What are your rights during pregnancy and childbirth?
From the start of your pregnancy until the birth of your baby, you will be followed in the health care system. Like any other patient, you have rights that medical staff must respect. These rights are guaranteed by the laws in Quebec and Canada.
Choosing a health care professional and birth location
Section 6 of the Quebec Act respecting health services and social services clearly states that “every person is entitled to choose the professional or the institution from whom or which he wishes to receive health services or social services.” The choice to be followed by a family doctor, a specialist, or a midwife is therefore entirely up to you. You can also change health care professionals at any time during your pregnancy.
However, the Midwives Act states that a midwife may only provide care and services as long as the pregnancy and birth are going smoothly. If a complication occurs, the midwife must transfer clinical responsibility for the patient to a doctor. One of the regulations governing midwifery work also mentions the conditions that would require mandatory transfer for medical consultation.
For example, midwives cannot care for twin pregnancies or deliver breech babies. It should be noted, however, that under the Midwives Act, a midwife may, “in an emergency, while awaiting the required medical intervention or in the absence of medical intervention,” deliver a baby in breech.
Regarding the birth location, women in Quebec who give birth with a midwife can choose to give birth in a hospital, at a birthing centre, or at home. According to the Regulation respecting the standards and conditions of practice for conducting home deliveries, a midwife is required to discuss options with the expectant mother and provide her with all the information necessary to make an informed decision. If the expectant mother chooses to give birth at home following this discussion, the midwife should also visit the home to ensure that services are provided in a safe environment.
Consent to interventions
Section 13 of the Civil Code of Québec states that, in an emergency, consent to medical care is not required if the person’s life is in danger or if their integrity is threatened and their consent cannot be obtained in due time. This provision is not intended to override a refusal of treatment by a person capable of consenting, but rather to allow for medical care when the person is not able to consent (e.g., if they’re unconscious).
Section 10 of the Civil Code of Québec stipulates that no one may interfere with the integrity of a person without their free and enlightened consent, except in cases provided for by law. In addition, Section 11 of the Civil Code of Québec states that no one may be made to undergo care of any nature, whether for examination, specimen taking, removal of tissue, treatment, or any other act, without their consent.
You therefore have the right to be informed of the risks and side effects of medications and treatments offered to you during pregnancy or childbirth. The health care professional monitoring your pregnancy is also required to discuss all available options with you. You’re free to refuse these interventions if you don’t consider them necessary.
If you’re being followed at a university institution, you have the right to refuse treatment by medical students if you’d rather not entrust them with certain important elements of care.
Interventions and the baby
The rights mentioned above also apply to the baby after birth. Parents have parental authority as long as their child is under 14 years of age, and they must give their consent before required care is provided. However, their decision must be made in the best interests of the child. The health care facility may seek court authorization if the person able to give consent to a minor’s required care refuses to do so without justification. Furthermore, if the parents’ decision is not in their baby’s best interests, the Director of Youth Protection may intervene. In an emergency, treatment can be carried out without parental consent.
Leaving the hospital
According to the Civil Code of Québec, no one can be held against their will in a health facility, unless the law or the court authorizes it. Therefore, as long as you are able to consent to care, you have the right to leave the hospital at any time after your child is born, even if this goes against the advice of the medical team. You also are not required to sign a refusal of treatment form.
As with medical interventions, this right also applies to the baby, as long as the decision is made in their best interests.
C-section and vaginal birth after a C-section (VBAC)
As with any medical procedure, your doctor should make sure you fully understand the risks of a caesarean section (C-section) and obtain your consent before proceeding.
Furthermore, the laws in Canada state that a woman can refuse to have a C-section, even if the medical staff is concerned about the safety of the fetus. According to case law, a baby becomes a human being only when it has fully emerged, alive, from its mother’s womb. That means the fetus does not have any rights that could limit those of its mother. However, if there is no medical reason to warrant a C-section, the doctor is not required to perform one, even if the expectant mother requests it.
If you’re pregnant and you’ve previously had a C-section, your doctor should inform you of the option to have a vaginal birth if it’s medically safe for you to do so. The Society of Obstetricians and Gynaecologists of Canada recognizes that, for some women, vaginal delivery is a safe alternative to a C-section. However, your doctor should also inform you of the risks associated with vaginal births. Once you have all the facts, you can decide which birth option is right for you. Remember that you can refuse to attempt a vaginal delivery and request a C-section.
Things to keep in mind
Like any other patient, a pregnant woman has rights that medical staff must respect.
She has the right to be informed of the benefits and risks of medications and treatments offered to her.
She can refuse any medical intervention that she deems unnecessary.
Legal review: Léa Charbonneau-Lacroix, lawyer
Research and copywriting: The Naître et grandir team
Updated: April 2020
Photo: iStock.com/Tatyana Sokolova
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Association pour la santé publique du Québec. “Droits des femmes : grossesse et accouchement.” www.aspq.org
Civil Code of Québec, CQLR, c. CCQ-1991. www2.publicationsduquebec.gouv.qc.ca
Criminal Code, R.S.C., 1985, c. C-46. laws-lois.justice.gc.ca
Vos droits en santé. “L’accouchement vaginal après césarienne.” www.vosdroitsensante.com
Vos droits en santé. “La procédure applicable au congé en centre hospitalier.” www.vosdroitsensante.com
Act respecting health services and social services, CQLR, c. S-4.2.
Midwives Act, CQLR, c. S-0.1. www2.publicationsduquebec.gouv.qc.ca
Regulation respecting cases requiring consultation with a physician or transfer of clinical responsibility to a physician, CQLR, c. S-0.1, r. 4. www2.publicationsduquebec.gouv.qc.ca
Regulation respecting the standards and conditions of practice for conducting home deliveries, CQLR, c. S-0.1, r. 14. www2.publicationsduquebec.gouv.qc.ca
Vos droits en santé. www.vosdroitsensante.com