Empowered Hospital Birth Series Part 1: Advocating for Yourself

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There is good reason that most people invite medical professionals to attend their pregnancy and birth. Doctors, midwives, and nurses possess volumes of information on childbirth and we certainly want them there to help us in case of an emergency. Often, we just need them there to tell us that everything that is happening is normal. Because expecting mothers rely heavily on their care provider for support and advice, they are sometimes nervous to ask questions or say something that their provider might not support. It can be easy to see a provider as being in a role of authority, and there are plenty of examples of medical professionals who dominate decision-making. It is important that you feel empowered to ask questions and make decisions. You are entitled to decline or consent to every touch, procedure and decision regarding both you and your baby.

When you walk into a hospital, you’re stepping out of your domain and into the doctor's. They know the routines, the expectations, and have experience with birthing mothers. They know how to manage your health and are going to use that knowledge to keep you and your baby safe and healthy throughout delivery. What they don’t know is what you’re thinking. There are some non-negotiable elements of labor and delivery care in a hospital birth, many of which are dictated by hospital policy. Much of this care is in your best interest certainly, but there are elements of your labor and delivery where you are entitled to choice.

Hopefully you have developed a good relationship with your provider and you will feel comfortable expressing your wishes when you’re in labor. In an ideal scenario, this is something you’d be able to talk to them about beforehand so that everyone is on the same page, but because of the way many practices and hospitals currently operate, you might not know the doctor or midwife on call very well. There are ways to advocate for yourself, and your baby so that you can have the birth you want and deserve.

A Few Ways to Advocate For Yourself:

  • Be familiar with your provider’s standard of care- If you're trying to avoid a cesarian, ask for your provider's C-section rate. If you want to know which hospital will allow you to labor in water, ask your provider if this will be possible. Knowledge is power in this situation and the sooner you know, the better so if you need to search for a better fit, you can.

  • Provide a written birth plan. If you’re not feeling up to remembering everything you’ve researched about how you want your ideal labor to go, print out a short and clear birth plan. This also provides your support team a baseline to work from when it comes to advocating with you and providing the assistance you need to labor well according to your wishes. Keep in mind that one page is plenty for a birth plan. Short and simple is best.

  • Ask for all of your options. Chances are that you might be able to have something if you just ask. Asking for all of your options starts a dialogue with your provider instead of stating demands. Use this as an opportunity to ask what they expect to see out of certain interventions, so you can understand the logic behind their suggestions and choose whether or not to proceed.

  • Bring a doula. While a doula should not speak on your behalf or make ANY medical decisions for you, they can certainly help start a dialogue. A doula can ask questions about what is happening and provide support. When it comes to navigating a world that is outside of your normal, they can also reiterate information that your provider has given you and offer a neutral perspective to assist in the decision-making process. Most importantly, they will support you with whatever decisions you made.

  • Actively suggest positive compromises. There are usually ways to come to a compromise that will satisfy both you and your provider. For example, if you know that you want to avoid an IV then perhaps suggest a heparin lock. Working together will allow hospital staff to stay within protocol while simultaneously respecting your wishes.

  • Ask for time. If you are feeling pressured into making a decision about something as big as an epidural or Pitocin, ask for time to decide. Even if you ask for 5 minutes, it will give you and your support team time to talk about the pros and cons and take off some of the pressure. It’s easier to feel good about a decision--even if that decision goes against your initial birth wishes--when it’s been made with a clearer head.

Regardless of if every detail of your birth goes as planned, you are likely to feel at peace if you are given a chance to advocate for yourself. How have you empowered yourself in a hospital birth? Did you find it easy or difficult to advocate for yourself?