We believe that people have a right to decide for themselves what constitutes an acceptable risk and a proven benefit. Diane Korte has said it best: "If you don't know what your options are, you don't have any!"

It is the Titus 2 policy that we provide the most complete information available whenever possible. This includes information in the childbirth education material, vaccine information, parenting education and labor support. It is the professional's responsibility to provide the information requested and the client's job to make the decision. It is also the client's responsibility to do their own research prior to making a decision since they alone will be able to determine what kind of information is most desired.

The accepted definition we use for informed consent is that the person making the decision be given:

• all known Benefits of the procedure
• all known Risks (regardless of how rare)
• a full Explanation of why and how a procedure will be done, how many times the caregiver has performed it, how experimental the procedure might be, how relative this procedure is to this person and their circumstances, what the expected outcome should be
• any Alternatives to this procedure, including doing nothing and their expected risk/ benefit/ explanation information
• an opportunity to make their own Decision without undue pressure

Pregnancy and Birth Options

Options to consider may include:

• type of caregiver and care desired and their professional information and statistics
• type of birthing environment and their safety and procedure statistics
• restrictions in care due to the chosen environment or care provider
• consent or refusal of standard tests and routine procedures
• information on pharmaceuticals recommended, either in pregnancy or in labor and following
• choice of attendants for the birth
• preventative information for common problems/conditions
• information on natural options for treatment

Parenting Options

Options to consider may include:

• type of caregiver and care desired and their professional information and statistics
• method of feeding the baby; i.e. breast or bottle
• circumcision of the baby
• vaccination decision
• type of parenting model chosen
• working or stay-at-home caregiver
• type of education preferred

Birth Professional Qualifications

Options to consider may include:

• type of care desired
• skill level and skills provided
• type of training received and from where
• length of practice and number of previous clients
• restrictions on practice, whether legal or circumstantial
• level of comfort and support obtained

Priority Topics

There are some areas we have decided to make a priority for clients. Those areas include:

• the safety and normalcy of birth
• the option of out-of-hospital births
• vaccine education
• attachment parenting models
• benefits of breastfeeding over formula feeding

It is my hope that those who seek my services on whatever level feel that they have received real informed consent and informed refusal. There is no real informed consent if we do not make room for informed refusal.

Applicants in the Titus 2 Birth programs are expected to reach for the same level of commitment to the informed consent/refusal education. The above priority topics are covered in the Titus 2 materials and are expected to be provided by each Titus 2 certified birth professional. If you have any concerns about an individual professional, please feel free to email me with your concerns.

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