You Always Have a Choice: Understanding Informed Consent and Informed Refusal in Any Birth Setting
Hey there, beautiful mama! If you've ever felt overwhelmed by medical decisions during pregnancy or wondered about your rights during birth, this episode is for you. Today we're diving into something every pregnant woman needs to know—informed consent and informed refusal. Whether you're planning a home birth, birth center delivery, or hospital birth, you have choices and rights that don't disappear when you walk through those doors. Let's explore how to navigate these decisions with wisdom, partnership, and faith.
🎧 Listen to the Episode
Knowledge + Collaboration = Empowerment
I want to start by setting the tone for our conversation today. This isn't about creating some kind of battle between you and your birth team. I've seen too many birth educators paint medical staff as the enemy, and honestly, that just breaks my heart because it's absolutely not the case.
The truth is, interventions have their time and place. Sometimes the wisest choice you can make is to choose an intervention that wasn't part of your original plan. And that's completely okay! Today, I want you to walk away feeling confident in your ability to make informed decisions while working collaboratively with your birth team.
What Is Informed Consent Really?
When I was pregnant with my first, I thought informed consent just meant signing a piece of paper. But it's so much more than that. Informed consent has four main components that serve as your foundation for every decision you'll make:
The Four Pillars of Informed Consent
Information - You have the right to receive complete, accurate information about any intervention being recommended
Comprehension - You have the right to have that information explained in terms you actually understand
Voluntariness - You have the right to make decisions free from pressure or coercion
Capacity - Recognition that you have the mental ability to make these decisions
You're not just an incubator, mama. You're a thinking, reasoning person who gets to choose what happens to your body and your baby.
The BRAIN Method: Your Decision-Making Framework
Let me teach you something I cover extensively in my childbirth education course—the BRAIN method. Honestly, it's been a game-changer not just for birth decisions, but for any health decision my family has faced over the years.
Benefits: What are the potential benefits of this intervention?
Risks: What are the potential risks or side effects?
Alternatives: What other options are available?
Intuition: What does your gut tell you?
No or Not Now: What happens if we wait or do nothing right now?
Where Faith Meets Decision-Making
Here's where I love to bring in James 1:5: "If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him."
When we're seeking God's wisdom in our decision-making, we can trust that He will guide our hearts and minds. Sometimes that inner knowing is the Holy Spirit speaking to you, so don't dismiss it.
I cannot tell you how many times I've used this framework—for everything from deciding on my kids' vaccinations to choosing treatment options when my husband had his back injury. It works for so much more than just birth decisions.
Understanding Informed Refusal
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's not—it's not about being reckless or completely ignoring medical advice.
Informed refusal means making a thoughtful choice after you've understood all the information. It can be temporary ("not right now, let's revisit this in an hour") or absolute ("no, thank you, I'm not comfortable with that option").
The key word here is informed. You're not just saying no to be difficult—you're making a thoughtful decision based on all the information you've gathered.
Your Rights Don't Change Based on Location
Whether you're planning a home birth, birth center birth, or hospital birth, you still have the same fundamental rights:
Home Birth Rights
Right to transfer to hospital if desired
Right to accept or decline certain protocols
Right to change your mind about interventions
Birth Center Rights
Right to discuss all policies and procedures
Right to decline routine interventions
Right to transfer to hospital care if needed
Hospital Birth Rights
Right to decline routine procedures (IV, continuous monitoring, etc.)
Right to request alternatives when safe
Right to have birth preferences respected when medically appropriate
Right to ask questions and request time to decide (when not an emergency)
Building Partnership, Not Opposition
When your doctor or midwife recommends an intervention, they're not trying to ruin your birth experience. They're making recommendations based on their training, experience, and evidence. They're motivated by the desire to keep you and your baby safe.
How to Approach Conversations Collaboratively
Instead of creating opposition, try these approaches:
Use "help me understand" language: "Can you help me understand why you're recommending this intervention right now?"
Ask about timing: "Is this something we need to decide immediately, or do we have some time?"
Express your values: "It's important to me that I'm able to move around during labor. Is there a way we can make this work?"
Acknowledge their expertise: "I really value your professional opinion, and I'm also feeling uncertain about this."
Remember, you all have the same goal—a healthy mom and a healthy baby.
When Flexibility Becomes Wisdom
Here's some mama-to-mama wisdom—sometimes the wisest choice is to choose something that wasn't your first preference. I've seen so many women feel like they "failed" because they ended up with an epidural when they wanted an unmedicated birth, or needed a C-section when they were planning vaginal delivery.
Flexibility isn't failure, mama. Flexibility is a strength. Sometimes choosing an intervention is the most loving thing you can do for yourself and your baby.
📖 Scripture for Your Heart
"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)
God wants to give us wisdom when we ask for it. He's not withholding it or making us jump through hoops to get it. When you're using that BRAIN framework and you get to that "I" for intuition—this is where you can pray and ask God for His wisdom. Sometimes our intuition is actually the Holy Spirit guiding us toward the best decision.
