I qualified as a midwife in 1972 and have worked for the NHS in both hospital and community. “Am I allowed?” was a question I have been asked countless times. How I wish I’d had a book such as this in my little black bag!
Gone are the days when women simply accepted and complied with tests and treatments being provided under the banner of ‘care’. They are now, thankfully, questioning more and more, with a wish to take control of their confinement and birth. A woman should not be made to feel part of a conveyor-belt system, but should be treated as an individual who is also protecting the rights of her unborn child.
Beverley Beech has years of experience campaigning on the rights of mothers during pregnancy and birth. I am sure she has been a thorn in the side of both the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists, but as a result of her efforts we have this well-researched, easy-to-read publication, which will empower women to make their own choices.
The book covers all aspects of pregnancy and birth, from antenatal planning and screening to choice of birthplace, delivery and post-natal care. I detect a slight bias towards home birth, but there is an enormous amount of information for women who choose to birth in hospital, with clear information about what to expect from procedures they may encounter.
In the introduction there is a mention of hospital protocols, which women rarely have sight of but have a right to see and a right not to follow. How many women know this? I have witnessed many changes in protocols, which have included, for better or worse, active management of labour. It is not easy to stay in control when you have little idea of protocols in the labour room. Knowledge is power, and Am I Allowed? will provide all the knowledge parents require in order to make informed choices.
I venture to suggest that this book should be readily available to all midwives and those involved with maternity care. Professionals also need to know what is consent and what is informed refusal. The paragraphs concerning the rights of both the mother and the baby while in hospital are particularly illuminating: the right to refuse treatment, the right to discharge oneself, and rights concerning the treatment of premature babies and death are rarely discussed in antenatal clinics. It is easy to be taken along on a conveyor belt, but not so easy to get off.
In addition to the considerable experience the author brings to discussing dealing with adverse events, there are numerous references to audit reports and published papers from peer-reviewed journals. The layout enables the reader to dip in and out, so the book can be used as a reference. It is light enough for a woman to take with her into hospital, if this is where she chooses to deliver her baby. The section on where to access help in the case of a grievance is particularly pertinent. Often parents are left floundering with no clear idea of how to proceed with a complaint. Am I Allowed? will give them the structure that is needed.
All in all, this book is a very good read. If governments had any interest at all in improving maternity services, they would make this publication readily available to all pregnant women and their professional teams.
Jane Dean is a lecturer in Obstetrics and Gynaecology at the College of Osteopathic Medicine, London.