I just wanted to add that while you should go over the birth plan with your doctor/midwife, you should also bring at least one copy to the hospital with you to show the nurses, because sometimes the doctor is not there for all of the labor.

oops i thought that was in there. bring a few copies for the nurses and doctors because like skylar said your doctor isn't always the one on. and the nurses might have shift change and so its good to have copies for everyone.

Remember that a birth plan is not a legal document. What matters are the orders that your provider writes. Regardless of who's signed your birth plan, it will not trump protocol unless your provider has ordered differently. It's not the nurses being mean; it's how it works.

No matter what your provider says you have the absolute right to say NO. You can refuse a cesarean, epidural, episiotomy...anything. And, if you've refused something...ex: You refuse an episiotomy and doc/midwife still cuts...that's considered rape. Anything placed within the vagina without permission is rape. Honey

Doula Honey wrote:No matter what your provider says you have the absolute right to say NO. You can refuse a cesarean, epidural, episiotomy...anything. And, if you've refused something...ex: You refuse an episiotomy and doc/midwife still cuts...that's considered rape. Anything placed within the vagina without permission is rape. Honey Not in all states, and it's completely not prosecutable. Giving people unrealistic expectations of the power of birth plans or of their control in a rapidly-changing medical setting is not fair.

Meghan said..."Not in all states, and it's completely not prosecutable. Giving people unrealistic expectations of the power of birth plans or of their control in a rapidly-changing medical setting is not fair." These cases disagree with the statement of being ..."completly not prosecutable" - Meador v. Stahler & Gheridian a jury awarded a woman and her husband 1.5 million dollar settelment. -Re:A.C. where Angela Carder's estate sued and won/reversed the decision George Washington University Hopsital waws awarded to force her to undergo a Cesearean at 27 weeks. Both she and her fetus died as a result of it. -Illinois Supreme Court upheld a pregnant woman's right to refuse a blood transfusion in Re: Fetus Brown =============================================== During Labor: Holding your hospital accountable under the emergency medical treatment and active labor act. The Emergency Medical Treatment and Active Labor Act (EMTALA) requires hospitals to admit women in active labor, explain the risks, benefits, and alternatives of all proposed treatments, and to honor their treatment wishes, including the right to decline treatment. To read the EMTALA statute and regulations, and to get more info... www.medlaw.com/healthlaw/EMTALA/index.shtml =============================================== You can download this info at... http://www.ican-online.org/resources/white_papers/wp_legalprimer.pdf While this is speaking more of your right to VBAC it does discuss your rights to birth and REFUSE TREATMENT. "And,refusing treatment is protected by; common law, case law, Constitutional law ( right to privacy & self determination protected by the 1st and 14th amendment), federal law (Emergency Medical Treatmen & Active Labor Act & the Patient Self-Determination Act), international tort law, state law, state mandated medical ethics and the eithcial guidelines of the AMA and American College of Obstetrics and Gynos. Provides all patients, pregnant or not, -the right to exercise self-determination & autonomy in making all medical decisions, including the decision to refuse treatment. -The right to bodily integrity: any form of non-consensual touching or treatment that occers in a medical setting constitutes battery. (episiotomy for example) ("In a medical setting battery is defined as touching or treatment that ocurs without obtaining proper informed consent:medical treatments that are substatially different from the ones a patient consented to: treatment that exceeds the scope of consent: or treatment provided by a physician other than the physician who obtained the patient's consent.") -the right to be provided with the necessary information on which to base medical decisions, including a diagnosis, recommended treatments and alternatives, the risks, benefits, discomforts, and potential disabilities of proposed medical treatments, realistic expectation of outcomes the right to a second opinion, and any financial or research interest a physician may have in proposing certain treatments. -The right to be informed of any potentially life threatenin consequences of a proposed treatment, even if the likelihood of experiencing such an outcome is rare. -The right to make medical decisions free from coercion or undue influence from physicians. -The right to have informed medical decsions witnessed, signed and documented by the attending physician and another adult. -The right to revoke consent to treatment at any time, either verbally or in writing." =============================================== And, under... "Customozing your consent forms:the new birth plan It's important to note here that birth plans are NOT legally binding documents. In fact, becaue they usually include a disclaimer declaring that the mother is willing to accept certain prcedures in the event of medical necessity, in reality birth plans function as blanket consent forms that allow hospital staff to perform any procedure THEY (emphasis mine) deem "necessary.' While birth plans can be a useful too for educating physicians and hospital staff about your wishes, a more effective means of enforcing your right to informed consent/refusal is to customize the hospitals's blanket consent form. ......most patients are unaware that they are not,by law, required to sign the hospital's consent form or that they have the right to make it reflect thier specific treatment wishes. It's possible for people to either customize the form themselves or to write down their refusal to consent to treatment on any piece of paper and sign it. To customize the hospital's form, put a line through any listed procedure and then add your own list of routine procedures, including cesarean surgery, which you wish to refuse, initial each change or addition and make sure to include the required signatures." A template to make your own informed refusal form can be found at... www.medlaw.om/healthlaw/EMTALA/formsample/index.shtml "Customized consent/refusal forms legally document your refusal to accept treatmen and alert staff that you understand and are prepared to protect your rights. In additon, such a document will require staff to obtain direct, verbal consent from you each time they want to do a procedure you've already declined in writing. Then you can decide at that time if a treatment is needed and if you should accept it or not." (Also, from personal experience...coming in with your form marked through, initialed, etc. really paved the way for one of my friends. She was treated with so much respect as was her due. All of her options were fully explained to her, she was given plenty of space both emotionally and physically to make decisons...no one brow beat her or did any scare tactics which is quite often used. Facts were given and if she asked for a personal opinion it was then given.) You can also get info about right to refuse treatment and how it is protected by the Center for Medicare and Medicaid Serviecs' Conditions of Participation. Basically any hospital who receives federal funding (about 80%) must adheare to the CoP that require hospitals to honor patients rights by many different bills and if they don't there are heavy fines and risk losing their medicaide/medicare funding. =============================================== So, yes...You do have rights....no matter who you are or where you live.

