I can see the legal part of negligence of a hp. If you are calling an ambulance you are putting them in a position where they owe you a duty of care. And legally and ethically, as a health carer, it is our responsibility to meet that duty of care to the best of our ability. Just as nurses are expected to continue resuscitation measures on a pt until a dr has declared them deceased, unless unsafe to do so. And in a way that duty of care does make them fully responsible for your care, until someone more experienced/trained takes over.
By saying this I'm not saying a hp has the right to force care, but it is their obligation to try to enforce the best care possible.
Legal stuff sucks sometimes hey. It's annoying that the autonomy of parents is compromised because people can be a bit litigatious if they don't want to take responsibility for their own choices. I'd have loved to be a candidate for hospital-linked home birth, and a history of fast births made that one of my safest options, but a previous PPH meant that I was 'too risky' for the hospital to insure the home birth, even though that placed me at higher personal risk. It's crazy. I don't know how much weight a waiver would carry, I know I'd be happy to sign a waiver saying that I was the one making the call to stay home.
FWIW, I play the 'dead baby' card to myself. I just assumed most parents did when working through any tricky logistics? I play the 'dead child' card when I am teaching my kids about road safety, choking or allergy hazards, electrocution, water safety, and so on. Death is a hazard of being alive. I am totally entirely confident in my ability to birth babies, and have done so very successfully and safely in the past. I'm not alarmist, I don't expect things to go wrong. I do like to have a contingency plan. If someone goes into a birth situation entirely unaware of all of the risks and possibilities and options available to them, I wouldn't call them fully informed.
I hated the birth class where they showed us forceps, ventrouse, various machines—scared the crap out of me—and I was cross about them playing the 'danger danger' card. But they (even being a low-risk birth centre) saw the need for those things arise from time to time, and I guess playing that unpleasant card meant I was informed, even though I never needed that level of intervention. Every deck of cards has crap and useless ones that come in handy sometimes.
I don't appreciate fear-mongering about work-throughable scenarios, and I have definitely come across that in health professionals, easily. I didn't interpret Nickle like that though—perhaps it helped me to remember that a paramedic is less likely to be called out to a straight-forward, complication-free 6 hour textbook labour, and more likely to be called out to a premature situation, transfer, or very quick/rushed situation, and risk management is more of an issue for them.
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