"BRAND" method for informed consent/choice/refusal

[Ellasundies]

I consider myself a pretty knowledgeable person in regards to reproductive things and I also consider myself to be untrusting of doctors (as in I don't take their every word as God's honest truth) and I'm pretty good at sticking up for myself. And yet he was able to tricked me into doing a completely unnecessary manual removal of the placenta. He did so by making things sound like they were urgent and that I was dying of a uterine rupture. When you throw in the fact that I was already a little scared having just delivered dd nearly 100% completely alone among other things I was mush when it came to his trickery. Unfortunately I'm still dealing with the physiological effects 2 years later (I may possibly be infertile from it) and to a lesser extent the psychological effects (I had PTSD very badly from the event but am mostly on the mend now)

You can go into delivery like I had with all the fight in you in the world, with the best advice at hand (such as the BRAND analogy and others) but when it comes to delivery, things happen fast and Mom isn't always able to advocate for herself with a clear head.

Speaking as someone who has BTDT. If a women feels the need to protect herself going into delivery (and heck even if she feels at peace going into delivery) you need to have someone there who is knowledgeable of birth, who is not affiliated with the OB and who can act as a 2nd opinion/advocate to the Mom.

Don't get me wrong, stuff like the BRAND analogy is GREAT when it comes to dealing with any doctor. But it won't always work for women in a delivery type situation or any health situation where the patient's attention is somehow diverted and/or they are lacking in knowledge.

I just don't want women to think that if they study things like this and know them by heart that they will be protected from being taken advantage of in the delivery room. Your best protection would be to use something like this analogy + a trusted doctor + a trusted advocate.

[hidden_star]

Originally Posted by Ellasundies I consider myself a pretty knowledgeable person in regards to reproductive things and I also consider myself to be untrusting of doctors (as in I don't take their every word as God's honest truth) and I'm pretty good at sticking up for myself. And yet he was able to tricked me into doing a completely unnecessary manual removal of the placenta. He did so by making things sound like they were urgent and that I was dying of a uterine rupture. When you throw in the fact that I was already a little scared having just delivered dd nearly 100% completely alone among other things I was mush when it came to his trickery. Unfortunately I'm still dealing with the physiological effects 2 years later (I may possibly be infertile from it) and to a lesser extent the psychological effects (I had PTSD very badly from the event but am mostly on the mend now) You can go into delivery like I had with all the fight in you in the world, with the best advice at hand (such as the BRAND analogy and others) but when it comes to delivery, things happen fast and Mom isn't always able to advocate for herself with a clear head. Speaking as someone who has BTDT. If a women feels the need to protect herself going into delivery (and heck even if she feels at peace going into delivery) you need to have someone there who is knowledgeable of birth, who is not affiliated with the OB and who can act as a 2nd opinion/advocate to the Mom. Don't get me wrong, stuff like the BRAND analogy is GREAT when it comes to dealing with any doctor. But it won't always work for women in a delivery type situation or any health situation where the patient's attention is somehow diverted and/or they are lacking in knowledge. I just don't want women to think that if they study things like this and know them by heart that they will be protected from being taken advantage of in the delivery room. Your best protection would be to use something like this analogy + a trusted doctor + a trusted advocate.

I agree, "BRAND" works for things when you aren't in labor or having quick decisions made. Example: I went to a midwife clinic and was going to get an on-call midwife at the hospital. They only had one on-call when I went to the hosptital (usually it's 2) and she just got taken, she came to check on me, but this hospital, the midwife can only have one patient. I ended up with an on-call OB, but that should be fine, I know what I'm doing, I had a birthplan. I got my son to crown in 15-20 min, I was doing great (especially since the stupid doctor made me push on my back because if I "was up at any angle I would sit on the baby"). Then he insisted I needed an episiotomy because everyone needs one (what?!?) so I'm telling him no, I'd rather tear than have him cut me. He got two nurses to help hold me still, cut me while I was telling him not to, he said I must not be thinking clearly from the pain (I have a high pain tolerance, and never once felt more than a 6 or 7 on the pain scale, and that was during contractions, I would still laugh and joke in between). He snipped three times and my son flew out (I wasn't even pushing) and he almost dropped him because he was still holding the scissors. I ended up with a 4th degree episiotomy. I don't know what I could have done different, there was no choices or options during labor. But I'm at a different hospital (way more birth friendly, in fact, the hospital I had my son at doesn't allow midwives anymore and when I was there, they were getting rid of all their natural birthing items) and I'm seeing an natural friendly OB and the hospital is loaded down with certified nurse midwives as the nurses. They even have birthing tubs in several rooms.

