This is the third chapter of our free ebook Your Best Birth: Providers, Plans, and Being Proactive.
Giving birth is life-changing—no matter when, where, or how it happens.
A healthy baby and a healthy mama is obviously what most women want above all else. But it’s ok (and perfectly normal and natural!) to also want a positive birth experience, where you felt that you and your feelings were an integral part of welcoming your child into the world. It’s also normal and natural to feel overwhelmed with or uncomfortable about the prospect of making sure your wishes are heard during the heady time of labor.
It’s ok (and perfectly normal and natural!) to want a positive birth experience.
Yes, giving birth is unpredictable but you can, and should, feel like a respected participant in your birthing process.
You only give birth to your baby once.
There is nothing wrong with safely and respectfully advocating for yourself and your wishes, both during your pregnancy, during labor, and afterwards. To outline effective strategies for finding your inner advocate, we spoke with Cristen Pascucci, the former vice president of Improving Birth and founder of Birth Monopoly.
Understand your basic rights as a birthing person.
Pascucci explains that you have the right to informed consent and refusal—a right that is also affirmed by the American College of Obstetricians and Gynecologists. This means that anytime a care provider or member of the medical staff wants to perform a procedure or treat you (even something as simple as putting in an IV line), they have an obligation to explain the procedure to you, including why it’s being suggested and the benefits and risks of the procedure, and then they must wait for your decision about whether or not you consent.
“You have the basic right to be the decision-maker about what is done to your body. Nobody can touch you without your permission and no one can administer a procedure without your permission.”
– Cristen Pascucci
This is true in any birth setting—hospitals, birth centers, home.
Informed consent means that you will be informed of and be given the opportunity to understand whatever is happening to both you and your baby. The people who have the medical knowledge and clinical experience should always give you all of the information you need, so you can make an informed decision about your care. This goes for all of the aspects that surround pregnancy and birth, from whether or not to undergo certain testing, accept an induction, or consent to interventions during labor. Pascucci says informed consent is not “Hey we want to do this, is it ok? It’s more of “We recommend this and here is why, what is your decision?”
Everyone on your birth team should understand your rights and how to advocate for them when you’re in labor.
This includes your partner, other family members, and doulas. This advocacy does not require an “us vs them” mentality or adversarial tone, it could be as simple as knowing how and when to ask questions and remind staff of your goals and preferences. Pascucci recommends that partners practice with a couple of role-playing scenarios before the big day: “What happens when a nurse comes in and says “Ok, we’re going to need you to do X,” or a provider says “We think it’s time for Y now?” What are you going to say that is both respectful, but also calm and assertive? It may feel a little silly, but it can prove helpful.”
Advocacy does not require an “us vs them” mentality or adversarial tone, it could be as simple as knowing how and when to ask questions and remind staff of your goals and preferences.
Remember that the people taking care of you are just that—people.
If you are asking them to do something outside of their comfort zone or normal clinical routine, be cognizant of and sensitive to that. Cultivate a human connection with your birth team: use humor whenever possible, explain why things are important to you, and don’t be hasty with the thank you’s. Keep things compassionate and respectful. That doesn’t mean compromising on your care, but rather understanding and acknowledging the work and efforts of the staff.
“In an emergency, you are really trusting your providers to look out for your best interest. In a true emergency, there may not be time to explain every possible choice and its repercussions. That’s why it’s important to be with a provider that you trust. That said, it’s important to remember that most situations in birth are not emergencies, so you should have time to ask questions and get all of the information you need.”
– Cristen Pascucci
Use your BRAIN
BRAIN is a useful acronym that you can employ to ensure you’re receiving the best information to make decisions that feel comfortable to you.
Ask yourself, your partner, your support people, and the medical staff these questions if and when a procedure or intervention becomes necessary:
What are the Benefits? What are the Risks? Are there any Alternatives? What is your Intuition telling you? What happens if we do Nothing?
What are the Benefits?
What are the Risks?
Are there any Alternatives?
What is your Intuition telling you?
What happens if we do Nothing?
Above all, don’t be afraid to speak up to make your wishes known.
Get the information you need to feel like an informed and respected participant in your baby’s birth story.