What a good birth is, according to WHO
The definition ends with the words "even when medical interventions are needed or wanted." It also requires that your expectations be fulfilled or exceeded, not lowered.
In 2018 the World Health Organization published 56 recommendations on care in labor. Its definition of what everyone is aiming for is worth reading in full.
Women want a positive childbirth experience that fulfils or exceeds their prior personal and sociocultural beliefs and expectations. This includes giving birth to a healthy baby in a clinically and psychologically safe environment with continuity of practical and emotional support from birth companion(s) and kind, technically competent clinical staff. Most women want a physiological labour and birth, and to have a sense of personal achievement and control through involvement in decision-making, even when medical interventions are needed or wanted.
Two clauses in there do a lot of work.
The last one. WHO's own definition of a good birth explicitly does not require a birth without interventions. A woman can have an induction, an epidural and a cesarean and still have had, by this definition, a positive childbirth experience.
The first one. A positive experience is one that fulfils or exceeds
her prior expectations. Not one that stays below them. This is the strongest single argument against the advice everyone gives, which is to expect less so you will be less disappointed. No study has ever tested lowering expectations as a way to improve birth satisfaction. What the four prospective studies that measured birth satisfaction consistently show is that expectations met went with higher satisfaction and expectations unmet with lower, which is a different claim entirely.
WHO's first recommendation, in full and in its own words:
Respectful maternity care - which refers to care organized for and provided to all women in a manner that maintains their dignity, privacy and confidentiality, ensures freedom from harm and mistreatment, and enables informed choice and continuous support during labour and childbirth - is recommended.
The three that follow it: Effective communication between maternity care providers and women in labour, using simple and culturally acceptable methods, is recommended.
A companion of choice is recommended for all women throughout labour and childbirth.
And, for settings with the midwifery workforce to deliver it, midwife-led continuity of care.
What ACOG says you are owed in the conversation itself. Its ethics committee defines shared decision making as a patient-centered, individualized approach to the informed consent process that involves discussion of the benefits and risks of available treatment options in the context of a patient's values and priorities.
And on the obligation: Meeting the ethical obligations of informed consent requires that an obstetrician-gynecologist gives the patient adequate, accurate, and understandable information and requires that the patient has the ability to understand and reason through this information and is free to ask questions and to make an intentional and voluntary choice, which may include refusal of care or treatment.
"I would like to be asked before things are done to me, even when they are routine."
"If there is no time to ask, tell me afterwards what happened and why."