22. Understanding Your Rights - Informed Consent & Informed Refusal in Any Birth Setting

In this episode, I'm breaking down something every pregnant mama needs to know: you always have a choice when it comes to your birth care, no matter where you're planning to deliver. We're diving deep into informed consent and informed refusal—your fundamental rights that don't disappear just because you walk into a hospital or birth center.

Too often, I see birth educators and doulas painting medical staff as the enemy, creating an "us versus them" mentality that honestly breaks my heart. The truth is, your birth team wants what's best for you and your baby. Interventions have their time and place, and sometimes wisdom means choosing something that wasn't in your original plan—and that's perfectly okay.

Whether you're planning a home birth, birth center delivery, or hospital birth, feeling overwhelmed by medical decisions, or simply wanting to feel more confident advocating for yourself—this episode will equip you with practical tools and biblical wisdom for navigating birth choices with peace and partnership.

In this episode, I share: 

🧠 The BRAIN method for making informed decisions (a framework I teach in my Online Christian Childbirth Education that works for any health decision) 

⚖️ What informed consent and informed refusal really mean—and why both matter 

🤝 How to work collaboratively with your birth team instead of against them 

🏥 Your rights in every birth setting: home, birth center, and hospital 

💭 Practical tips for advocating for yourself while building partnership 

✝️ How James 1:5 fits perfectly into wise decision-making during birth

Scripture Shared: 

"If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him." – James 1:5 (ESV)

Mentioned in this episode: 

🎧 Episode 5 Creating Your Birth Preferences: A Step-by-Step Guide - A good overview of typical choices you’ll want to think through before birth

✨ Christian Mama Birth Prep Library - Free birth prep tools, worship playlists & more

✝️ Online Christian Childbirth Education - Explore my complete birth preparation self-paced course

💛 Work with Me 1:1 - Personalized pregnancy and birth support that integrates faith and evidence-based care, including virtual coaching, doula support, and comprehensive childbirth education

If this episode empowered you, please subscribe, leave a review, and share it with a mama who needs to hear this message.

Let's choose knowledge and collaboration over fear and opposition, one birth decision at a time. Go here for the full blog post, show notes, and all resources mentioned!

