Where can I choose to give birth?

● In most areas there’s a choice of giving birth:

○ At home with a midwife to support you

○ In a birth centre where all care is given by midwives

○ In a hospital where both midwives and doctors are available

● Your midwife should explain the benefits and risks of each of these and support you in your choice.

● If your midwife or doctor thinks your pregnancy is ‘high risk’ they will probably advise you to give birth in hospital but should explain why they think this would be safer for you and your baby.

● You have the right to give birth at home even if your pregnancy has been labelled ‘high risk’. If your midwife is unwilling to support you to have a homebirth see the AIMS webpage Booking a Homebirth.

● Birth centres often don’t want to take ‘high risk’ mothers. But they should not refuse you unless they can show that you and your baby would be safer in hospital. Push for this option if it is what you want.

● You have the right to give birth in an NHS hospital and don’t have to go to your local one. You can contact the hospital you want to use or ask your midwife to refer you.

For more on this see Choosing your Place of Birth | AIMS

If you are struggling to get support for a homebirth, to go to a birth centre or to the hospital you want contact the AIMS Helpline

Can I choose to have a caesarean?

● If you have not been offered a planned caesarean but feel that it would be best for you, you can ask for one.

● You should then be offered the chance to talk to a senior midwife or doctor about the benefits and risks of having a caesarean.

● You should also be offered counselling if you are asking because you are anxious about giving birth.

● If you are then sure that you want a planned caesarean you should be given one. If your own doctor doesn’t want to do it, they should refer you to another doctor who will.

● If you decide during labour that you want a caesarean your midwife or doctor should explain all your options and support you to do whatever you decide is best.

● That could be waiting a bit longer, trying other medical treatments like drugs to speed up the labour or having a caesarean.

For more on caesareans see Caesarean Birth | AIMS or the book Caesarean Birth - Your Questions Answered available from the AIMS shop

For more on your right to make decisions see Making decisions about your care | AIMS and the books AIMS Guide to Your Rights in Pregnancy and Birth and AIMS Guide to Resolution After Birth.

If you are struggling to get support for a planned caesarean contact the AIMS Helpline

What is informed consent?

● The law says you have the right to decide whether to accept any medical treatment or test.

● You can refuse even if that might appear to put you or your unborn baby at risk of harm.

● Doctors and midwives must have your ‘informed consent’ before they carry out any treatment.

● This means they have explained why they are offering the treatment, what the benefits and risks are, and what other options you have, including doing nothing.

● If you have not given informed consent, then the person giving you the treatment is breaking the law.

● The information must be factual, tailored to your situation, your wishes and needs, and explained in a way that is easy for you to understand.

● If you haven’t been given all the information that you need - keep asking!

● A doctor or midwife should respect your decision even if they do not agree with it.

● No-one should try to bully, scare or pressure you into changing your decision.

● If they do, this is called coercion and you will not have given informed consent.

For more on your right to make decisions see Making decisions about your care | AIMS and the books AIMS Guide to Your Rights in Pregnancy and Birth and AIMS Guide to Resolution After Birth.

If you are struggling to get support for your decisions or want to make a complaint about being treated against your consent, contact the AIMS Helpline

Do I have the right to have pain relief?

● Yes - the law says that you should not be refused suitable pain relief when you ask for it.

● You also have the right to be told what types of pain relief are available and the risks and benefits of each so that you can decide what’s right for you.

● Rarely there may be a medical reason why a type of pain relief is not suitable for you. Your midwife or doctor should explain why this is and what alternatives you have.

● No-one should refuse to give you pain relief, or delay giving it, as a way of pressuring you to agree to something that you don’t want.

● You do not have to have a vaginal examination before you can have pain relief.

● If you are being given pain relief it must not be stopped without your agreement.

● If your midwife says it’s too soon or too late. to have your chosen pain relief, ask her to explain why.

● If you want an epidural but are close to giving birth, there may not be time to get it set up before your baby is born.

● Everyone feels pain differently and only you know how much pain you are in - so say how you feel and what you need.

For more on the different types of pain relief see Ways of managing your labour | AIMS

For more on your rights see the books AIMS Guide to Your Rights in Pregnancy and Birth and AIMS Guide to Resolution After Birth

If you are struggling to get support for your decisions or want support to make a complaint about being refused pain relief, contact the AIMS Helpline

What are my options if my midwife or doctor do not agree with me?

● The law says that you have the right to make decisions about your care and to have those supported by your midwife or doctor.

● You also have the right to be treated with dignity and respect.

● You should be given the opportunity to discuss your birth options and agree a personal care plan that meets your needs.

● If you find that your midwife or doctor are not supportive of your decisions:

○ You can change your midwife and/or your doctor.

○ You can ask for a second opinion from another doctor (including during labour).

○ You can change your hospital to one that has a more flexible approach.

○ You can write or ask to speak to the Head/Director of Midwifery, a Professional Midwifery Advocate (PMA) or a Consultant Midwife.

○ You can speak to the Patient Advice and Liaison team (PALS) in your hospital. They can help you to make a complaint about how you are being treated.

● Assert your rights:

○ Be very clear about what you want to achieve.

○ Be persistent

○ Write a birth plan to make it clear what you do and don’t want.

For more on your rights during pregnancy and childbirth see Making decisions about your care | AIMS and the books [AIMS Guide to Your Rights in Pregnancy]19] and Birth and AIMS Guide to Resolution After Birth

If you are struggling to get support for your decisions or want support to make a complaint, contact the AIMS Helpline