Tuesday, April 12, 2011

Essay on Informed Decision Making

Since the health-care maternity system is a consumer-orientated operation concerned with attracting mothers and keeping them healthy and satisfied, you would think that more effort would go into helping these women make informed decisions about their care.  However, those who serve the medical system are not always vigilant in supporting the needs and wishes of their patients and institute policies that could potentially conflict with these choices.  Informed-decision making creates a partnership, or shared-care, with regards to the relationship between patient and healthcare provider. As mothers learn about childbirth, they can begin to understand their options and develop necessary skills.  This approach builds confidence and self-esteem and promotes growth to both the individual and as a mother.  The process of each mother’s education is a joint venture in which the mother helps determine what she needs to know and how much information she will need to truly be informed.

An informed mother is an advocate for health consumerism.  When weighing the risks involved in medications or medical interventions, caregivers may at times interject subjectivity in to the decisions and patients need to understand this to truly make informed choices.  This is perhaps based on tradition or accepted practice, but this subjectivity can be a cause for disagreement concerning the best of course of treatment for a given situation.  The fear of malpractice claims is a great motivator in such subjective approaches.  Therefore;  informed decision-making and informed consent benefits both parties.  By gaining as much information as possible, gathering evidence-based facts, weighing the pros, cons, risks and benefits about a recommended treatment and exploring other alternatives and possible outcomes, the mother is able to offer knowledgeable and responsible input.  Mothers then can be more actively involved in making decisions and in guiding the course of their treatment for themselves and their babies.  This also enables healthcare providers to broaden their perspectives based on consumer input.

Informed decision-making means the patient consents or declines treatment based on sufficient information and education.  Since education is the key, patients must take the initiative to self-education and discovery of what choices are right for them based on a variety of situations.  The majority of medical situations allow adequate time for the mother to seek answers and to ask questions, but she needs to know which questions to ask and what answers to seek.  A mother has the right to: understand what she is giving consent to; to understand the benefits and risks of any particular medication or intervention and how if will affect her, the baby and her labour; if there are any alternative methods that can be tried; to know if this procedure is medically indicated, why it’s being suggested, if it is elective, new or experimental; to have her questions answered completely and courteously; to seek another medical opinion and to accept or refuse treatment based on the best evidence-based practice.  Informed decision-making is not a prerequisite for quality healthcare.  However, it does increase the chances for positive outcomes for the mother who has accepted the responsibility for becoming knowledgeable and actively involved in the management of her pregnancy, birth and postpartum care.

Until recently, many mothers had felt they had few choices about their experiences, with hospital and physician policies dictating the course their care.  Real change happens when an awareness and attitude shift occurs, either among healthcare providers or with their patients.  This is where support services can play an enormous role in educating and advocating for information in the choices available to women and how to help them succeed in creating a positive environment of communication with their care providers.  One of the primary roles of support is to encourage mothers to be active participants in the care they receive and to take responsibility for their actions.  Sometimes this shift in mentality encourages a change in care provider or paves the way for an understanding with a present one.  My primary goal in providing support services would be to educate and locate resources about evidence-based practices in birth for my client through reading material, conversations, classes, online resources and prenatal meetings.

However, it is important to determine how informed a woman is in her choices, if at all, before bombarding her with information and resources.  Some mothers may be unaccustomed to questioning a statement or suggestion made by their healthcare provider.  A mother not accustomed to being actively involved in her care may need more guidance in how to effectively approach her care provider to ensure a positive interaction and a healthy working relationship.  Presenting facts to a mother will help her discover options that best suit her needs and goals and begin the learning process on how to make informed decisions.  By helping a mother develop her awareness of her rights and responsibilities, she’ll gain confidence in herself, the process of birth and her maternal instincts.   For the mother that is already well versed in dealing with her healthcare provider through informed decision-making, my support services would  be more to help her clarify her wants and needs.  By facilitating her empowerment through my words and actions, I can encourage her to further growth and continued belief in her abilities.

Since every birth is unique, so will be my approach to each and every woman I support.  Every woman has an array of experiences and resources that make her needs different from another.  Respect will be given to each woman’s background, cultural diversity and personality.  This personalized approach with every mother – one that assesses her needs, capitalizes on her strengths and praises her accomplishments – will lead to a mother’s satisfaction in both her communication with her care provider and in her birth experience.  By facilitating this growth through words and actions, my belief is that a mother will trust her instincts in birth, ask questions and seek the best care for herself and her baby through informed decision-making.

To summarize, informed decision-making is the responsibility of both the mother and the healthcare provider to develop a relationship based on communication and trust.  The more exposure a mother has to asking questions, seeking educational opportunities through written and online resources and receives the support she needs to find her voice, the more positive the experience will be regardless of interventions or method of birth.  And sometimes, the attitude towards out-dated practices, policies and procedures are changed, due to the educated and informed patient for the benefit of others.

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