Human Rights In Childbirth – What You Need To Know
Having a baby is one of the most amazing and exciting times for a woman and her family. There is so much to look forward to, and surprisingly a lot of planning!
With the vast majority of women giving birth in hospitals in Australia, it’s easy to believe there’ll be no issues with how your pregnancy and birth will go.
And for many women, they have a positive and successful birth experience and never question why.
There is a framework of laws that protects the human rights of women in childbirth, which works to reduce abuse, disrespect and unsafe practices in maternity care.
Based on these laws, all women are entitled to access safe and quality care which recognises their right to make decisions without fear of being discriminated against or disadvantaged in any way.
While this might not seem like something that you need to worry about, it’s important to have an awareness and knowledge about human rights in childbirth. That way, you can recognise if you’re not being centred in your care and know how to deal with it.
What are human rights?
The term human rights has evolved out of the idea every person in the world has the same basic rights, which are based on values such as dignity, respect and independence.
We tend to think of human rights being about such situations as slavery or lack of access to basic health care. But they also apply to specific experiences, such as pregnancy and maternity care.
Human Rights In Childbirth, a leading charity organisation focused on protecting women’s human rights in maternity care, says there are four main areas of basic human rights:
The World Health Organization says international human rights frameworks are important to ensuring health systems provide respectful and quality maternity care.
What are my rights when I am pregnant and giving birth?
There are human rights laws which give all women the right to receive safe, quality maternity care and to make your own choices about the care or treatment you are offered.
These laws also mean maternity healthcare professionals and hospitals must treat you with respect and dignity at all times, including your autonomy to make decisions about yourself.
Where do our human rights come from?
The idea that humans have basic rights probably steam from way back in 1215 in Britain with the Magna Carta Libertatum or the Great Charter of Freedoms. From that time, a number of laws were developed that developed further the idea that all humans deserved the same rights and freedoms.
The Second World War and the atrocities that happened as a result increased the pressure to make the protection of human rights a priority for all countries around the world.
In 1945, the United Nations was formed and 50 Member States worked to contribute to the Universal Declaration of Human Rights, adopted in 1948.
Australian rights are decided based on international law, laws made by our courts, and laws enacted by our parliament. In 2008 The Australian Charter Of Healthcare Rights was adopted by federal and state health ministers. It was developed by the Healthcare Commission on Safety and Quality in Healthcare, in consultation with the Australian government, health sector and health consumer groups.
The Australian Charter Of Healthcare Rights outlines the rights of patients, consumers and anyone using the Australian healthcare system. These rights ensure the safest and highest quality healthcare is provided to all people.
How do human rights apply to maternity care?
Human rights laws extend to how women can expect to be treated during pregnancy and birth.
The four key areas of human rights mean women should be respected to choose the care and treatment they wish for.
Care providers must provide maternity care that respects human rights, particularly with regards to informed consent and the right to autonomy.
What rights do I have in maternity care?
When you’re first pregnant, it’s difficult to know what the ‘right’ thing is to do. Often we look for guidance from others, whether that’s to do with which care provider and birth place to choose, and information about pregnancy and birth.
Almost all women in Australia go through the public or private hospital system to give birth. In this setting, it can be really easy to defer to the authority of healthcare professionals.
While care providers all have the same end goal in mind, which is the safe birth of your baby and you being safe too, it’s important to know you have autonomy over decisions about this process.
Human rights in childbirth include:
- Privacy and confidentiality
- Information and the right to give informed consent or refusal of consent
- Respect for their choices and preferences
- To be treated with dignity and respect
- Access care that is free from discrimination based on race, sex or religion
- Autonomy and the right to self determination without coercion
- Be free of harm and poor treatment
- Access to the highest level of care.
Your rights in maternity care should centre around you as the key decision maker in all aspects of pregnancy and birth care. This is what is known as informed consent.
Informed consent is the process by which your healthcare provider (doctor or midwife) is legally obliged to tell you the risks/benefits of treatments or procedures they’re recommending.
You have the right to be informed of the risks and benefits of any treatments or procedures so you can decide if you consent to them.
This means your care provider should:
- Offer a description/diagnosis of the situation
- Discuss the treatment or procedure
- Go through the risks and benefits of these actions
- Offer alternatives available (with risks/benefits)
- The risks and benefits of refusing treatment.
If your care provider doesn’t cover these points with you and goes ahead with a procedure without your consent, or demands you agree to one without full information, then it’s not informed consent.
If you’re refused treatment that you ask for, such as pain relief, to prevent suffering, this would be considered inhumane or degrading treatment and not respecting your human rights.
You have the right to refuse medical treatment if you believe it’s not right for you.
Do human rights protect an unborn child?
In Australia, an unborn baby doesn’t have separate rights to their mother. As such, until birth the mother is free to make choices about her care that affect her baby. She can’t be forced to accept treatment even if it’s said to be in the best interest of her baby.
This may be something as simple as your doctor wanting to induce labour at 41 weeks before the small risk of stillbirth increases.
After having all the risks and benefits of both the induction procedure and the risk of stillbirth discussed, you may choose to refuse the induction. This is your right.
If your care provider believes you or your baby is at significant risk of harm or death and you refuse treatment, they may ask a court of law to force treatment.
Are there any circumstances in which treatment can be given without consent?
It’s very rare that you will not be able to give consent to treatment during your pregnancy and birth.
The only time your care provider may treat you without consent is if you’re unable to make a decision in an emergency and you can’t make your wishes known. This may be if you’re losing consciousness due to severe blood loss and your doctor needs to provide urgent life saving treatment.
Being informed about pregnancy and birth helps you to prepare for the unexpected and have your preferences already known to your care providers.
Building a relationship with them during your pregnancy creates a mutual understanding of how you envisage your birth and your expectations should things change. It’s important you choose the right maternity care provider for you for this reason.
What can I do if my rights have not been respected?
It can feel really challenging when you realise you’re unhappy with how you’ve been treated, especially at such a vulnerable time as when pregnant or giving birth.
You may want to talk to a trusted friend, family member or even another healthcare professional, such as a midwife or doctor. You can also speak to a birth doula to debrief your experience and help you understand what has happened.
This can help you to have clarity about the situation and work through the best process for you to move forwards.
If your human rights in childbirth haven’t been respected, you can make a complaint against either the person or service such as a hospital.
The first step is usually to approach the healthcare provider or service directly. You can either speak to them in person, with an advocate present, or make a complaint in writing. Write down what happened, who was involved and the solution you are hoping for. It’s important to ask for a written response and the healthcare provider or service should acknowledge they’ve received your complaint.
If you’re unhappy with their response, or you’re not comfortable with this approach, you can take your complain to either the following organisations:
- Your state or territory state or territory health complaints organisation (the Health Complaints Commissioner in Victoria)
- the Australian Health Practitioner Regulation Agency (AHPRA).
They will work with you to deal with your complaint and work out a resolution you’re satisfied with. If you don’t want to make a formal complaint, you can call AHPRA on 1300 582 113 and discuss what options might are available to resolve your concerns.
Nurtured Birth offers workshops and services to support you choosing a maternity care provider, becoming birth informed, or even be there for you on the day. Please get in touch with us to find out more.