
Which means, you’re allowed to do or not do whatever you like. This is not meant to be a video about anarchy, radical opposition to OBs and midwives, but just a reminder that you *do* have a choice about everything. When your care provider tells you that you need to get an ultrasound, you’re allowed to say no. When they want you to do the test for gestational diabetes, you’re also allowed to say no. When they tell you it’s time for an induction, or that they need to break your bag of water, or that you can’t eat during labour, you’re allowed to say no. And the reason why you’re allowed to say no is also because you’re allowed to say yes; they’re proposing something as your care provider and you have the right to consent and agree, or not give your consent and say no. You are a medical consumer, you are their client, and YOU have the final say.
I absolutely have seen over and over how their suggestions sound more like preferences, or like it’s the only option or sometimes it sounds like a straight-up demand, but it’s your body and your medical care and if you say yes then it was your choice. Think back to all the examples above: “When they tell you that you need to...”, “When they want you to…”, “When they tell you it’s time...”, “When they tell you they need to…” or “When they tell you that you can’t…” none of those are examples of conversation between someone who has authority, your care provider, and someone who is vulnerable or under their care, you. Those sentence-starters are the reason why consensual conversations and thus consensual decisions are, heartbreakingly, not commonplace in some of today’s birth culture here in the GTA.
When you hear someone say, “I wasn’t allowed to eat during labour,” it was a suggestion that their care provider offered them, and in all fairness it sometimes comes with a side of coercion or threat, but that family agreed to do it. If it involved coercion or threat then it was not a consensual decision but at the end of the day, they had the choice and they chose to not eat. So “I couldn’t eat during labour,” actually should sound like, “The doctors didn’t want me to eat during labour so I didn’t.”
Part of what I want for you is to start using the BRAIN concept to have really good conversations with your care provider to be able to pick up on the can’ts, won’t let’s, and need tos so that you’re able to critically and honestly decide that if that’s what you would choose for yourself. It’s hard to make a decision if it doesn’t seem like there are any other options and knowing the benefits, risks and alternatives opens the door to getting the whole picture. If no other options are presented then it sounds like there are none, and if there’s no conversation at all surrounding a certain procedure, intervention, situation then it’s really hard to engage in any sort of consensual decision-making.
We will go over this a bit more in the prenatal but I’d like you to just start swirling this around in your head and see how you feel about it. If this rings true for you, if this is important to you, then we can delve into it deeper and do some role-playing and talk about different ways all of this can manifest. And if it’s something that you’re not super interested in exploring, that’s okay too. The whole point of consent is that you get to decide for you, and I will always 100% respect all of your decisions.
Check out the resources below if you’re so interested and there’s also a little fun-sheet that has some reflection questions regarding consent and other birth stories you’ve heard or maybe that you’ve experienced yourself.
As always, shoot me a text or give me a call if you want to chat, and I hope to hear from you soon.