***An excellent resource to help pregnant women/couples engage in aware discussion with
their chosen Obstetrician or Medical Midwifery care provider during pregnancy.


As the distinguished obstetrician Dr. Roberto Caldeyro-Barcia, while President of FIGO, the World Congress
of Obstetricians-Gynecologists, cautioned two decades ago:  "In the last forty years many artificial
practices have been introduced which have changed childbirth from a physiological event to a very
complicated medical procedure in which all kinds of drugs are used and procedures carried out,
sometimes unnecessarily, and many of them potentially damaging for the baby and even for the mother".

A growing body of research makes it alarmingly clear that every aspect of traditional American hospital
care during labor and delivery must now be questioned as to its possible effect on the future well-being
of both the obstetric patient and her unborn child.

There has been a three hundred percent increase in the rate of autistic children in the United States in
just one decade. One in every 35 children born in the United States today will eventually be diagnosed as
retarded; in 75% of these cases there is no familial or genetic predisposing factor. One in every 10 to 17
children has been found to have some form of brain dysfunction or learning disability requiring special
treatment. Such statistics are not confined to the lower socioeconomic group but cut across all segments
of American society.

The Pregnant Patient has the right to participate in decisions involving her well-being and that of her
unborn child, unless there is a clearcut medical emergency that prevents her participation. In addition to
the rights set forth in the American Hospital Association's "Patient's Bill of Rights," the Pregnant Patient,
because she represents TWO patients rather than one, should be recognized as having the additional
rights listed below.

1.  The Pregnant Patient has the right, prior to the administration of any drug or procedure, to be
informed by the health professional caring for her of any potential direct or indirect effects, risks or
hazards to herself or her unborn or newborn infant which may result from the use of a drug or procedure
prescribed for or administered to her during pregnancy, labor, birth or lactation.

2.  The Pregnant Patient has the right, prior to the proposed therapy, to be informed, not only of the
benefits, risks and hazards of the proposed therapy but also of known alternative therapy, such as
available childbirth education classes which could help to prepare the Pregnant Patient physically and
mentally to cope with the discomfort or stress of pregnancy and birth. Such classes have been shown to
reduce or eliminate the Pregnant Patient's need for drugs and obstetric intervention and should be
offered to her early in her pregnancy in order that she may make a reasoned decisions.

3.  The Pregnant Patient has the right, prior to the administration of any drug, to be informed by the
health professional who is prescribing or administering the drug to her that any drug which she receives
during pregnancy, labor and birth, no matter how or when the drug is taken or administered, may
adversely affect her unborn baby, directly or indirectly, and that there is no drug or chemical which has
been proven safe for the unborn child.

4.  The Pregnant Patient has the right if Cesarean birth is anticipated, to be informed prior to the
administration of any drug, and preferably prior to her hospitalization, that minimizing her intake of
nonessential pre-operative medicine will benefit her baby.

5.  The Pregnant Patient has the right, prior to the administration of a drug or procedure, to be informed
of the areas of uncertainty if there is NO properly controlled follow-up research which has established
the safety of the drug or procedure with regard to its on the fetus and the later physiological, mental and
neurological development of the child. This caution applies to virtually all drugs and the vast majority of
obstetric procedures.

6.  The Pregnant Patient has the right, prior to the administration of any drug, to be informed of the
brand name and generic name of the drug in order that she may advise the health professional of any past
adverse reaction to the drug.

7.  The Pregnant Patient has the right to determine for herself, without pressure from her attendant,
whether she will or will not accept the risks inherent in the proposed treatment.

8.  The Pregnant Patient has the right to know the name and qualifications of the individual administering
a drug or procedure to her during labor or birth.

9.   The Pregnant Patient has the right to be informed, prior to the administration of any procedure,
whether that procedure is being administered to her because a) it is medically indicated, b) it is an
elective procedure (for convenience, c) or for teaching purposes or research.

10. The Pregnant Patient has the right to be accompanied during the stress of labor and birth by
someone she cares for, and to whom she looks for emotional comfort and encouragement.

11. The Pregnant Patient has the right after appropriate medical consultation to choose a position for
labor and birth which is least stressful for her and her baby.

12. The Obstetric Patient has the right to have her baby cared for at her bedside if her baby is normal,
and to feed her baby according to her baby's needs rather than according to the hospital regimen.

13.  The Obstetric Patient has the right to be informed in writing of the name of the person who actually
delivered her baby and the professional qualifications of that person. This information should also be on
the birth certificate.

14. The Obstetric Patient has the right to be informed if there is any known or indicated aspect of her or
her baby's care or condition which may cause her or her baby later difficulty or problems.

15. The Obstetric Patient has the right to have her and her baby's hospital- medical records complete,
accurate and legible and to have their records, including nursing notes, retained by the hospital until the
child reaches at least the age of majority, or, alternatively, to have the records offered to her before
they are destroyed.

16. The Obstetric Patient, both during and after her hospital stay, has the right to have access to her
complete hospital-medical records, including nursing notes, and to receive a copy upon payment of a
reasonable fee and without incurring the expense of retaining an attorney.

It is the obstetric patient and her baby, not the health professional, who must sustain any trauma or
injury resulting from the use of a drug or obstetric procedure. The observation of the rights listed above
will not only permit the obstetric patient to participate in the decisions involving her and her baby's
health care, but will help to protect the health professional and the hospital against litigation arising from
resentment or misunderstanding on the part of the mother.

Doris Haire ©2000
The Pregnant Patient's Bill of Rights

provided by the Alliance for Improvement of Maternity Services
prepared by Doris Haire