Imagine during one of the most substantial times in your life being treated not as a fellow human being but as a vessel, having a condition to be rescued from – with your experiences made up of processes, checks, and procedures instead of being listened to and cultivating relationships through trust and disclosure.
For many pregnant people, that is an unfortunate reality throughout maternity care. If you’re not receiving the care you deserve, speak up. Here are a few ways you can advocate for yourself during pregnancy.
#1: Remember, You are in Charge
The “doctor knows best” mentality has lulled us into a false sense of security, but birth is not a one fits all event and providers are working under major pressures. They are making decisions based on so many factors and it doesn’t always match up with your specific goals, expectations and desires. If you don’t feel safe or like you’re being heard or respected during your appointment, you have the right to end that appointment and to look for a new provider.
#2: Educate Yourself
I love what Cristen Pasccuci writes in a blog post called Dear Friend, Birth Doesn’t Have to Suck:
“‘Unlearning’ about birth is almost as important as learning about it. There’s so much inaccurate, outdated information and so many negative messages out there, you kind of must start from scratch. Accept that a lot of what you think you know is simply not true. We live in a country where 1 out of 3 births is by surgery, and many of those surgeries are “emergency,” even though optimal care says that the majority of women could give birth safely without medical interventions and without complications. We create a lot of emergencies in the U.S.”
Many of the emergencies are caused by the medical system, like cervical stripping, cervical exams after waters are broken, and most common, induction, which is known to cause a slew of issues including distress to the baby.
#3: Where and with Whom Matters
The provider and place of birth you choose has a massive impact. If you are at a hospital that does c-sections 43% of the time vs a hospital that doesn’t do them 25% of the time, the numbers don’t lie. This is true for providers. Research has shown that the #1 predictor for a csection, is which door you walk in and has nothing to do with you or your circumstances.
There are lots of different care providers. Midwives are an option and they specialize in preventing complications. There are some wonderful OBs out there who practice evidence-based, respectful, patient-centered care, but you have to do your homework.
I’ll post a link to a great article on our website about Red Flags but If you hear things like, “You’re not allowed” or “We can’t let you,” please, take your business elsewhere, to someone who will treat you like a competent adult.
#4: Know What Evidence-Based Care Is
Outdated practice patterns are the name of the game in most labor and delivery units around the country, driven by liability concerns, financial concerns, and convenience. Consider these 6 questions you should ask your provider.
In addition, see what your provider’s stance is on:
- Freedom of movement
- Freedom to eat and drink as you like
- Intermittent monitoring
- One-to-one continuous support by someone who is educated in childbirth
- Water immersion for pain management
- Privacy so you can focus
- No vaginal exams during labor unless there is a specific reason for it or you want to know your dilation
- Freedom to push in whatever position feels comfortable to you
Evidence-based care also includes interventions when medically necessary and if medical interventions are recommended, receiving full and accurate information on their risks, benefits, and alternatives, and support of whatever decision you make. It also means that labor and pushing go as long as you feel comfortable and you and baby are doing fine.
#5: Seriously Consider a Doula
Doulas can make the difference. Having someone who only has your interest at heart is crucial especially if you’re wanting a VBAC.
#6: Know Your Rights
Those papers you sign on admittance does not give staff permission to do whatever they want. At every turn you have the legal right to informed consent and right of refusal. That means you can say “No” or “Stop” at any time. You’re also entitled to a full discussion with your care provider about the risks and potential benefits of anything they are suggesting, and about your alternatives, with the right to say “no” to anything.