E5: Autonomy, Authority, Coercion & Consent: Who Decides in Maternity Care?

People are shocked when they learn that the American College of OB/GYN (ACOG) says that women and pregnant people have the final say in medical decision making. Jen Kamel, founder of VBAC Facts®, discusses the principles of informed decision making in the context of vaginal birth after cesarean (VBAC) versus repeat cesarean. Emphasizing the ethical obligations in healthcare, Jen explores ACOG's Committee Opinion on respecting a pregnant woman's autonomy and decision-making rights. Real-life testimonials from petite readers who had successful VBACs highlight the possibilities and challenge common misconceptions. The episode also addresses ethical dilemmas, coercion, and the importance of respectful and supportive communication between healthcare providers and birthing people, especially when recommended treatments are refused. 01:23 VBAC Wins: Petite Readers Share their VBAC Stories! 04:02 ACOG's Ethical Guidelines on Refusal of Treatment 07:57 The Importance of Informed Consent 11:34 Ethical Dilemmas in Obstetric Care 33:35 Directive Counseling vs. Coercion 36:58 Ethical Guidelines Against Coercion in Obstetrics 38:45 Medical Professionals are Lifeguards, Not Gods 41:03 Documenting Patient Refusal of Treatment 41:47 Arguments Against Court-Ordered Interventions 46:35 Barriers to Needed Care and Discriminatory Effects 49:35 Effective Communication and Patient Understanding 59:59 Decisional Capacity and Emergency Cases 01:07:02 Supporting Patients and Healthcare Teams Post-Adverse Outcomes 01:09:29 Conclusion and Call to Action Have a comment or question for the podcast? Want to suggest a guest we should interview or a topic we should discuss? Go to https://vbacfacts.com/podcast to give us your feedback! VBAC Facts® resources Petite readers share their VBAC story on Facebook and Instagram: https://www.facebook.com/100063753092... & https://www.instagram.com/p/DCKamOfzz... American College of Obstetricians and Gynecologists. (2016). Refusal of medically recommended treatment during pregnancy. Committee Opinion No. 664. Obstetrics & Gynecology, 127, e175-82. https://www.acog.org/clinical/clinica... Article: Vaginal birth after two cesareans (VBA2C): An overview of the evidence: https://vbacfacts.com/vba2c Article: Vaginal birth after three or more cesareans (VBA3C/VBAMC): An overview of the evidence: https://vbacfacts.com/vba3c VBAC Facts® professional membership: where we house a library of continuing education trainings including The Truth About VBAC™ for Professionals, The Limited Evidence on VBA3+C: Decision Making in the Midst of Uncertainty, and The Truth About VBA2C: Risk, Rates, & Outcomes: https://vbacfacts.com/membership Our course for people with prior cesarean(s): "The Truth About VBAC™ for Families:" https://vbacfacts.com/vbaccourse Schedule an in-person training in your community: https://vbacfacts.com/speaking Schedule a consulting call with Jen: https://vbacfacts.com/consulting Studies mentioned "One study found that over half of the people who had a cesarean for FTP, failure to progress, were not six centimeters, which is one of the criteria they need to meet in order to receive that diagnosis." Zhang, J., Troendle, J., Reddy, U.,et al. (2010). Contemporary cesarean delivery practice in the United States. The American Journal of Obstetrics & Gynecology, 203(4), 326.e1-326.e10. https://www.ncbi.nlm.nih.gov/pubmed/2... Music produced by (Analogue)/(prod. Analogue). Instagram: @prod.analogue