Advocating for yourself during childbirth can feel challenging. However, creating a birth plan, choosing a birth advocacy partner, and learning how to make informed decisions can help ensure you feel safe and in control in the delivery room.
Giving birth can bring on a whirlwind of emotions. You may feel scared or uncertain while simultaneously feeling joy and excitement. It’s common to feel a mix of emotions.
However, you should also feel in control and safe throughout the experience.
For women of color, and Black women especially, giving birth is
Seeking safe, fair, and high quality maternal care should not be the person’s responsibility. However, learning how to advocate for yourself can be the first step to helping close this gap.
One of the most effective ways you can advocate for yourself during labor is to be well prepared. A birth plan can help you do just that by giving you the space to reflect and decide on your preferences ahead of time.
A birth plan is a written summary or outline of your preferences before, during, and after delivery. You can share this with your care team, including your obstetrician–gynecologist (ob-gyn), and go over the plan together before delivery.
Most hospitals have birth plan templates they can provide you with, but you can also create your own. It can be beneficial to keep multiple copies with you, including:
- a printed-out copy in your hospital bag for easy access
- a copy with your birthing partner
- a digital copy on your phone
However, it’s important to keep in mind that your birth plan serves as a guide. It may not be able to be followed exactly and may need to be adapted if your situation changes. Remember, the goal is for you and your baby to be safe and healthy.
When creating your birth plan, it can be helpful to consider the following:
During the first stages of labor
- Would you like to be able to move around freely during labor?
- Would you like to eat and drink without restriction?
- Would you like a warm shower or bath to help provide relief?
During delivery
- If you require any fluids or medication, would you prefer an intravenous (IV) line or a saline lock (a thin tube that is capped off and placed on your hand or arm)?
- Do you want someone in the room with you when you give birth?
- Would you like to use any birthing tools, such as a squat bar or a birthing chair, stool, or ball?
- Would you like to avoid anesthesia unless you specifically ask for it?
- Do you have any preferences for birthing positions you would like to try, such as on all fours, on your side, or on your back?
After delivery
- Would you like to wait to clamp the umbilical cord?
- Would you like your birthing partner or a healthcare professional to cut the umbilical cord?
- Would you like immediate skin-to-skin contact after giving birth?
- Would you like to nurse or bottle feed your baby, or use a combination?
- Would you like your baby to stay in the room with you at all times, only when you’re awake, or only when it’s time for feeding?
It’s OK if you’re unsure about any of these questions and haven’t reached a decision before labor. You can choose to be asked how you feel in the moment. You can also change your decision in the moment.
A birth partner is someone who can provide emotional and physical support to you during labor and advocate for you if needed. They can help voice your preferences if you are unable to, and ensure your birth plan is followed, where possible.
When choosing your birth partner, it can be beneficial to consider people who can help create a comforting, safe, positive, and reassuring environment for you during labor.
A birthing partner is often a:
- romantic partner
- close relative, such as your parent or sibling
- close and trusted friend
- professional birth doula
Some hospitals may allow for more than one birthing partner to be with you during labor. However, you should check their guidelines beforehand to avoid feeling disappointed or unprepared.
During labor, it can be easy to feel as though there is no time to ask a question or request a moment to pause and think. While it’s important for a medical team to act quickly, it is also important for you to be able to collaborate on your care decisions and give informed consent.
Using the labor and birth decision making tool, known as BRAIN, can help you feel empowered to make an informed choice and feel in control before, during, and after giving birth.
BRAIN is an acronym that encourages the following questions about a birthing decision:
- Benefits: What are the potential benefits of this intervention or procedure for me or my baby?
- Risks: Are there any potential risks to this intervention or procedure for me or my baby?
- Alternatives: What alternative options are available?
- Intuition: How do I feel about this choice? What is my gut telling me?
- Nothing: What happens if I do nothing or choose to wait?
This decision tool can help you fully understand your options and advocate for yourself when giving birth. It may also help you avoid feeling pressured into accepting a medical decision you are unsure about.
You are allowed to say no
Remember, you always have the right to say no to any medical interventions during labor, even if it is recommended by your care team. This includes vaginal examinations or the medical induction of labor (where medication is used to artificially start labor).
If you feel dismissed or ignored before, during, or after giving birth, it can be helpful to clearly voice your concerns and share your needs with your care team.
The following phrases may help you advocate for yourself:
- “I understand that you are busy, but I have concerns that are important to me that I would like to speak about as soon as possible.”
- “I do not feel heard. I do not want to continue until you have addressed my concerns and answered my questions.”
- “I am no longer comfortable with this [intervention or examination], and I would like to stop immediately.”
- “I consent to my birth partner making this decision on my behalf. I would like you to listen to what they say.”
Another option is to ask to speak with a more senior member of staff or another healthcare professional, who can revisit your concerns and offer a second opinion.
You also have the right to file an official complaint with the hospital. Further information on this can typically be found on the hospital’s website, where you can search for their grievance policies.
Advocating for yourself during childbirth can feel challenging. One of the most effective ways you can advocate for yourself during labor is to be well prepared.
Taking the time to decide on your preferences and learn how to make informed decisions can help ensure you feel safe and in control in the delivery room.