Prenatal Testing and Informed Consent
There are so many tests that pregnant women are offered as part of routine care these days. This handout will help you get the information you need to decide which ones to have or decline. Each woman will make different decisions based on her individual situation, beliefs and values.
You should not feel pressured by your caregivers. There should be an atmosphere where you feel comfortable to ask questions and where your choices are respected. Take time to do your research and then decide. Even in labor you can say, “We’d like some time alone to consider”.
Some things to think about regarding prenatal testing are:
What will you do if the tests show a likelihood of a baby affected by genetic or other disorder? Will you have an abortion? If not, perhaps you might opt to skip the tests. Some parents want to know even if they will not have an abortion so that they can prepare.
The uncertainty while waiting for test results changes your experience of pregnancy. Women find they keep themselves from getting attached to the baby in case they choose to terminate the pregnancy. Some women feel very stressed about the testing procedures themselves. They find they cannot relax and enjoy the pregnancy and start loving the baby until all the tests are done. Some women feel stressed not doing the tests. Only you know what’s right for you.
Some tests are not very accurate or may not change anything about the course of your prenatal care or birth.
Tests cannot tell everything. There are some things that will not be picked up or findings may be inconclusive requiring follow up with other tests or procedures. Tests may not be able to predict the severity of the effect on the baby. For example: The baby may have Down’s Syndrome but be minimally affected. S/he will be able to go to school and live an independent life or s/he may be severely affected. Even if you have every test available the baby could be affected by something there is no test for.
Testing is not prenatal care.
There is a difference between nourishing yourself and your baby to promote health and looking for problems. Prenatal care is what you do every day for yourself and your baby. Eating well, being active, minimizing stress, having supportive relationships, educating yourself, sending love to your baby and yourself will nourish your body, mind and spirit. These things are what will do the most to help your body function well and grow a healthy baby. Testing is screening for problems.
Procedures for birth
Many procedures or common practices used to “manage” birth have not been well researched or shown to be of true benefit for mothers and babies. Episiotomy is one example. Ask your caregiver what they do routinely, find out all you can about the procedures and decide whether or not you want them done to you.
If you find that you and your caregiver disagree on too many things you may want to change to another caregiver who is more compatible.
Intuition or inner knowing is a valid source of information.
Mothers know inside themselves what is going on with themselves and their babies. This intuition is very important and can be very accurate when practiced. Take time to tune in to yourself and your baby. Sometimes you need help with contacting your inner wisdom and sorting out the inner voices. Find people in your area that can support you in your efforts and help you with this.
Use a combination of reason and inner knowing to make your decisions.
Some resources you might find helpful:
Books:
The Thinking Woman’s Guide to a Better Birth- Henci Goer
Ina May’s Guide to Pregnancy- Ina May Gaskin
A Good Birth, A Safe Birth: Choosing and Having the Childbirth Experience You Want- Diana Korte
Birthing From Within- Pam England
Gentle Birth, Gentle Mothering- Sarah Buckley
A Guide to Effective Care in Pregancy and Childbirth- Murray Enkin, others
Immaculate Deception- Suzanne Arms
Books by Michel Odent
Websites:
www.childbirthconnection.org
www.cfmidwifery.org
www.motherfriendly.org
www.ican-online.org
www.mothersnaturally.org
www.cochrane.org/reviews/
QUESTIONS FOR TESTS AND PROCEDURES
Use these questions to help you get information to make a decision as to whether to have a test or procedure done.
You have the right to know everything about your care. You have the right to refuse any treatment or test. You have the right to choose who will take care of you. Use both your head and heart to make the best choices for yourself.
TESTS
* What is the name of this test?
*What information will this test give?
*What will it not tell?
*Are there any risks associated with this test?
*Are there other ways to get the same information?
*How accurate is this test? Can it give a false negative or positive result?
*If the results are negative, what will be done next?
*If the results are positive, what will be done next?
*What if you choose not to have this done?
PROCEDURES
*What is the reason for this procedure?
*What are the benefits?
*What are the risks or side effects?
*How is the procedure done?
*Does this procedure always work? If not, why and how often?
*If this procedure doesn’t work, what will be done next?
*What other choices are available?
*What are the potential consequences of not having the procedure done?
To refuse a procedure if a practitioner is not paying attention to your wishes you can strongly state “I refuse to consent to____”
Using your BRAIN helps you to remember what questions to ask.
B= Benefits
R= Risks
A= Alternatives
I= Intuition. What is your gut feeling telling you?
N= Now or never? Do we have to decide now? When? What if we do nothing?
"Birth is not only about making babies. It's about making mothers—strong, competent, capable mothers who trust themselves and believe in their inner strength."
— Barbara Katz Rothman
Herbs for the Childbearing Season
Women have always called upon herbal allies during pregnancy, birth and lactation. Herbs help to heal by working with your body to nourish and improve functioning in the areas to which they are specific. They can be considered special foods that supply high quality, easily assimilated nutrients along with their other beneficial qualities.
One of the best and easiest ways to take these herbs is to make an infusion.
Preparation: Fill a quart jar 1/4 - 1/3 full of dried herbs. Fill the jar with boiling water. Cover and let steep 2-4 hours. Strain and drink. Refrigerate leftovers.
The following herbs are recommended throughout your pregnancy and postpartum. In fact, the whole family can enjoy them! Try each one separately at first to see how your body reacts. Then you can mix them together and add juice, lemon, honey, etc. if you desire.
Oatstraw or milky seed (Avena sativa)
Wholesome food. Lots of calcium for strong bones and teeth. Nourishes the nervous system helping you to sleep better and deal with stress. Strengthens capillaries of the vascular system to help prevent and shrink hemorrhoids and varicose veins.
Nettle leaves (Urtica dioica)
Nourishes the hormonal system. Rebuilds kidneys and adrenals which work very hard during pregnancy. High chlorophyll content. Rich in vitamins A, C, K, calcium, phosphorus, iron, sulpher and folic acid. Good for preventing anemia.
Red Clover blossoms (Trifolium pratense)
High protein content. High vitamin and mineral content. Anti-carcinogenic, calming, fertility tonic.
Alfalfa (Medicago sativa)
Great nourishment! High in vitamin K.
Red Raspberry leaves (Rubus ideaus)
Specific for uterine toning. Rich in calcium, vitamin C and iron. Eases morning sickness.
After birth sitz bath:
Yarrow (Achillea millefolium)
Decreases swelling, bleeding and bruising, fights infection, speeds healing. Pain reliever. Shrinks hemorrhoids
Comfrey (Symphytum officinale)
Rich in vitamins A, C, B-complex, B12 and minerals (calcium, potassium, iron). Contains a cell proliferant that encourages the growth of normal cells and the elimination of abnormal ones. Speeds healing.
Liver nourishers:
Dandelion root (Taraxacum officinale)
Milk Thistle seed (Silybum marianum)
Burdock root (Arctium lappa, spp.)
I may recommend additional herbs depending on your individual needs.