Pregnancy and birth come with plenty of decisions. Some are made well before labour begins, while others may come up unexpectedly, sometimes when you're tired, uncomfortable or trying to concentrate on something else entirely.
You might be offered an additional scan, an induction of labour, pain relief or an intervention during birth. Sometimes the recommendation will be straightforward, and you'll feel comfortable saying yes. Other times, you might want a little more information before deciding.
And that's perfectly okay.
Informed consent isn't about questioning every recommendation or challenging your maternity team. It's about understanding what's being suggested, why it's being recommended and having the opportunity to be involved in decisions about your own care.
You don't need to know all the medical terminology, have researched every possible intervention or arrive with a long list of questions. You simply need to know that you can ask.
What does informed consent actually mean?
Informed consent means being given the information you need to make a voluntary decision about your care.
That includes understanding what is being recommended, the expected benefits, the potential risks, any reasonable alternatives and what might happen if you choose not to proceed.
It also means having the opportunity to ask questions and make a decision without pressure or coercion.
In New Zealand, the Code of Health and Disability Services Consumers' Rights protects your right to receive information, make informed choices and give or withhold consent.
Consent isn't simply signing a form or agreeing because a procedure has been recommended. It's an ongoing conversation.
You might agree to something earlier in pregnancy and have more questions when the time comes. You might want an explanation before a vaginal examination, or you might change your mind about something you previously thought you wanted.
Your maternity team should explain what's happening and seek your consent before providing care, except in the limited circumstances where the law allows otherwise.
You can trust your maternity team and still ask questions
One thing I often remind parents in my antenatal classes is that asking questions doesn't mean you don't trust the professionals caring for you.
Your midwife, obstetrician and other maternity professionals bring their clinical knowledge, training and experience. You bring something equally important: your preferences, values, concerns and knowledge of yourself.
Good maternity care brings those things together.
Sometimes a recommendation will be made because there is a genuine concern about your wellbeing or your baby's. Understanding that concern can help you feel more comfortable with the decision.
For example, if an induction is recommended, you might ask:
“Can you explain what you're concerned about and why you're recommending induction now?”
That's not challenging someone's expertise. It's asking to understand the reasoning behind their recommendation.
And sometimes, once you've heard the explanation, your answer might simply be, “Yes, that makes sense to me.”
That's informed consent too.
BRAIN: Five little letters that can make a big difference
One of the tools I teach in my antenatal classes is BRAIN.
It's a simple way to organise your thoughts when you're being offered a procedure, intervention or change to your care.
B – Benefits
What are the benefits of this option? How might it help me or my baby?
R – Risks
What are the possible risks, side effects or disadvantages?
A – Alternatives
Are there other reasonable options available?
I – Intuition
How do I feel about this? Is there something I'm unsure about or want to understand better?
N – Nothing
What might happen if we do nothing for now, wait or choose not to proceed?
You don't have to work through every letter each time a decision comes up. Sometimes one question is all you need.
For example, if your maternity team recommends continuous monitoring during labour, you might ask why it's being recommended and whether there are options that would allow you to continue moving around.
Or, if a caesarean is recommended, you might want to understand the reason, how urgently it needs to happen and what to expect.
The questions will be different depending on the circumstances, but the principle remains the same: you deserve to understand what's happening and why.
What if you prefer to go with the flow?
Not everyone wants a detailed birth plan.
Some women have clear preferences about particular aspects of their labour and birth. Others are quite comfortable taking things as they come and making decisions along the way.
Neither approach is better than the other.
You can be happy to go with the flow and still want to know what's happening. You can trust your maternity team to make recommendations while remaining involved in the decisions.
Informed consent doesn't require you to anticipate every possibility or have an opinion about every intervention before labour begins.
It simply means that when a decision arises, you have the opportunity to understand your options and express what matters to you.
And if you're unsure what you want, it's okay to say that too.
Your birth partner can help
During labour, you may be concentrating on contractions, feeling tired or finding it difficult to take in a lot of information at once.
This is where your birth partner can be particularly helpful.
They don't need to know all the answers or make decisions on your behalf. Their role is to support you, help you understand what's being discussed and make sure you have an opportunity to express your wishes.
They might ask:
“Could you explain that again for us?”
“Is this something we need to decide right now?”
“Can you tell us what the other options are?”
“Could we have a moment to talk about it?”
Your birth partner can also remind you of questions you wanted to ask or help communicate your preferences when you're focused on labour.
Importantly, unless someone has the appropriate legal authority to make a decision on your behalf, your partner's role is to support your decision, not replace it.
What happens when decisions need to be made quickly?
Not every decision during birth comes with plenty of time to think.
Occasionally, circumstances change and your maternity team may need to recommend urgent care. When that happens, there may be less time for a lengthy discussion.
But urgency doesn't automatically mean communication and consent stop mattering.
Your team should still explain what's happening, why action is recommended and involve you in decisions as much as the circumstances allow.
Sometimes a brief explanation is all that's possible in the moment. There are also limited emergency situations where treatment may legally proceed without consent, such as when a person cannot consent and the relevant legal requirements are met.
If events move quickly and you're left with questions afterwards, you can ask your maternity team to talk through what happened and why particular decisions were made.
Understanding your birth experience can be important, even when everything has gone well.
You don't have to remember everything
This is probably one of the most important things I want parents to take away from my antenatal classes.
You don't need to remember every question, every medical term or every possible pathway your labour and birth might take.
You don't need to become an expert in obstetrics.
And you certainly don't need to feel that you must challenge every recommendation to have an active role in your care.
What matters is knowing that you are allowed to ask questions, that your preferences matter and that consent is part of your care.
Sometimes that might mean asking about the benefits and risks of an intervention. Sometimes it might mean requesting a little more time. And sometimes it might simply mean saying, “I'm happy to go ahead.”
All of those can be informed decisions.
A final thought
Over my years of teaching antenatal education, I've seen how much difference a little understanding can make.
Parents don't need to know exactly how their birth will unfold to feel better prepared. What helps is knowing what questions they can ask, understanding that they have choices and feeling comfortable being part of conversations about their care.
Informed consent isn't about controlling every aspect of birth. It's about being informed, being heard and being involved.
And sometimes, it starts with five simple words:
“Can you explain that, please?”
Janine Gard
Diploma Qualified Birth & Parenting Educator
Founder, Bellies to Babies