A template to make your own informed refusal form can be found at... www.medlaw.om/healthlaw/EMTALA/formsample/index.shtml OOPs the correct template addy is... www.medlaw.com/healthlaw/EMTALA/formsample/index.shtml Honey

In order to be prosecutable, the case must be accepted by the prosecutor's office. Having worked in support for sexual-assault survivors longer than I want to think about ,I can tell you that an episiotomy one did not consent to is going to be very low on their sexual-assault priority list. Second, the Angela Carder case (a civil claim, by the way) referenced above involved a woman with cancer who was sectioned preterm against her wishes and died as a result of the surgery, not a rape case at all. Citing the A.C. case does not bolster the claim that episiotomy=rape. Realistically, the only section one will be sued for is the one that isn't done. It's pretty much the first thing most people learn when they begin to work in birth care.

Pardon the confussion, I wasn't saying the AC case was equal to or evidence supporting that an episiotomy was equal to rape. It was being used as evidence that a woman has the right to refuse treatment. Also, while an episiotomy I'm sure is low on the sexual assult list...it's still a sexual assult. I understand that fully. But, low on a list of 'priorities' doesn't make it right...or mean it should be ignored or forgiven. While I don't think that is what you're saying at all. But mearly stating that it would be hard if not impossible in today's court systems. Most doctors are never punished. So many women back down or are afraid so say anything when they have been assulted during birth. When you quoted my info about being able to refuse a c-sec,epi, or episi, I thought you were saying that the unrealistice expectations also applied to that. But, on a side note...I don't think it is unrealistic for a woman to seek justice for an unwanted episiotomy. Assult is assult. (A client of mine had an episiotomy performed on her even after saying no so many times to it. She actually split all the way up into her labia when he cut her. For her 2 births after that she was terrified beyond belief during the pushing stage and not to mention the amount of extra healing, her own feelings of being disfigured because her labia has a scar, much like what a cesearean scar looks like, running from her perinium to the middle half of her labia major. It has also effected her sexuality/desire in a quite negitive way.) But, the information provided was that all women, men, children, have the right to refuse treatment and that if it is ignored it can and will be found punishable if people can only out last the bull that comes with cases such as these. And, you're quite right about the doc being sued for the section he didn't do. But, fear of what could happen should not hamper our lives. We all still drive or fly even though we could die. Yes, we were seatbelts, but most women also receive prenatal care and have healthy bodies. Sometimes, there has to be trust in women and their bodies. So many ignore that. But, trust or not from a doctor, s/he should ALWAYS respect what ever decision/choice a woman or man or child has concerning their care. We all have control...absolute control...over our own bodies....it's the whole reason this board is up...a woman's right to control what goes on with her body. Honey