Pregnancy is a period of great change for women and their families. With these changes, and throughout the stages of pregnancy, labour, birth, and the postpartum, families are presented with many choices to ensure optimal care. One of the fundamental principles of midwifery care is to engage women as active participants in their care by using a format of informed choice.
The College of Midwives of BC states that “Midwifery actively encourages informed choice throughout the childbearing cycle by providing complete, relevant, objective information to facilitate decision making. The practice of midwifery enables women to develop the understanding, skills and motivation necessary to take responsibility for and control of their own health.”
Informed choice is a right that pregnant women should be able to access regardless of whether they have a midwife, a physician or an obstetrician caring for them. The intention of informed choice is to provide answers for the following questions:
- What is the purpose of the proposed procedure/intervention?
- Are there any risks to this procedure, and what are the benefits?
- Are there any alternative choices?
- What happens if I choose not to have this procedure/intervention?
- How much time do I have to make a choice?
In an informed choice discussion, women can expect their midwife to provide the most current and relevant evidence, discuss options without bias, and inform them about community standards. The midwifery philosophy of care upholds the belief that women are the primary decision makers in their care. The most common informed choice discussions are in the following topic areas:
- Genetic Screening
- Ultrasound/ Amniocentesis
- Gestational Diabetes Screening
- Group B Streptococcus Screening
- Choices surrounding labour and birth: birth place (home or hospital), options in the post-dates
period, and interventions during labour including medications and cesarean section.
- Newborn Procedures: Screening, Vitamin K injection, Antibiotic eye prophylaxis, circumcision,
and infant feeding.
- Areas where there may be a need for a transfer of care to a physician or an obstetrician.
These are just some of the areas where you can expect to be able to discuss openly and fully what your options are in the childbearing cycle. No matter what circumstances may arise, you can rely on this relationship of shared decision-making with your midwife.