Transcript

Natalie Portman: 0:45

Hey there, beautiful Mama. Welcome back to the show today. I'm so glad you're here because we're diving into something that I think every pregnant mama needs to know about, and that's your rights when it comes to informed consent and informed refusal no matter where you plan to give birth. So before we jump in, I want to set the tone for today's conversation. This episode is all about empowering you with knowledge, not about creating some kind of battle between you and your birth team or your provider. I've seen this way too many times with doulas and childbirth educators, and they paint the medical staff as the enemy. And honestly, that just breaks my heart because it's absolutely not the case. The truth is interventions can have their time in place. Sometimes the wisest choice you can make is to choose an intervention that wasn't a part of your original plan, and that's okay. Today I want to walk alongside you so that you feel confident in your ability to make informed decisions while working collaboratively with your birth team. Because here's the thing, knowledge is power and collaboration leads to the best outcomes for you and your baby. So what is informed consent? We'll start there. You know, when I was pregnant with my first, I thought informed consent just meant, you know, signing the paperwork that they throw at you at the hospital. But it's so much more than that. Informed consent. There are four main components, and I want you to remember these because they're the foundation of every decision you'll be making during your pregnancy and birth. Again, no matter where you're giving birth home, birth center, or at the hospital. So the first is information. You have the right to receive complete accurate information about any intervention that they're recommending. So not just the bare minimum, but you can ask for that whole picture. So the second is comprehension. So this is. You having a good understanding of the information that they're explaining and that it's in terms that you understand if your medical team is using medical jargon or other terms that you don't understand that go over your head. Just ask them to break it down so that you have an understanding of what they're talking about. And then third is voluntariness. And so this is, you have the right to make decisions free from pressure or coercion so nobody can be rushing you or should be rushing you to make a decision. You're doing this voluntarily. You're making choices. Voluntarily. And then finally, capacity. And this is recognizing that you have the mental ability to make these decisions. You are not an incubator mama. You are a thinking, reasoning, image bearer of God. And who gets to choose what happens to your body and to your baby is you. So now I want to teach you a very helpful acronym that I teach inside my childbirth education online course. But I'll kind of touch on it briefly here, and I call it the BRAIN acronym. And you maybe have heard of this before. Or the brain method. And honestly, it's been a game changer, not just for me and making birth decisions or as I kind of help doula and birth coach my clients, but also for making decisions outside of birth. This is, it's something you can take into, you know, care for yourself talking with your provider outside of pregnancy and birth or with your child's pediatrician. There's just so many ways you can. You know, use this brain method, so it stands for the following. B in brain stands for benefits. So this is where you're gonna be asking what are the benefits of this intervention? And just really understanding like, why are we wanting to go with this particular intervention? What are we trying to avoid? What are we trying to help with? Like understanding what's the benefit of that intervention. The second is R and R stands for risks. And this is you understanding what are the potential risks or side effects, and that includes both common and rare complications or risks and side effects for certain interventions. So just having an understanding of, okay, if we decide to go with this am I comfortable with these risks or side effects? The A in the brain acronym stands for alternatives, and this is you having an understanding of what are other alternative options that are available besides this one intervention you're proposing. Maybe there's a middle ground or a completely different approach that might be appropriate or reasonable. So that's a good thing to talk through with your provider as well. And then I stands for intuition. And this is you, like really checking in like what's your gut telling you? What's the Holy Spirit telling you? And this is where I love to tie in James one, five. And this verse says, if any of you lacks wisdom, let him ask God who gives generously to all without reproach and it will be given to him. So I think it's so beautiful that if you are trying to check in with the Lord about a certain intervention, you just need to ask him. If you lack wisdom, ask God. Lord, give me the wisdom to know what decision to make. And if you have the time and your provider is giving you the time, I would absolutely stop and just pray about it and just check in with the Holy Spirit and just say. Holy Spirit, please just fill me with a supernatural wisdom to know what to do or not do. And that finally leads me to the last letter in the brain acronym N. And this stands for no or not. Now. And this is when you say No, thank you for whatever intervention they're proposing or say. Not now or can we wait? And those are both reasonable things to say, especially if you're talking about risks. Say the risks you're uncomfortable with or there's an alternative that you would rather try that alternative first. Or just flat out you're praying about it or you're just in your gut. There's something just telling you, don't go for this intervention then, you know? And I just cannot tell you how many times I've used this brain acronym, method framework. And again, from deciding things about my kids' vaccinations or, choosing treatment options if I am, having a certain symptom or something, it works for so much more than just birth decisions, but I find it to just be a really helpful guide as you are moving through decision making. And then let's talk now about informed refusal, because this is where some people get nervous, especially in a more clinical setting, typically. But informed refusal is simply your legal right to decline any intervention, even if it's being recommended by your medical team. But here's what it is not. It is not being reckless or completely ignoring and being disrespectful to medical advice. Really this is just you wanting to make an informed choice after you've gotten all the information. And even a no could just be as something as simple as not right now, or let's revisit this in, you know, an hour or, you know, whatever, how much time you need. And sometimes it is gonna be a no thank you or I am not comfortable with this option or intervention. The key word with all of this is informed. You are not saying no just to be difficult. You are making a thoughtful decision based on all the information you've gathered, and also, again, checking back in to the Holy Spirit, to your gut what you're knowing to be the best course of action would be. And you know, here's something really important that I want you to hear me say is your right. Don't change based