Your doctor tells you, “We're going to do (insert whatever test or procedure) at your next appointment.”

Do you just accept that plan of action, or do you start asking questions?

Medicine is as much an art as it is a science. Often, there are several possible approaches to address your health needs. When it comes to maternity care, many of the tests and procedures are done as part of standard practice, but they may not refer to concerns about your individual health status. They are often done to screen patients to provide documentation to reduce liability, to move patients efficiently through the system, or to increase revenue with a billable procedure. It's up to you to learn why the test or procedure is being done, its risks and benefits, what problem it will solve, what information it will reveal, and what the next steps will be if a problem is found or there is a complication. Then, it's YOUR decision whether or not to move forward with the test or procedure.

I recently spoke with a woman who had NINE ultrasounds during her healthy pregnancy, and she still had several months until her baby was due. At each appointment, her doctor just said, “We're going to take a look at your baby now!” Her friends were surprised that she was having so many ultrasounds, and the woman herself did not understand why she was being done either, although she enjoyed seeing her baby. Since it was presented in a way that did not appear to be a choice, she did not realize she could refuse. She also did not realize that her quiet acceptance was being viewed as informed consent. But, since she did not know why it was being done, what the doctor was looking for, what would happen if something was found, or the risks of having multiple ultrasounds, her was not really informed, was it?

Since she was told at each ultrasound that her baby looked great, I asked if the ultrasound machine was in the doctor's office, which it was. Research has shown that when medical practices have their own in-office ultrasound machines or labs, the doctors order tests more frequently. The tests and their results are available available and the office can bill insurance companies for the procedures. Rather than enhancing health, multiple ultrasounds increase risk to the baby and do not improve outcomes at birth either. Did she really need all those ultrasounds? Probably not.

Even when there is a health issue that needs to be addressed, there may be several ways to handle it. There are questions you can ask to learn more about all the options that might available to you, including watching and waiting to see if the problem resolves itself. Ask about the risks, benefits, and possible alternatives.

It's your right as a patient to be fully informed about any test or procedure your doctor, midwife, or nurse advises, and it's your right to make the final decision about whether or not to consent to having it done. Even if it is not presented to you as a choice, the choice is there. Make sure your consent is properly informed, and decline procedures that do not have clear benefits, even if they appear to have few risks. Your health and your baby's health depend on it.