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Mums having procedures without consent
[Posted: Mon 10/03/2008 by Niall Hunter, Editor www.irishhealth.com]
Just over 60% of women in labour in Irish maternity hospitals have had procedures performed on them during labour for which they have not given full permission, according to a new survey.
Of the women surveyed, only 38.4% said consent had been sought during labour by healthcare staff and given for all medical procedures,tests and treatment.
During the actual birth, only 33.3% of mothers said consent had been asked for and given for procedures; while for during pregnancy, the figure was 48.4%.
More than three-quarters of mothers surveyed said consent was an issue of concern for them with the Irish maternity system. The survey was carried out by the Association for Improvements in the Maternity Services Ireland (AIMSI).
The organisation has pointed out that all medical procedures, tests and treatments require informed consent by law. Informed consent is when information is presented to women in order for them to decide if they wish to consent to a procedure, test or treatment.
AIMSI says informed consent in the maternity setting means that the care provider addresses what the procedure is, why it is being suggested, what alternatives there are and any risks and benefits involved.
In the survey, which had 161 respondents, 61% said that in pregnancy (outside of antenatal classes) they had no opportunity to discuss choices and information regarding hospital policies, routine procedures and common procedures, tests or treatments which they may need to make a decision about during their pregnancy, labour or birth.
Just over 96 per cent of those surveyed said they would like to see information booklets readily available in all maternity units, health centres, and GP surgeries outlining maternity-related procedures, tests,treatments and benefits/risks.
Jean Kelly of AIMS Ireland told irishhealth.com the implications of the study findings were 'extremely serious'.
"It would appear that the rules of consent for procedures are adhered to in all other areas of medicine except maternity care. A woman going into a maternity unit should be given all the necessary information in relation to her care so that she can make informed decisions about it," she said.
Comments made by mothers in the AIMSI survey included:
"After the birth I was put on antibiotics without my knowledge . I thought they were painkillers, and as a result developed a bad case of thrush."
"A registrar came to check me and was about to perform a sweep (vaginal examination), when I asked what she was doing and stopped her. She assumed I would want one without even telling me what a sweep was."
"I had an ARM (artificial rupture of membranes - for induction) without my consent and against my wishes. I said
I did not want it and it was done anyhow."
"I feel that all women should have the right to the type of birth they want and should be treated with dignity and respect."
If you have recently experienced a maternity hospital, or any other type of hospital and would like to rate the level of care and service, click on irishhealth.com's Rate my Hospital facility at... http://www.ratemyhospital.ie
|Irishmum Posted: 10/03/2008 15:05|
|This is shocking and very worrying for any first time mums! Is it the case that once you enter a maternity hospital you have no rights? Even my vet has to get my consent before performing any procedures on my dog....it looks like Irish women aren't afforded the same respect.|
|L(JUQ59596) Posted: 10/03/2008 22:45|
|I am not suprised by these results. There is the attitude that you are merely a baby-carrying vessel when you're pregnant and that you should put up and shut up for the sake of your baby. It doesn't even matter if your baby is perfectly healthy. There is little dignity or respect when having a baby in Ireland. You would imagine this is the one area you would be safe from medical intervention, considering most pregnant women aren't going into hospital because they are ill...|
|Anonymous Posted: 11/03/2008 15:33|
|Is this a surprise to anyone, I doubt very much that it is a surprise to any woman who has given birth in an Irish Hospital. You are quite simply a unit which must be taken through a system as quickly as possible. If you try to interfer with the "system" you will quite quickly be shown what "Choices" Irish maternity care offers - Absolutely no choice whatsoever. The most choice you'll be offer is on the menu they will offer you on the postnatal ward afterwards and for that matter most of that tastes the same too. This is a human rights issue and if this is ignored by the Irish government then what exactly does "Government" mean, are our laws there for the breaking. Perhaps this is an issue which needs addressing at a European level, as it is clear that the legal rights of women mean very little in this country.|
|Niamh(nhealy) Posted: 14/03/2008 20:18|
|Cuidiu-Irish Childbirth Trust antenatal classes aim to educate and empower parents to make informed decisions about their care. Ultimately all decisions should be the parent's based on full information from health professionals and other sources. Performing procedures without consent is assault of a sort. Cuidiu's 'Consumer Guide to the Maternity Services in Ireland' highlights the differences in policies, practices and birth statistics nationwide. See www.cuidiu-ict.ie and click on Consumer Guide. It also has a section on 'What to expect' with a useful guide at the end on informed decision making. http://www.cuidiu-ict.ie/frulcrum.html?ep=13&ad=24&to=0|
|Anonymous Posted: 15/09/2008 14:14|
|I attended hospital last week for my first antenatal appointment. In advance I was given information about blood screening but nothing about the ultrasound. I was assessed by a midwife and then told I was being brought up for my ultrasound, I was given no information at all and I was not asked for my consent. I refused to have the ultrasound and as a result had to meet with a Consultant the following week. I met a Junior Doctor (I am a public patient) she discussed the issue with me, I gave her the research that concerned me and she said that I might like to discuss the issue further with the Consultant, which I refused. Why was there no information given about an ultrasound? Why was I not asked if I wanted one? Why did they not accept my decision? Why do they continue to advise that I should speak to others? Consent is a problem in Irish hopitals and one which should be addressed.|
|houseonthehill Posted: 05/07/2009 19:43|
I am due to give birth to my first baby in September, and this is exactly the kind of thing I've been dreading. In fact, the amount and type of interventions that could be made against my wishes worry me far more than the possibility of being in pain. The 'pain' is part of a normal bodily function - giving birth. I am aware of my need to focus completely on the birth process and 'go into myself', and I do not want to have to 'do battle' by having to resist numerous unnatural interventions. Just the thought of having to to defend myself while in labour is stressful, and stress is one of the main factors in making labour painful... which could lead to the need for intervention! It's a vicious circle, and as someone previously said, we are not 'ill' when we are in labour. Obviously there are women who are happy to hand themselves over to 'the experts' and are so afraid of being in pain in childbirth that they 'want every drug going!', which I can understand, but these interventions may actually make the labour process - something their body has been designed to do - longer and more painful, with after-effects to cope with too. Obviously, things can go wrong, which is why I will be at the hospital on the big day, but until they do, I'd just like to be able to get on with giving birth naturally, and asked for my consent to any interventions which are deemed necessary, after thay have been explained to me. I urge all expectant mums to look into the pros and cons of pain relief and interventions before they go into labour - a little research may make any decisions easier on the day.