🙏 A Prayer for Your Birth Journey
God, thank You so much for this precious mama listening right now and for the baby she's carrying. As she prepares for birth, would You fill her with Your wisdom? Help her to ask good questions and make decisions that are right for her family.
Give her courage to advocate for herself and also the humility to work well with her birth team. When things don't go according to plan—and let's be honest, they often don't—remind her that You're still in control and You're still good.
Help her trust You through the whole process, Lord. We love You. Amen.
📎Resources & Links Mentioned
🎧 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
📣 Let’s Stay Connected
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Grab your free birth prep tools at the Christian Mama Birth Prep Library.
Meet Your Host —
Natalie is a certified birth doula and childbirth educator in Jacksonville, FL. She equips Christian women to experience peaceful, faith-filled births through virtual and in-person support. Her heart is to help mamas navigate pregnancy and birth with confidence, wisdom, and trust in God's perfect plan.
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📄 Full Episode Transcript
Hey there, beautiful mama! Welcome back to the show. I'm so glad you're here today because we're diving into something that I think every pregnant woman needs to know about, and that's your rights when it comes to informed consent and informed refusal, no matter where you're planning to give birth.
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. I've seen way too many doulas and childbirth educators paint medical staff as the enemy, and honestly, that just breaks my heart because it's absolutely not the case.
The truth is, interventions have their time and place. Sometimes the wisest choice you can make is to choose an intervention that wasn't part of your original plan, and that's okay. Today I want you to walk away feeling 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 let's start with the basics. What exactly is informed consent? You know, when I was pregnant with my first, I thought informed consent just meant signing a piece of paper. But it's so much more than that.
Informed consent has four main components, and I want you to remember these because they're your foundation for every decision you'll make during your pregnancy and birth. First is information. You have the right to receive complete, accurate information about any intervention that's being recommended. Not just the bare minimum - the whole picture. Second is comprehension. This means you have the right to have that information explained in terms you actually understand. If your doctor uses medical jargon that goes right over your head, you can ask them to break it down for you.
Third is voluntariness. You have the right to make decisions free from pressure or coercion. Nobody should be rushing you or making you feel bad about asking questions. And finally, capacity - this is the recognition that you have the mental ability to make these decisions. You're not just an incubator, mama. You're a thinking, reasoning person who gets to choose what happens to your body and your baby.
Now, I want to teach you something that I cover extensively in my childbirth education online course - it's called the BRAIN method, and honestly, it's been a game-changer not just for birth decisions, but for any health decision my family has faced over the years.
B stands for Benefits. What are the potential benefits of this intervention? Really understand what the upside could be. R is for Risks. What are the potential risks or side effects? And don't be afraid to ask about both common and rare complications. A is Alternatives. What other options are available? Maybe there's a middle ground or a different approach altogether.
I is for Intuition. What does your gut tell you? And here's where I love to bring in James 1:5: "If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him." When we're seeking God's wisdom in our decision-making, we can trust that He will guide our hearts and minds. Sometimes that inner knowing is the Holy Spirit speaking to you, so don't dismiss it.
And finally, N is for No or Not Now. What happens if we wait or do nothing right now? Sometimes the answer is "no, thank you," and sometimes it's "not right now, but maybe later if things change."
I cannot tell you how many times I've used this framework - for everything from deciding on my kids' vaccinations to choosing treatment options when my husband had his back injury. It works for so much more than just birth decisions.
Now let's talk about informed refusal, because this is where some people get nervous. 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's not - it's not about being reckless or completely ignoring medical advice. It means making an informed choice after you've understood all the information. It can be temporary, like "not right now, let's revisit this in an hour," or it can be absolute, like "no, thank you, I'm not comfortable with that option."
The key word here is informed. You're not just saying no to be difficult - you're making a thoughtful decision based on all the information you've gathered.
Here's something really important that I want every mama to understand - your rights don't change based on where you're giving birth. Whether you're planning a home birth, birth center birth, or hospital birth, you still have the same fundamental rights.
If you're planning a home birth, you have the right to transfer to the hospital if you want to. You have the right to accept or decline certain protocols your midwife suggests. And you absolutely have the right to change your mind about interventions as your labor progresses.
Birth center mamas, you have the right to discuss all the policies and procedures. You can decline routine interventions if you're not comfortable with them. And just like home birth, you have the right to transfer to hospital care if you feel that's what's best.
And hospital birth - oh, this is where I see so many mamas feel like they lose all their choices, but that's just not true. You have the right to decline routine procedures like IVs or continuous monitoring if your situation allows for it. You can request alternatives when they're available and safe. You have the right to have your birth preferences respected when it's medically safe to do so.
And 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.
Now, I want to spend some time talking about something that's really close to my heart - working with your medical team, not against them. When your doctor or midwife recommends an intervention, they're not trying to ruin your birth experience. They're making recommendations based on their training, their experience, and the evidence they have. They're motivated by the desire to keep you and your baby safe. And often, they're working within institutional policies and legal requirements that you might not even be aware of.
