After my first pregnancy, I remember schlepping myself and my breastfed baby to my six-week postpartum appointment at the hospital an hour away. This way the doctor could check things out, give me some contraceptives, and I could be on my way. A quick and easy appointment, right?
The doctor spent a minute or so explaining my choice of contraceptive – the copper IUD. I nodded along, laid back, and let them do their thing. As the doctors inserted the IUD, I experienced an intense, sharp sensation that brought me right back to six weeks ago, in labor with my baby. Suddenly it felt like I was back at 10cm dilated. I held back tears, caught off guard by the pain I was experiencing. The doctor finished and left the room. Behind closed doors, just my baby and I in the room, I was immediately flooded with emotion.
Maybe, if I had known better about what the procedure might entail I might have brought my husband or a supportive partner. Having someone to help ease my emotional and physical pain might have been helpful. Someone to help with the baby. Instead, I was left alone and dysregulated, wondering – how was I not better prepared for this?
My story is not unique because what was missing from this equation, and many others like it, was proper informed consent.
When informed consent is lacking or missing it can lead to patient dissatisfaction and decreased trust in the medical system. However, the experience can be much more profound and even result in significant medical trauma. When a situation becomes traumatic, it can impact your mental, emotional, physical, and even spiritual well-being for years, well beyond the actual procedure itself.
Providing context, choice, and connection enhance patient safety and are three essential ingredients that are supported by the process of proper informed consent. When one or more of these elements are not present, as in the case of inadequate informed consent, it becomes much more challenging for your nervous system to feel settled and move toward regulation.
Let’s break the three essential ingredients down further:
Context
Your nervous system wants to understand and make sense of what you are experiencing so it knows how to navigate the situation or relationship you’re in. Informed consent can provide context about why a medical procedure or intervention is appropriate for your situation.
Choice
When you are provided with the risks and benefits of a procedure, as well as information about alternative options, you then have the relevant information needed to decide what is best for you. Do you have the capacity and support required for this intervention? Is there a less invasive option that might be better? Are you prepared for what this procedure entails and the results? When you are not provided with all the relevant information, your choice is not a fully informed one. This lack of choice alerts your nervous system that a threat is present, and a survival response becomes activated.
Connection
We are pack animals, so survival depends on relationships and community. When you sense disconnection, your nervous system moves into a state of protection. The erosion of informed consent creates a wider gap between the patient and the provider. This moves us farther away from a sense of safety within ourselves and in connection with those we ideally trust.
Below are some ways that will help you to feel empowered knowing you are the best advocate for yourself and your child:
Don’t be afraid to ask questions
You are not a bother for asking as many questions as you need to feel comfortable with a decision you are going to make. Before your appointment, write your questions down, so you don’t forget them once you’re at the appointment. If your doctor doesn’t answer all of them, ask if there is room to delay the procedure until your questions are sufficiently answered.
Read about the procedure or interventions beforehand
Don’t be afraid to read research articles about the topic or procedure. Bring what you find into your appointments, and request appointments with the specialist.
Consider the elements of your experience that would help you feel safe
Take into account any traumas from your past. Inform your provider of any specific accommodations you want to enhance your safety during a procedure. Such as having a team of only women or requesting no medical students be present.
Trust your gut
Involve your intuition when making choices. Make decisions from a grounded place of trust rather than when feeling pressured, forced, or rushed.
