No Signature - No Cesarean

Informed consent is an important issue for the pregnant woman who feels that no one is hearing her, and feels that she is bring coerced into having a unnecessary cesarean. A cesarean section cannot be performed unless a women has given written consent to the operation.

According to the South African Patients Rights Charter, informed consent means that: "Everyone has the right to be given full and accurate information about the nature of one’s illnesses, diagnostic procedures, the proposed treatment and the costs involved, for one to make a decision that affects anyone of these elements."

Some women feel that they are not being given a choice because they have had a previous cesarean and now their caregivers, despite the available research, will not support a natural birth also known as a VBAC (vaginal birth after previous cesarean).
Many mothers in South Africa are being pressurized into having unnecessary cesareans by caregivers that insist the baby is too big, too small, too early, too late. Women are being given too many reasons that are not research based and that should be carefully questioned before being accepted.

There is no harm, and often much benefit in obtaining a second objective medical or midwife opinion elsewhere if you feel that your caregiver is giving you incorrect information.

No matter the outcome, women tend to feel better about their birth experiences whether natural or cesarean, if they feel that they have been well informed and have been part of the decision making process. In most instances there is adequate time to make an informed decision. True emergencies are rare, and in these circumstances women do usually not feel uncertain, as it is clear that there is a real emergency at hand. Obviously in these instances, decisions need to be made quickly in order to facilitate a swift emergency cesarean section.

Finding information by consulting GOOGLE does help to a degree, but many women prefer to have the opportunity to discuss their particular situation with another caregiver. This second opinion often either clarifies that the cesarean is well indicated or informs them adequately so that they can make a decision about how they should proceed.

VBAC information is abundant on the internet and websites such www.ican-online.org and www.vbac.co.uk and www.vbac.com have articles on informed consent with regards to VBAC.

As a final note, I can't resist including and encouraging everyone to read this beautifully written and insightful article on "The Emotional Impact of Cesareans" by Pam Udy published on the Midwifery Today website.

We really do not need the 60-80% cesarean section rate that is afflicting our country and impacting our mothers and  in our private sector.

Let's stop the unnecesareans.