In this episode of The Pulling Curls Podcast, Hilary welcomes certified nurse midwife Juli Pyle to dive into the topic of informed consent in labor and delivery. Together, they break down what informed consent really means, the key components every patient should know, and how it plays out during childbirth. Juli and Hilary share personal stories from both sides—provider and patient—highlighting why these conversations matter and how they can empower you to make the best choices for your birth experience. Whether you're planning your first delivery or looking to better understand your options, this episode provides practical tips for having more effective, respectful discussions with your care team.

Big thanks to our sponsor The Online Prenatal Class for Couples -- if you want to learn to communicate better, it is the class for you!

Today's guest is Today's guest is Juli Pyle (she/her) a certified nurse midwife who practices at a community hospital in rural Pennsylvania. Juli was a stay at mom for many years to five children before deciding to return to school to pursue a degree in nursing. She graduated from Colorado Mesa University with a bachelors of science in nursing degree in 2016 and then began her nursing career as a labor and delivery nurse. She quickly discovered that this was her true passion (as she had suspected since having her own children) and quickly gained a reputation for professionalism, compassion and expertise among colleagues and patients. She then returned to Frontier Nursing University to complete a Master's degree in Nursing with an emphasis in midwifery. In 2020, she graduated and began as a certified nurse-midwife at a small community hospital in central Pennsylvania where she has been since that time. Her focus as a CNM is to provide evidence-based education to all birthing families, give true autonomy and informed consent throughout their time with her and to share love, understanding, empathy and true shared-decision making. When not immersed in the birthing world, she enjoys spending time refinishing furniture, gardening, raising and breeding different types of chickens, hiking and vacationing with her family.

Links for you:

Julie's previous Episodes:

The Best Providers for Your Baby's Arrival: A Deep Dive with CNM Juli Pyle -- Episode 204

What Your Providers Think When You're in Labor with CNM Juli Pyle – Episode 189

Timestamps:

00:00 "Informed Consent Importance in Medicine"

04:20 Balancing Patient Communication and Time

09:24 Respectful Informed Consent Dynamic

10:29 Patient Choice in Labor Induction

14:06 Informed Consent for Episiotomy Decisions

18:17 Informed Consent for Induction

22:31 Labor Induction and Position Choices

25:56 Documenting Risk in Patient Decisions

29:16 Holistic Prenatal Care Approach

32:33 Nurses' Role in Informed Consent

35:45 Patient Communication with Providers

37:21 Importance of Informed Consent

Keypoints:

Informed consent in labor and delivery is a crucial and often misunderstood part of medical care, emphasizing the patient's right to understand and make decisions about what happens to their body.
There are five main components of informed consent: patient understanding, absence of coercion, full disclosure of risks/benefits/alternatives, the right to decline, and documentation of the discussion.
Time pressure, provider biases, and regional/cultural differences often affect how effectively informed consent is communicated in hospitals.
Patients are encouraged to ask, at any point, for the risks, benefits, and alternatives to a procedure—it's their right, even for routine interventions.
Some medical staff may overwhelm patients with information, while others may inadvertently minimize discussion; finding the right balance to suit each patient is key.
Regional culture, age, language, and personal preference play huge roles in how much information patients want or are comfortable with during labor and delivery.
Informed consent isn't just for major decisions like C-sections or epidurals—it can and should apply to things like cervical exams and labor positions, even in less formal, conversational ways.
Declining a recommended intervention (e.g., breaking water, episiotomy, induction) is absolutely an option for patients, and the birth experience should support their decision, barring emergency situations.
The benefits of midwifery care are highlighted, including a more holistic and consistent approach to informed consent and labor support, but ultimately provider style matters more than title.
Good communication and shared decision-making between providers and patients help prevent birth trauma and litigation, reinforcing the importance of patients feeling informed and respected during their birth experience.

Producer: Drew Erickson

Keywords:

informed consent, labor and delivery, childbirth, induction, epidural, c-section, certified nurse midwife, obstetrician, patient rights, shared decision making, medical risks, medical benefits, alternatives to treatment, refusal of treatment, documentation, birth trauma, labor nurse, pregnancy, patient-provider communication, cervical exam, water breaking, episiotomy, pain management, delivery positions, hospital protocols, regional differences in care, language barriers, birth plan, stillbirth risk, maternal fetal medicine