Why Informed and Not Implied Consent In Birth Means So Much

There is a meme going around on social media about consent and how it should be stated. There have been rebuttals to it stating:

“When you are having a baby you have to expect that you will have things done to you. It is expected.”

“This meme is disgusting. Women do not need to have vaginal exams at all. Stop vaginal exams all together. Stop this disgusting meme.”

“I am grateful for this meme because of what was done to me in my labour. I asked my Doctor to stop because she was hurting me and she didn’t listen. It really traumatized me.”

Consent is imperative in all aspects of our daily life. Consent is incredibly important when it comes to birth, and there are so many reasons why.

We, in Western culture cross many blurred lines when it comes to consent. We can see at the world level right now that lack of consent is incredibly damaging, traumatizing and terrifying for many individuals. We all have evidence in our daily lives of what our lived experiences are when we feel like boundaries have been crossed and informed consent has not been our reality. Each person’s lived experience will be different and we need to be completely trauma informed around the topic of consent.

If a birthing individual has a trauma history, re victimization can happen frequently in the birthing process with the policies and procedures that are community standard. A birthing individual needs to feel emotionally and physically safe during the whole process of the birth. Each step of the process must be met with permission for each procedure, each intervention, each attempt to examine the birthing individual’s body. Body autonomy is crucial for each individual because if the primary care providers do not have knowledge of a trauma history, vicarious trauma can often be the birther’s lived experience of birth. Compassionate care and including the birthing individual in every situation every step of the way needs to be the norm. Birth has to include the person giving birth, it is not to happen “to them.”

Implied consent is often the belief system of institutions and hospitals, and when forms are signed, many people believe that they are handing their well being over to those in charge of their care. It is not true and does not have to be this way. Many of our clients tell us about their birth experiences and the trauma they suffered and did not know they could advocate for themselves, and also were unaware that their partners could advocate. Many clients tell us that they did not even know how to discuss advocacy with their partners. Clients may not disclose their trauma history to their partners, may not be fully aware of their trauma themselves, and trauma may in fact surface during birth. We must be aware of this and know how to provide the right support to traumatized individuals and how to provide informed consent so that clients are not traumatized by their experiences.

As doulas, we are trauma informed. We do our very best to understand how birth can impact each individual and help provide support to make sure that trauma informed care is carried out. We are there to advocate, support and work with our clients and their health care providers around informed consent.

Birth shouldn’t be scary. Birth should be on your terms. Care provided in birth needs to ensure the birthing individual has the felt experience of being safe, seen, secure and soothed. Every step of the way.