So how do we approach these conversations in a way that builds partnership instead of creates opposition?
First, use "help me understand" language. Instead of "Why do I need that?" try "Can you help me understand why you're recommending this intervention right now?" Ask about timing. "Is this something we need to decide immediately, or do we have some time to discuss it?" Express your values. "It's important to me that I'm able to move around during labor. Is there a way we can make continuous monitoring work with that?" And acknowledge their expertise. "I really value your professional opinion, and I'm also feeling uncertain about this. Can we talk through it together?"
Remember, you all have the same goal - a healthy mom and a healthy baby. You can have mutual respect for different perspectives while keeping communication open about concerns and preferences.
Okay, so let's get practical. How do you actually exercise these rights in real life, especially when you're in labor and maybe not thinking as clearly as you normally would?
First, prepare your questions in advance. Write them down, put them in your birth preferences, whatever works for you. When you're in labor, your brain is focused on other things - having your questions ready ahead of time is huge. Bring a support person who can advocate for you. This might be your partner, your doula, your mom - whoever you trust to speak up when you're in the thick of labor.
Don't be afraid to ask for time to discuss things with your partner or support team, as long as it's not an emergency. "We'd like a few minutes to talk this through - is that okay?" And if you're not getting the collaboration you need, you can always ask to speak with a supervisor or patient advocate. Most hospitals have these available. Also remember - you can always change your mind. Maybe you said no to something earlier, but your situation has changed. That's completely okay.
Here's something I really want you to hear - there's a difference between emergency situations and routine recommendations. In a true emergency, your options might be more limited, and that's okay. You can still maintain some autonomy even when accepting interventions by asking questions like "What are we watching for?" or "How will we know if this is working?"
And here's some mama-to-mama wisdom - sometimes the wisest choice is to choose something that wasn't your first preference. I've seen so many women feel like they "failed" because they ended up with an epidural when they wanted an unmedicated birth, or needed a C-section when they were planning vaginal delivery. Flexibility isn't failure, mama. Flexibility is a strength. Sometimes choosing an intervention is the most loving thing you can do for yourself and your baby.
You know, throughout this whole process of making decisions about your birth, I keep coming back to that verse we talked about earlier - James 1:5. God wants to give us wisdom when we ask for it. He's not withholding it or making us jump through hoops to get it.
When you're using that BRAIN framework, and you get to that I for intuition - this is where you can pray and ask God for His wisdom. Sometimes our intuition is actually the Holy Spirit guiding us toward the best decision. I love that God desires to give us wisdom, and He does it generously. He's not rolling His eyes at us for asking. He's not annoyed that we need guidance. He wants to help us make good decisions for our families.
And you know what? Even when decisions feel really difficult, we can trust that God's wisdom is available to us. That doesn't mean every decision will feel easy, but it means we're not walking through this alone.
Before we close, I want to point you to a couple of resources that can help you prepare for these conversations. If you missed episode 5, "Creating Your Birth Preferences: A Step-by-Step Guide," definitely go back and listen to that one. It pairs perfectly with today's episode.
And when you sign up for free access to the Christian Mama Birth Prep Library, you'll get the Birth Preferences Checklist that goes along with that episode. This checklist will help you think through your preferences ahead of time so you can have these informed consent conversations more easily when the time comes. Remember, preparation leads to confidence. The more you think through these things ahead of time, the more empowered you'll feel when you're actually in the moment.
Before we wrap up, I want to pray for you: God, thank You so much for this precious mama listening right now and for the baby she's carrying. As she prepares for birth, would You fill her with Your wisdom? Help her to ask good questions and make decisions that are right for her family.
Give her courage to advocate for herself and also the humility to work well with her birth team. When things don't go according to plan - and let's be honest, they often don't - remind her that You're still in control and You're still good. Help her trust You through the whole process, Lord. We love You. Amen.
Let me just recap the main points we covered today. Knowledge plus collaboration equals empowerment. You are not a victim in your birth experience - you're an empowered decision-maker. Your birth team isn't your enemy - they're your partners who want the best for you and your baby.
Medical interventions are tools, not enemies. And sometimes wisdom means choosing interventions you didn't initially want. That's not failure - that's good decision-making. God has equipped you with wisdom to make good choices for your family. Trust that, mama.
Next week, I have such a beautiful birth story to share with you. I'm going to be talking with a mama who prepared so well for an unmedicated birth - she did all the things, knew all her options, had her birth preferences ready. But when she found out her baby was breech, everything changed and she ended up with a C-section instead.
Her story is the perfect example of what we talked about today - trusting in the Lord when your birth preferences seem to go completely out the window, but still having a beautiful, God-honoring birth experience even when everything goes differently than you planned. You're going to love her heart and her perspective on how God was faithful through it all.
Alright, that's a wrap for today. Take care, mama!
