The Language and Limitation of Risk

photo credit Sammie Vasquez

I’ve been hearing about ‘risk’ a lot recently. Clients who are deemed high risk because of age, weight, fertility treatment, medical issues or twin pregnancy. High risk might mean extra scans, or consultant-led care or denied access to the birth centre. However in these cases, it’s so important for the person to weight up the difference between perceived risk and actual risk and make an informed decision.

For example, I have had a number of recent clients who are over 40 when they have their first baby. They are recommended to be induced at 40 weeks because of the risk of medical complications including stillbirth beyond due date. Or some women are sent to the labour ward as apparently birth is ‘more risky’.

It’s important to look at the situation from a broad perspective. Consider other factors such as general health, previous history, family history when weighing up risk. I often recommend ‘The Heart in the Womb’ by Dr Amali Lokugamage. It’s the personal story of a Consultant Obstetrician and her decision to have a home birth, despite being ‘high risk’ due to age, gestational diabetes and other factors.

Don’t be passive or agreeable. It’s your body, and your experience. You have the right to delay or decline intervention, or request alternatives. Be informed by reading the NICE guidelines and protocols in different hospitals and trusts. Speak to organisations like Birthrights or AIMS. Prepare your body with pregnancy yoga or active birth preparation. Prepare your mind with hypnobirthing or sophrology. Attend your local Positive Birth Movement group.

The language of high and low risk is outdated. Even for ‘low-risk’ situations, the very presence of the word risk creates the suggestion that something isn’t safe. We need to do better.

Resources:

https://evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404541/