A Story of Informed Consent: How it May Be Gathered During the Pregnancy, Labor, Birth, and Postpartum Journey

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On September 17, 2009, I gave birth to my first child. She was a little thing. 5lbs. Perfectly healthy, lungs functioning lovely, ten little fingers and ten little toes. Beautiful as she wanted to be.

I was medically induced 37 weeks into my pregnancy. The high-risk OB/GYN that I was assigned (under the direction of my primary OB/GYN) to visit bi-weekly and then weekly, said that at 36 weeks and 6 days, my amniotic fluid was low and that he was scheduling an induction (never was there an opportunity presented for the giving of my consent, every decision was presented as an order, with very little accompanying information) because he said the baby would grow better on the outside than it was on the inside.

Better on the outside of my young, healthy, baby moving often and predictably, feeling physically well but dealing with a lot of external pressures and foolishness, no reliance or usage of prescriptive or illicit drugs, medicaid having, non-income producing at the time, not a soul in the room explaining things, let alone advocating, Black body in the South than it was on the inside? Ain’t that some stuff?

Now, as a mother of five, who went into spontaneous labor four times after this at 39ish, 40ish and 41ish(x2) weeks, and as a Certified Birth Doula and fiftenn year veteran of the middle-of-the-night, underground writer and researcher of all things How Can Black Mothers Get Through AND Thrive in America club - I host many questions over a scenario like the one I lived, these days. Such as, what kind of low amniotic fluid are we talking about here? What is this doctor and his practice’s definition of low? What are the benefits beyond better on the outside? What does that really mean? What are the risks that I’m taking when I comply with this directive? Might I be more likely to welcome other interventions during the course of my labor that affect, or potentially risk my life or the life of my baby? Could the synthetic oxytocin being used here, tone down my body’s own natural desire to flow its love hormone all over and through me, and will this effect my ability, postpartum, to maintain my happy, maintain my mental wellness? Might breastfeeding be harder to establish with a drug induced and managed birth? While we’re here, what has specifically deemed me high-risk? My OB labeled me such when she said an ultrasound showed that my baby was measuring small for gestational age. What does this doctor and her practice deem small? And where might my “just shy” of 5’ 4” husband and my size zero clothing, fresh out of college, fit in with the size our baby seems to be shaping up to be in utero? Also, since I wasn’t quite sure when I conceived or the exact date of my last period - when my ignorance gave introduction to technological equipment and its standard equations (and what does standard mean, like, for all pregnant people or does the algorithm have certain sizes determined for certain folks’ babies?) for determining the gestational age of my baby - how are we certain that the baby they said was something like small, with fluid they said was something like low, was actually 36 weeks and 6 days at all and ready to be born ahead of the five weeks and one day the average, healthy mother and healthy pregnancy has left to blossom? Are there alternatives to this induction? To this label of high-risk? Could I lay down for a while, day by day, week by week, up to a month even?

My intuition, even then, told me that my baby was perfectly fine. Healthy and strong, and smaller than the average American baby. That her mother was thin, that her father was short, that doggone it, WHY didn’t I keep better track of my freaking periods! I’d been having them for over a decade by then, why didn’t I have my own habitat down to its own science? Why didn’t I know that I could wonder, toss around the idea even, what it would and could have been if I decided I wanted my baby to stay growing in utero and choose to do nothing that was demanded at all? And why on earth was I not equipped, at 23 years old, to ask all of my questions, to be my own mother-loving advocate, to quite possibly, after gathering all of the information I needed to give some balanced, healthy, as thoroughly as could be gathered informed consent, say,

“no?”

But ‘no’ with a period.

“No.”

“PERIOD.”

I do a better job of tracking my periods these days, by the way. Your girl has learned all her little mother-loving lessons. Gave myself license to use my BRAINs. Speaking of, I’ve added an ‘s’ to the standard acronym of BRAIN that birth doulas commonly use to encourage our clients as they gather their own informed consent:

Because support really does matter. It matters a whole lot. It matters to and for every human being from every walk of life, every sphere of this atmo. And in this birthing world, in birthing bodies, with folks who are new to growing life inside their bodies, with folks who are new to growing the life of another new body again, inside their bodies - we need support as we make decisions for our lives, for our bodies, for the lives that we carry.

Birth in America, specifically in its lording systems and predominant model of care - needs to be delivered anew. All of them births. Black birth, brown birth, everybody who births - ought be unquestionably supported through procedures and decisions. Ought be supported through the decision-making processes. Ought find somebody right next to them after they’ve made a personal decision that says you know what, i’m right here in this with you, I am here for you. We ought feel licensed to safely gather access to informed choice, supported decisions, and supported experiences.

As with most mother-loving lessons I’ve learned over the course of my hard-fought quest to getting through AND thriving - it wasn’t for me that it came the hard way, that it came without the BRAINs. It was for my children, and it was for some other mommas and some other daddies and some other babies that I got through what I got through, that I fight through what I fight through. That I went on to spend long nights and continue on in the long days and the long nights gathering and nurturing what the folks need for their own birthing, for their own freedom, for their own license. It was for the people who I will always inform, who I will always support - to birth anew.

May this story give thought and confidence to the attainment of a holistically informed and supported pregnancy, labor, birth, and postpartum journey.