See the link below for an interesting article on the 'Casade Of intervention in Childbirth.'
|buzz Posted: 06/07/2009 16:45|
Pain IS part of a normal bodily function yes but would we say the same of a man who has been thrown of a motorcycle and is lying at the side of the road with his femur protruding? Inferring that a woman should undergo pain in order to be more "at one" with the birthing process is frighteningly mysogynistic in it's approach. I have a friend who was forced to undergo labour without drugs because her religious FREAK of a husband did not want her to access drugs, telling her she should "feel the entire process and all it's beauty". What bullsh*t. If a woman carries a child for nine months and undergoes labour to give that child life then if she needs a little help on the way then why not. it is HER choice. To me, anyone who tries to tell a woman that she should or should not have pain relief throughout labour has either never given birth or gave birth in her sleep. Pain thresholds are relative and if a woman feels better with pain management that is her choice.
|houseonthehill Posted: 07/07/2009 13:14|
Of course it is her choice, which is surely the point of this article? What I object to is interventions being made against the woman's wishes. If a woman feels she needs an intervention or pain relief to help her give birth I am all for it; I just think that sometimes women don't realise that certain interventions may not be helpful to them in the long run - obviously this needs to be decided individually, in an informed way.
There is a big difference between a person in pain after a motorcycle accident, with a broken femur, and a woman in labour. Women have been giving birth for thousands of years and our bodies have been designed/have evolved accordingly. Birth does not necessarily have to be painful - there are plenty of birth stories and videos on the internet to back this up. Often it is painful (often, ironically, due to the anticipation and fear of pain), and if a woman decides she needs help it should be available. However some of us feel that interventions interfere with a natural process and they should not be routinely made without consideration for an individual's feelings.
To me, it is misogynistic to force procedures on a woman in labour, and assume she has no say in the matter.
|buzz Posted: 08/07/2009 13:33|
Of course it is just as wrong to force drugs on a woman against her consent, but I was not aware that this happened? Certainly it does not seem to be as rife as women being made to feel like they are bad people because they need some help along the way. I am aware that legally a woman is entitled to pain relief if she wishes but it is not the legalities that cause the problem, it is midwives, partners and other women who will judge and make their feelings heard even though it is none of their business. Yes women have been giving birth for thousands of years but in the absense of certain procedures many of these women DIED during childbirth. We could argue the "natural" theory until the cows come home but that does not make it right for women to be judged for needing help. It is NATURAL for the baby to pass through the birth canal, but that doesnt mean that an emergency c-section should not be carried out. It is NATURAL for people to fall ill, does that mean we should deprive them of cure? Or make them feel bad for wanting it?
|Ber Posted: 03/08/2009 02:46|
Pain is not necessary in childbirth! We are conditioned to expect pain as part of labour-even the word labour has negative connotations. My 1st labour was slow and painful and I took whatever pain relief was going- including epidural. During my 2nd pregnancy, I attended a number of sessions with a hypnotherapist, specifically trained to assist women prepare for childbirth and my 2nd baby's birth was so different. While I certainly experienced discomfort, it was nothing like before. I was in hospital less than 15 minutes before my baby was born and neither I nor my baby had the effects of drugs to deal with - she scored an excellent Apgar score, and latched on the breast to feed almost straight away. I felt more in control during the whole experience. The hypnotherapist I attended was based in Letterkenny and the sessions were individual, with the birth partner involved as well. If you do decide to try it, put your inhibitions to one side (it does sound very American-ish!) and really make the effort - you have to practice at home on your own to get maximum benefit. It's not like stage show hypnotists, it's about utilising your own body's mechanisms and not fighting against what is a wonderful experience. Good Luck and I hope all goes well!
|lir Posted: 10/06/2010 21:28|
How common is 'membrane swipe' prior to full term? Do we know its actually been done if an internal examination is been done?
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