Play this game to teach your clients about informed consent

mamWhen it comes to the birth process, parents shouldn’t simply be told their rights, they must be shown how to apply them. In this piece, childbirth educator and postpartum doula Nicole Wheeler shares her unique tool for teaching parents about informed consent: a rousing game of BINGO.

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“I told them that I didn’t want to push on my back but they made me. I didn’t have a choice.”

“They wouldn’t let me get up to go to the bathroom.”

“I didn’t know I could wear my own clothes at the hospital. They told me I had to wear a hospital gown.”

Ever heard a client say something like this? I have, and I’ve talked to countless doulas, midwives and childbirth educators who have heard the same things.

Unfortunately, as a new childbirth educator, I quickly discovered it’s not enough to simply tell parents what legal rights they have – that they can accept or refuse any proposed treatment, medication or intervention. New parents can’t simply be told their rights: they must be shown how to apply them.

Here’s how I do it.

After introducing the subject of informed choice, I dive right into a rousing game of BINGO. I created my own using this Bingo game generator that focuses on The Rights of Childbearing Women. You can find the link to my BINGO word phrases here. Copy and paste this into the generator and then print out each statement and throw them in a container to draw at random.

As you read each statement, add your own personal notes and engage your clients. For example, when I draw “Every woman has the right to accept or refuse procedures, drugs, tests and treatments, and to have her choices honored. She has the right to change her mind.” I say, “So let’s pretend your nurse offers you an epidural and you refuse. Just because you say ‘no’ at this point in your labor doesn’t mean you can’t have one later. If a time comes that you decide you want one, you are absolutely free to change your mind.”

This concept may sound simple, but reinforcing these rights with examples really helps parents understand their very specific rights. I end the activity by distributing the handout The Rights of Childbearing Women and encouraging parents to read it in their free time.

Once you have covered rights, I like to discuss example scenarios that they may run into. I created various scenarios I’ve heard come up frequently and printed them on cardstock, titled, “What Would You Do?” You can take a look at or print these cards here.

Before beginning this exercise, it’s vital to stress that there are no right or wrong answers – that the point of the exercise is for parents to realize that they have options. I hand each person a card (or two, depending on the class size) and give them a few minutes to review the scenarios and decide what they would do in that situation. On the back of the card, I list out some specific questions in case they need help in get the creative juices flowing!

So to walk you through what this activity looks like, I hand everyone at least one card and tell them to look it over. For the sake of example, one of the cards reads, “You are 10 centimeters dilated and the nurse tells you that you can begin pushing. You are unmedicated and do not feel the urge to push yet.”

After giving everyone a few minutes to think, I choose someone to start. For the sake of this example, let’s say I called on the person who had the scenario I laid out above. I ask them to read their scenario aloud and then ask, “What would you do if you were in this situation?” Sometimes the person is forthcoming and has lots of thoughts to share; more often I have to ask leading questions, often rewording the ones from the back of the card to suit the individual. Again, I reiterate that there are no right or wrong answers here and that the important thing is that they know they have a choice.

The cards I created cover issues I have heard many of my clients talk about. I have found that showing a couple that they can say yes or no to anything – even something phrased as an order or that seems very simple (like the fact that they don’t have to wear a hospital gown!) – is far more effective than just listing off their rights.

If you are a childbirth educator or anyone who regularly educates expectant parents, teaching informed choice in an effective manner is essential to the quality of your curriculum. As in all things, showing is more effective than telling. Don’t make the assumption that parents will intuitively understand the importance of consent the way you do – show them why it matters and give them the chance to “get it” themselves.” Reduce the number of clients telling you their stories of being coerced into positions or interventions they didn’t want. Show them their rights. Show them they have a choice. Don’t let your classes miss one of the most important topics of labor and birth.

Nicole Wheeler is a Lincoln, Nebraska childbirth educator, postpartum doula, blogger, wife, and mother. She writes th Birth Beyond Bias blog, providing insight and inspiration to thousands of readers. Her writing has also been featured around the web on sites such as” title=”The Huffington Post”>The Huffington Post, BabyMed and The Birthing Site. When she isn’t teaching, talking or writing about birth, Gabrielle enjoys writing and playing soccer.

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