How do you feel about 'assumed consent'?

[onthefly]

You know, you posted a similar question some time ago and I said that I was cut without consent, but it was ok because i'd consented to the forceps and just figured the episiotomy was necessary.

I've changed my mind completely. I honestly feel really ashamed to have been treated this way and to have tried to convince myself that it was ok.

How on earth anyone could think it's ok to cut someone's genitalia without explicit permission (and excepting in a life & death situation where the woman is incapable of giving consent) is completely beyond me.

Ultimately women should and must assume and retain autonomy over their bodies. Ideally, they will be cared for with dignity and respect by a carer who will work with them to ensure they have the best birth possible. For most mothers, this means they will feel trust and security in the advice offered by their carer. I kidded myself that I trusted my OB - but it was a sham to protect myself. He didn't think I deserved even an explanation, let alone the opportunity to decide for myself.

[Ree*Ree]

MadB, I could almost have written your post word for word, except I had a vacuum assisted delivery.
I'd had an epidural, so although I felt no pain I could feel the tug of the scalpel on my skin *shudder*.
I was never asked for consent, nor even told that I'd had an episiotomy until 3 days later when I asked the nurse who was cutting my stitches how everything was healing down there, and she said the 2nd degree tearing and the cut were healing well... It's not until right now that I realise how wrongly I had been treated, and how angry I am about it, and am determined not to let it happen ever again

So yes, informed consent is a must. NEVER assume consent in any situation.

[little_O]

Thanks for sharing. Do you know why you feel this way? i know the messages i got from my mum were labour is scary, you don't have much say and that is the way it is ('leave your dignity at the door' kind of comments). I thought her view sucked and so i looked into it further, but i think some of her fears still rubbed off. DS' birth changed this for me, and for my Mum.

Do you feel similarly about other professionals (health or otherwise)?

I'd think it would be from other both experiences I had been raised hearing. From the research I had done prior to birth I had decided I should be able to avoid being cut, and despite my ob's explanation I had written in my birth plan I wanted to avoid an episiotomy if possible. I guess it happens so often and appears common that you forget to question it.

I would say I am fairly trusting, but I also like to be educated even if that means me doing my own research. There are some things I would refuse medically completely, and if they were violated I would be angry to say the least. I believe in trying to work in with the hcp so that everyone is comfortable in the end. In the end though every patient has the right to accept and refuse medical treatments without judgement or pressure.

My mum actually tells me she wishes there was the same education of women in birth as I have afforded myself.

[Heaven]

Wow I am absolutely outraged at how many people this has happened too. That is awful! I had in my birth plan that I did not consent to episiotomy and I also told DH if he saw anyone coming at me with the scissors to stop them!

Luckily it was never mentioned but I am so sad and outraged for all you ladies who weren't so lucky

[Butterfly Dawn]

Here's a question in a round about way. Ds 2i had tearing as he was face up. Dd i had tearing cause i didn't stop pushing lol. But ds1i was cut, no question, 3times even though i screamed and begged her to stop. She cut up- not down and didn't stitch anything afterwards. It changed alot of things after, one being i get uti easy now.
Anyways, my question is, why would she cut up-not down? and why couldn't it be sewen back up? it bled for ages, like weeks.
She was busy, hospital team and 3of us were giving birth at the same time, met 1of the others in a class run at a birth centre. But still, there was no ripping other then the cuts up she did.

Sorry if it doesn't make sense, the barefoot princess is covering me with kisses

[chody47]

I think I must be an exception to the rule. I had an epi. I didn't realise at the time. I didn't feel it. DD was coming out very fast (I saw on my hospital notes recently when seeing my ob for #2 that it took just 13 mins). I knew I had stitches afterwards, I thought it was because I tore. It wasn't until I saw my hospital notes back in my room that I saw 'epi' written and realised what had happened. It healed very well.

I say that I'm an exception to the rule as I honestly don't mind it was done. I think if I knew they were doing it I would have been more nervous. TBH, my main wish for the whole birthing experience was to have DD in my arms safely and that happened. TBH, if I had the exact same birth with this bubs I wouldn't care, I just want my baby.

[little_O]

I think I must be an exception to the rule. I had an epi. I didn't realise at the time. I didn't feel it. DD was coming out very fast (I saw on my hospital notes recently when seeing my ob for #2 that it took just 13 mins). I knew I had stitches afterwards, I thought it was because I tore. It wasn't until I saw my hospital notes back in my room that I saw 'epi' written and realised what had happened. It healed very well.