[litllegreekmama]

Originally Posted by hidden_star I agree, "BRAND" works for things when you aren't in labor or having quick decisions made. Example: I went to a midwife clinic and was going to get an on-call midwife at the hospital. They only had one on-call when I went to the hosptital (usually it's 2) and she just got taken, she came to check on me, but this hospital, the midwife can only have one patient. I ended up with an on-call OB, but that should be fine, I know what I'm doing, I had a birthplan. I got my son to crown in 15-20 min, I was doing great (especially since the stupid doctor made me push on my back because if I "was up at any angle I would sit on the baby"). Then he insisted I needed an episiotomy because everyone needs one (what?!?) so I'm telling him no, I'd rather tear than have him cut me. He got two nurses to help hold me still, cut me while I was telling him not to, he said I must not be thinking clearly from the pain (I have a high pain tolerance, and never once felt more than a 6 or 7 on the pain scale, and that was during contractions, I would still laugh and joke in between). He snipped three times and my son flew out (I wasn't even pushing) and he almost dropped him because he was still holding the scissors. I ended up with a 4th degree episiotomy. I don't know what I could have done different, there was no choices or options during labor. But I'm at a different hospital (way more birth friendly, in fact, the hospital I had my son at doesn't allow midwives anymore and when I was there, they were getting rid of all their natural birthing items) and I'm seeing an natural friendly OB and the hospital is loaded down with certified nurse midwives as the nurses. They even have birthing tubs in several rooms.

Your story is why I INSISTED on a midwife. When mine went out two days before my due date on medical leave I told the practice that if they didnt find me another midwife to deliver me I'd never come back to their practice. There is NO way in HECK i'm taking on the on call OB at the hospital. As it was the Nurse practitioner made the descions reguarding my delivery and talked me into an uneccesary induction when i was already in labor! BRAND is a great thing to remember, but it is SO easy to get talked into doing something by even a midwife or someone who claims to be "all natural" when they use your baby's life against you (IE the heartrate isen't what it should be, or this could potentially harm the baby). This time i'm going to tell my midwife beforehand what exactly i expect and what I will and won't let them do. I know there are great nurses out there but they can be even more pushy than the dr sometimes!! They're who I have to be firm with. They gave me morphine without asking and it made pushing way harder! They were the ones who forced me to deliver on my back which was SO much more painful, AND they held my legs up even though i told them that my legs were having severe muscle spasms and to DROP them.
Why in our informed day and age are the medical professionals still treating us like helpless little lambs when it comes to doing something that our bodies KNOW how to do!?

[rainydaysunshine]

Bev- I would have been screaming at the top of my lungs " I will sue your *** if you cut me!". Bet that would have gotten his attention

But seriously, I know that a handout can't stop the medical professionals from doing what's "in your best interest" 100 percent of the time, but perhaps if it's something you go over beforehand, at least they know you've got your eye on them, and are less likely to let them bully you.

Eta: when the hospital staff puts their hands on you or administers procedures against your wishes, it is assualt, and you have legal recourse.

[TeachinAuntie]

Thanks! I saved it as an attachment to my Birth Plan!

[ktmelody]

Gosh. I hear stories on here all the time about this subject. I must have gotten lucky. My OB and the nurses I have dealt with have never given me any trouble. Never been told I had to do something.

This def makes sense even outside of prrgnancy. I hear too many doctors that retract foreskin before parents even have a chance to stop them. Thankfully I dont let my son undress in front of any doc without first stating he is intact and they are not allowed to retract him.

Good info. Hope mamas that need it will use it!

[rainydaysunshine]

Katie-i see your 2009 baby is named Thea. My name is Thia, short for Anthia

[Hillargh]

The two hospitals that do waterbirth here have a huge handout encouraging you to do these very things. They take it very seriously, and request you immediately report and dismiss anyone that you feel is violating your right to choose from handling your care. It actually gives me a little bit of hope for the doctor and hospital world.

[nursekatie]

This is great! I am lucky and have wonderful midwives that basically follow that each time we need to make a decision about my care or babies care.

[cinderella08]

Originally Posted by hidden_star I agree, "BRAND" works for things when you aren't in labor or having quick decisions made. Example: I went to a midwife clinic and was going to get an on-call midwife at the hospital. They only had one on-call when I went to the hosptital (usually it's 2) and she just got taken, she came to check on me, but this hospital, the midwife can only have one patient. I ended up with an on-call OB, but that should be fine, I know what I'm doing, I had a birthplan. I got my son to crown in 15-20 min, I was doing great (especially since the stupid doctor made me push on my back because if I "was up at any angle I would sit on the baby"). Then he insisted I needed an episiotomy because everyone needs one (what?!?) so I'm telling him no, I'd rather tear than have him cut me. He got two nurses to help hold me still, cut me while I was telling him not to, he said I must not be thinking clearly from the pain (I have a high pain tolerance, and never once felt more than a 6 or 7 on the pain scale, and that was during contractions, I would still laugh and joke in between). He snipped three times and my son flew out (I wasn't even pushing) and he almost dropped him because he was still holding the scissors. I ended up with a 4th degree episiotomy. I don't know what I could have done different, there was no choices or options during labor. But I'm at a different hospital (way more birth friendly, in fact, the hospital I had my son at doesn't allow midwives anymore and when I was there, they were getting rid of all their natural birthing items) and I'm seeing an natural friendly OB and the hospital is loaded down with certified nurse midwives as the nurses. They even have birthing tubs in several rooms.

Oh I am so, so, so sorry he did that to you.....