on where you're giving birth. So say you're planning a home birth, or you know, a birth center or a hospital birth. These all of these rights that I'm listing out are the same fundamental rights. If you are planning a home birth, you have the right to transfer to a hospital if you want to at any point and you have the right to accept or decline certain protocols. That your midwife is suggesting you absolutely have the right to change your mind about interventions as your labor progresses. Say you guys talked at one point about, wanting to avoid a certain intervention, but things are changing and okay, we're gonna change course here. If a birth center is, you know, the. Place where you would like to give birth. You have the right to discuss all of the birth center's policies and procedures, and you also can decline routine interventions that you're not comfortable with. And again, just like home birth, you have the right to transfer to hospital if that is where you feel like the best care for you would be. Okay. And then in a hospital birth again, I feel like most women kind of associate losing their choice at this point. But no, you absolutely have the right to decline routine procedures and interventions things like, you know, IV fluids or having continuous monitoring if intermittent is appropriate for your situation, you can request alternatives if they're, available safe options. And you have the right to have your birth preferences respected when, especially when it's medically safe to do that. But anyway, in any setting, you have the right to ask questions and request time to make decisions as long as it's not an emergency situation. And that sometimes can be a tell. Also say you're, they're trying to push on intervention for you to make a decision right away. Just say, can we pray about it? You know, if they're not a believer, they might also be uncomfortable with you saying Hey, can I pray about this? But just say, we're gonna pray about this. And if they're like. Okay, well then, you know, it's not an emergency situation. If it was a true emergent emergency situation, they're not going to give you the time to think things through, which again, you don't need to be coerced into just making a decision based on fear, because again, we are operating in faith over fear. So now I want to spend some time talking about something that's really close to my heart, which is working with your medical team, not against them. When your doctor or midwife recommends an intervention, they are not trying to ruin your birth experience. They are trying to make recommendations. Based on their different levels of training or experiences and the evidence that they have. So they're motivated most of the time. Like I, I may feel like most people that are in this field are motivated by the desire to, keep you and your baby safe. And often they're just working within institutional policies and legal requirements and all these things that you might not be aware of. That's not to say that it's right for them to, you know, do what they're doing but just having an understanding that they're likely coming from a really good place. The other thing that I like to point out is like just the humanity of that provider. I've seen so many times where a provider. Might in my mind make a really almost seems like rash decision about an intervention or something during the birth. But I have to kind of step back and remember they have likely seen. Or experienced something, maybe even something traumatic at a birth or had experience or something where they're trying to protect not only you, but themselves from experiencing a horrible situation. And so just to approach your medical staff, medical birth team with just so much grace and love and there is a way to say. No thank you or not right now in a way that is so respectful. In the same way that you want to be respected for your choices, being able to, with grace, decline certain interventions or want to, really move forward with alternatives to what they're proposing. But again, it's all about, Fostering that collaborative approach to your birth experience, it's also gonna help you have an overall better experience instead of feeling like it's us versus them. You know, you can use language will you help me understand, or I'm not really fully understanding this. Instead of saying something like, why would you suggest that? Or why would I even need that? Just having just a grace with the way that you're relaying that information can really go a long way. And then ask about timing. Ask outright, is this something we need to decide immediately? Or do I have some time to think about this, talk about this and discuss it more. Pray about it. And then again, just being able to express your value so you can say again and again. You know, it's important to me that I'm able to move during labor. So is there any way we can find continuous monitoring that's wireless? So that I can, continue to move and that way, they're just trying to understand where you're coming from. It's not that you just don't wanna be continuously monitored, but you acknowledge that moving in labor is really important. So just trying to, relay your heart in why you're wanting to make the decisions that you're making can also go a long way. And acknowledge their expertise. You don't have to be, disingenuous or overly nice, but you can, just acknowledge whether like how you're saying it or just outright, just say I really value. Your professional opinion, but I'm also feeling uncertain about this. Can we talk about this more? Just remember, you and your provider both have the same goal of having a healthy delivery, healthy baby, healthy you. But I just think, you know, sometimes the means in which that gets done can be different. And so just having that open communication really does go a long way in making that experience the best it can be. So now let's get a little more practical. So how do you actually exercise these in real life, especially if you're in labor and you're not really able to think clearly or communicate clearly? So first I would say prepare your questions in advance. And so this typically looks like before you are actually in labor. You write down your questions, you write down your birth preferences, and you get to have an open conversation about your birth preferences. The other thing to do is to have your support person, whether that's your husband your doula, your mom, a friend, your sister, whoever. Who's, whoever's a part of your birth team, make sure that they are aware of your birth preferences as well, because they also can speak up when you're in the thick of laboring and not able to communicate in that moment. Don't be afraid to ask for more time or have your support team ask for more time to be able to discuss interventions you can just, always simply say, can we take a couple minutes to talk this through? What are they gonna say? No? Of course. You can always have some time to kind of think through and talk through some interventions. And if you're not getting the collaboration you need, you can always ask to speak with a supervisor or the charge nurse or a patient advocate. Most hospitals will have these kind of upper level, like next level people that you can speak with, depending on if you're having an issue with the nurse or with your actual provider. But just know you can always kind of escalate it if it's really