I say that I'm an exception to the rule as I honestly don't mind it was done. I think if I knew they were doing it I would have been more nervous. TBH, my main wish for the whole birthing experience was to have DD in my arms safely and that happened. TBH, if I had the exact same birth with this bubs I wouldn't care, I just want my baby.

This is what I have been trying to say, always thought it was a necessary evil. I just have a massive fear of being cut....and needles lol. Although new research says tearing is actually better (which also had me freaked out), either way that area may get mutilated!

[chody47]

This is what I have been trying to say, always thought it was a necessary evil. I just have a massive fear of being cut....and needles lol. Although new research says tearing is actually better (which also had me freaked out), either way that area may get mutilated!

I had a massive fear too, which is actually part of the reason I'm glad I wasn't told. I didn't need to worry about it about to happen.

[PumpkinZulu]

Wouldn't you have rathered you'd not been cut at all though?

[chody47]

Wouldn't you have rathered you'd not been cut at all though?

Yes, if I wasn't going to tear then I do wish that, but if I was going to tear (and I guess i trust my ob in that they wouldn't have cut me unless I was going to) who is to say it wouldn't have been worse than the cut? Yes, it could have been less and I guess we will never know either way. Either way, I guess I'm happy with how my body has healed and feel that I had a pretty positive birth experience over all. I guess I've got a pretty simple way of looking at it.

[Rouge]

His thread has mad me so angry. And horrified for all women. And disgusted. Did I mentioned that.

[little_O]

His thread has mad me so angry. And horrified for all women. And disgusted. Did I mentioned that.

Why are you horrified an disgusted?

[bellany]

Why are you horrified an disgusted?

I would say because women are being treated like slabs of meat, having their genitals cut without any warning or even being asked.
Tearing is almost ALWAYS less painful, quicker to heal, carries less risks, less infections etc so I know I would be livid if I was cut instead of being 'allowed' to tear naturally.
I have birthed 9lb babies with only a graze and a 7lb baby with a small tear so its impossible for an ob to predict you will tear and how badly imo.

[PumpkinZulu]

Because women are having their genitals cut (often without true medical need, just in the name of routine) without their permission, and the only reason it's not seen as assault is because the person doing it went to university for a few years more than most people.

[nothing2lose]

I think there is a difference between having a relationhip with an OB (through the private system) that you have chosen and you trust to do the right thing when it is game time, versus having your child delivered by someone you have never met before within the public system.

I would also prefer to be cut, with or without my informed consent, if it meant having a healthy child born alive at the end.
I imagine most HCP would see that as their end goal and would assume, rightly or wrongly, that most women would too.

[shan23]

I would also prefer to be cut, with or without my informed consent, if it meant having a healthy child born alive at the end.
I imagine most HCP would see that as their end goal and would assume, rightly or wrongly, that most women would too.

Same here. And I agree with Chody too, I dont mind that I was cut. I went public, but I still trusted that the ob who was there with me had my sons best interests at the top of his priority list. When I saw him grab the scissors and asked what they were for and he told me, I was fine with it. Maybe I feel so 'meh' about it because I had zero healing issues with it and it wasnt painful. Idk. I definitely was not treated like a slab of meat, or feel like I was assaulted or anything like that.

[BellyBelly]

Even though I have seen and heard this for years Rouge its fired me up about it too. Ive actually been at a breech birth where episiotomy was discussed before the birth, she said she didnt want it. At the birth (that was going beautifully) he announced he was going to do an episiotomy, so she turned to her husband and said something, cant remember but either a 'what do you think/I dont want this' and the Ob defiantly said back that he was telling her she's having one. I was so angry.

The thing is too, episiotomy also cuts through layer of muscle and as an expert once pointed out to me, Obs are specialists in obstetrics, not muscles. They do a quick stitch up job often without consideration to the muscles. So you hear of women who have bad recovery jobs. And Obs allowed to practice saying things like this to the husband: 'Would you like me to put in a couple of extra stitches for you?' (make her tighter. Grrrr so angry right now.

[BellyBelly]

You only have to speak to independent midwives - many have done NO episiotomies or some remember one or two they had to do in their career. Rates in hospitals are way too high, private much worse and interventions facilitate many of these happening in the first place. Sure you can trust your Ob but sometimes you dont know what to ask because you have no idea what you're going to come up against.