Is your consent an informed one?

Sofia, Bul­gar­ia

Under this slo­gan on Novem­ber 25, women in Bul­gar­ia, will start dis­trib­ut­ing infor­ma­tion­al brochures in front of two of the biggest mater­ni­ty wards in the coun­try in Sofia and in Var­na. The goal of the cam­paign is to edu­cate women on their right of informed con­sent before any med­ical pro­ce­dures are per­formed on their bod­ies. We will do that by dis­trib­ut­ing brochures that out­line the oblig­a­tions of the Repub­lic of Bul­gar­ia accord­ing to inter­na­tion­al and domes­tic legal stan­dards. Brochures will be dis­trib­uted in front of local mater­ni­ty wards, in med­ical clin­ics, birth/parent edu­ca­tion class­es and to women in gen­er­al. As part of our cam­paign we have sent let­ters to Bul­gar­i­an hos­pi­tals ask­ing them to put a copy of their Informed Con­sent form on their web­site and to make it avail­able to women dur­ing pre-natal vis­its. We will also send a let­ter to the Min­istry of Health to lob­by for imple­men­ta­tion of the legal stan­dards regard­ing informed con­sent in practice.

Cur­rent­ly, the doc­u­ment enti­tled Informed Con­sent is used as a tool of coer­cion and intim­i­da­tion in Bul­gar­i­an mater­ni­ty wards. It does not con­tain any mean­ing­ful infor­ma­tion about pos­si­ble risks or side effects, or offer alter­na­tives, but sim­ply enu­mer­ates a list of the pro­ce­dures that will be per­formed. Women are usu­al­ly pre­sent­ed with the doc­u­ment dur­ing active labor and they don’t have time to either read it care­ful­ly or to under­stand its sig­nif­i­cance. There are severe reper­cus­sions if the woman refus­es to sign the doc­u­ment. Usu­al­ly the staff becomes abu­sive and uses threats and intim­i­da­tion until the woman suc­cumbs and signs. Some­times the staff retal­i­ates by using more inva­sive pro­ce­dures or with­hold­ing anes­the­sia dur­ing stitch­ing. This is clear­ly in vio­la­tion of all inter­na­tion­al legal treaties to which Bul­gar­ia is a sig­na­to­ry and even to domes­tic leg­is­la­tion. We feel it is very impor­tant for women to know what their rights are in child­birth and to receive all nec­es­sary infor­ma­tion to make an informed deci­sion regard­ing their care and health.

Insti­tu­tion­al vio­lence against women dur­ing child­birth is a seri­ous prob­lem in Bul­gar­i­an hos­pi­tals. Women endure both phys­i­cal and psy­cho­log­i­cal abuse. Pro­ce­dures are per­formed as a mat­ter of rou­tine, with­out regard to the mother’s or baby’s health needs, and often against the mother’s wish­es. Doc­tors’ desire for pre­dictable work sched­ules and high­er pay­ments over­rule med­ical neces­si­ty, lead­ing to a Cesare­an birth rate close to 40% of all births. Even worse, all these pro­ce­dures are accom­pa­nied by ver­bal abuse and the patron­iz­ing atti­tude of the staff. Women are shout­ed at by any­one on the staff, from nurs­es and doc­tors, to cus­to­di­al staff and order­lies. Get­ting slapped for not fol­low­ing the direc­tions of the staff is not unheard of.

This event is orga­nized by Estestveno (www.estestveno.com), an NGO that advo­cates for active birth, breast­feed­ing and par­ent­ing in har­mo­ny with nature, and Rodil­nitza (www.rodilnitza.com), an orga­ni­za­tion advo­cat­ing for the rights of women in preg­nan­cy and childbirth.
The print­ing and dis­tri­b­u­tion of brochures is made pos­si­ble with the help of the Net­work of East-West Women (www.neww.eu).

Support us

Please sup­port our efforts to bring this issue to the fore­front and require action from the Gov­ern­ment to ensure that wom­en’s rights are respected.

What you can do:

Send a let­ter of sup­port to us and we will hand it in with the col­lect­ed sig­na­tures from the Bul­gar­i­an pub­lic — info@rodilnitza.com

and/or

Send your let­ter of sup­port direct to the author­i­ties:

Health Min­is­ter Dr.Stephan Konstantinov
5, Sve­ta Nedel­ja pl.
1000 Sofia
Bulgaria
minister@mh.government.bg

Direc­tor of the Nation­al Health Insur­ance Fund Dr.Neli Nesheva
1, Krichim Str.,
1407 Sofia
Bulgaria
jvatkova@nhif.bg

Thank you!

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To assist you, we have pre­pared a sam­ple let­ter, which you are free to use and amend as required.

Inter­na­tion­al let­ter of support
in pdf format

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Inter­na­tion­al let­ter of support
for Word