needed. And then also remember, you are allowed to change your mind. So maybe you said no to something when you first got there. And then the situation changed and so you changed your mind about something and that's totally fine too. And they recognize that as well. But just for yourself to recognize that even if you drew kind of a hard line in the sand over some intervention just knowing that if the situation changes and you go back on that, that is totally okay. It might not be what you wanted, but again, there is some wisdom in making a decision that is most appropriate for the situation you find yourself in, not this kind of hypothetical situation you're planning for. And then here's something I also want you to hear, that there is a difference between emergency situations and routine recommendations. In a true emergency, your opinions might be more limited. And again, that's not ideal but you will get through it. So you can still maintain some autonomy even when you're accepting interventions by asking questions like, what are we looking for? How will we know, this intervention's working. And then, sometimes the wisest choice is to choose something that wasn't your first preference. I've seen so many women feel like. You know when we're debriefing after the birth or something like they feel like they failed because they ended up with an epidural when they wanted unmedicated birth or a C-section if they were really trying to go for a vaginal delivery. But flexibility isn't failure. Flexibility is really a strength. And so choosing an intervention that you originally didn't want, but that served you and your baby well and got you and your baby safely to the finish line. That is the most loving thing you can do and just one of the best ways you can care for yourself and your baby. Throughout this whole process of making decisions about your birth, I just keep coming back to that verse we talked about earlier, James 1:5, where, God wants to give us wisdom when we ask for it. He is. Not withholding it or making us jump through hoops to get it. And so when you're using that brain acronym, that framework, and you get to that I, for intuition, this is where I would love for you to just pause and pray and ask for the Lord's wisdom. Sometimes our intuition is the Holy Spirit guiding us towards the best decision. I love that his heart is desiring us to gain wisdom and he does that so generously. So he's not rolling his eyes at us for asking. He is not annoyed that we need his guidance. He wants to help us make these decisions for our family. And even, when decisions feel really difficult, we can trust that God's wisdom is available to us. And that doesn't mean every decision will feel, easy or that we'll have, just the most peaceful feeling about every decision we make. But it's not about the feeling, it's about just knowing that we are abiding in him and that we are not walking this alone. That he really is there to walk alongside us no matter the outcome. But before we close, I wanted to point you to a couple of resources that I feel like would be helpful. The first is going back and listening to episode five. It's called Creating Your Birth Preferences, A Step by Step Guide. So definitely go back and listen to that one because it pairs really nicely with today's episode. And then when you sign up for access to the Christian Mama birth prep library, you'll also get access to the birth preferences checklist, which like is a perfect companion to episode five. And kind of today's episode as well. But this checklist will help you think through preferences ahead of time so that you can have these informed consent. Conversations with your provider more easily towards the end of the pregnancy before you go into labor. And just remember preparation is truly gonna lead you to more confidence. The more you can think through these things and communicate your wants and desires, the more you feel empowered to get into that moment. So highly recommend you looking that up. And I'll have all of that in the show notes as well. Before we wrap up today, I just wanted to just stop and say a prayer for you as you're thinking through, decisions for your upcoming. Dear Lord, I just, I thank you so much for this precious mama who's listening right now and for the baby or babies that she's carrying. I just pray, Lord, that as she prepares for this birth, I ask that you would just fill her with your supernatural wisdom. I pray that she would begin to think through good and wise questions to start asking so that she can make the best decision for her and her family. I just ask that you would give her courage to stand up and advocate for herself with a spirit of humility. And collaboration so that she can work well with her birth team. And, when things don't go according to her plan, which, you know, they rarely do, but I just pray that you would help. Just remind her that you are still in control, even if the situation doesn't feel it and that you still so good. I just pray that you would help her to trust you through this whole process. Her pregnancy, the birth, the postpartum. Lord, you are there with her. You have not abandoned her. And we just thank you, Lord, for the way that you're with us. Always. We love you, Lord. It's in your name we pray. Amen. So let me just recap some of the main points that we covered today. Knowledge plus collaboration equals empowerment. Just remember, you are not a victim in your birth experience. You are an empowered decision maker, and your birth team is not the enemy. They're partners for you accomplishing the birth that you desire. Of course, every provider can have a slightly different lean or slant or typical path that they go, but medical interventions are wise, tools not the enemy. And sometimes wisdom means you choose an intervention that you originally didn't want or didn't see the need for. And that is not failure. That is you rolling with the punches and just taking life as it comes. Just remember God has equipped you with the wisdom to make these good choices for your family. So you need to trust that he will meet you when you have that need. So that's it for today's episode. I hope that was encouraging to you and just, gave you practical information for kind of how to approach informed consent and informed refusal, but also just understanding my heart behind, how to approach that and how it can lead to just much better outcomes for you and your birth story. next week I hope you join in because I'll be sharing a beautiful birth story. From a doula client of mine where she's gonna be talking about how she actually prepared this, unmedicated birth and had done all this preparation, had done all the right things and she had a c-section because her baby was wanting to be breach and transverse and all kinds of crazy things. But I love her story because it is a perfect example of what we're talking about today, where, trusting in the Lord even when your birth preferences don't seem to go the way you want. But still having a beautiful God-honoring birth experience. And that's such a gift to be able to look back on your birth, even if it didn't go as planned, and still be so in love with the Lord and what he brought you through and just love the birth experience that you had, even if it wasn't the one that you would've written for yourself. But stay tuned for that next week and I hope you take care Mama. I'll see you next week.