What can honestly be promised
A short list of things that do not depend on luck, biology, or how the labour goes.
Here is the second box, written out. None of it depends on your outcome.
That you will be told the truth, at a level you can follow. ACOG: The highest ethical standard for adequacy of clinical information requires that the amount and complexity of information be tailored to the desires of the individual patient and to the patient's ability to understand this information.
That you can say no. ACOG: An adult patient with decision-making capacity has the right to refuse treatment, including during pregnancy, labor, and delivery and when treatment is necessary for the patient's health or survival, that of the patient's fetus, or both.
That includes tests. ACOG states that consent for any testing requires explanation of risks and benefits, including those associated with declining the test.
That a signature is not the point. ACOG: A signed consent document, however, does not guarantee that the patient's values and priorities have been taken into consideration in a meaningful way and that the ethical requirements of informed consent have been met.
That honest counselling is your right, not the doctor's discretion. ACOG, writing about outside interference: Nor should laws interfere with the patient's right to be counseled by a physician according to the best currently available medical evidence and the physician's professional medical judgment.
That you will be treated with dignity. WHO Recommendation 1, in full: 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.
requires that beneficence-based obligations to all patients be routinely fulfilled by providing them with an evidence-based standard of care.That is a duty on the doctor. It is not a bargaining position that can be adjusted down because a patient has been taught to ask for less.
One honest note. ACOG's own ethics committee and the professional responsibility model do not describe the fetus in the same way, and they say so in print. On disclosure, on coercion, and on your right to decline, they agree completely.
"I would like this written in my notes as something I declined after discussion."