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Shared Decision-Making: Working with Your Maternity Care Provider

Written by Theresa Administrator. Posted in News Updates

our doctors attending to mothers in maternityWhen pregnant, giving birth and in the postpartum period, it is your responsibility to make informed decisions for yourself and on behalf of your baby. It is your legal right to give — or deny — permission for care. But how do you know what’s best for you both? Making informed decisions about maternity care means finding the best available information on your options and using that information to decide what's right for you and your baby. It sometimes means having the courage and confidence to ask tough questions of potential or current care providers and birth setting staff to ensure the options you want are available to you.

Rights and Responsibilities

Here at St.Theresa Mission Hospital-Kiirua,our  Maternity care providers are responsible for providing scientifically supported care and for meeting the legal standard of informed consent.This means that they must tell you about the possible benefits and harms that a reasonable person in your situation would want to know to make an informed decision.

 

Informed Consent
Whenever a medical procedure, drug, test or other treatment is offered to you, your legal right to informed consent means that your health care provider is responsible for explaining:

  • Why this type of care is being offered;
  • What it would involve;
  • The harms and benefits that are associated with this type of care; and
  • Alternatives to this care, and the harms and benefits of those other options, including the possibility of doing nothing at the present time ("watchful waiting").

 

Informed consent is not a form or a signature. It is a process between you and your care provider that helps you decide what will and will not be done to your body. In the case of maternity care, informed consent also gives you the authority to decide about the care that affects your baby.

Care Provider Rights
Your care provider has the right to agree or disagree to provide care that you may request. For example, if a woman requests a cesarean and has no medical need for this procedure, her care provider has the right to refuse to do the surgery. This is another reason it is important to be aware of your options in advance and seek more responsive birth settings or care providers if you are not getting the answers you want.

 

Shared Decision-Making: Working with Your Maternity Care Provider

Now that you have obtained information from high-quality sources on maternity care options, risks and benefits, you may be wondering how to have a productive conversation about all you’ve learned with your care provider. Ideally, you and your provider will engage in a process called “shared decision-making.” This process involves working together to consider the best available scientific evidence and your values and preferences.

If a high-quality “decision aid” tool is available for a decision that you face, it can prepare you to have a fruitful discussion with your care provider. Key elements of decision aids include: clarifying that there is a decision to make, identifying the options, presenting pros and cons of the options and helping you think about how the options might align with your values and preferences.

Having a strong working relationship with your care provider based on open communication, mutual respect and similar points of view can support this shared decision-making process. You may also want to make a list of questions before each visit and jot down answers during your visits. To get the information you need, you may need to say:

  • I don't understand.
  • Please explain this to me.
  • What could happen to me or my baby if I do that? What if I don't?
  • What are my other options? What if I take no action (“watchful waiting”)?
  • Please show me the research to support what you're recommending.
  • Where can I get more information?
  • I have some information I'd like to share with you.
  • I'm uncomfortable with what you are recommending.
  • I'm not ready to make a decision yet.
  • I'm thinking about getting a second opinion.

Be sure to take care to choose a doctor or midwife who respects your needs, values and goals. If you find out over time that you disagree with your care provideror the policies at your planned birth setting, you can explore other options.

 

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