Advocating for yourself during your labor and delivery can be difficult! One of the main reasons that families choose to hire doulas is to ensure that there will be someone in the delivery room who will help the family advocate for themselves. Of course, doulas do advocate for their clients and their wishes, however, doulas are only present for labor and delivery. Doulas do not attend prenatal appointments with OBs or midwives. Self-advocacy should be occurring throughout the pregnancy- if you are advocating for your wishes for the first time in the delivery room, there is a major problem. I was recently discussing self-advocacy with a soon-to-be mom, and she told me that she wanted to be able to effectively advocate for herself and her wishes, but that she was worried about sounding like a “Karen”. Other moms have expressed that they don’t feel comfortable asking questions to their providers because they don’t want to come across as “impertinent” or “difficult”. It is okay to be impertinent and difficult when you are giving birth. Your needs and wishes for your birth matter and should be respected by everyone in the delivery room. However, that doesn’t mean that sticking up for yourself is easy. In this blog post, I will be sharing a few tips that can help you build confidence in your self-advocacy skills.
Tip #1: Don’t Be Afraid to Ask Questions
One of the most common complaints I hear from moms about their care providers is that providers aren’t willing to answer their questions. The average OB visit is 10-15 minutes, meaning that there is hardly time for an in-depth conversation. If your provider expresses a disinterest in answering your questions, run for the hills. A good provider will be willing to take the time to answer your questions thoroughly, no matter how many questions you have. In fact, I recommend writing out a list of questions and bringing it along with you to your prenatal appointment to ensure that you remember to ask every question that you have. Remember that your doctor works for you, not the other way around. If you come out of your provider’s office feeling dismissed, this is a major red flag. If your provider is unwilling to prioritize your needs during a prenatal appointment, what is the likelihood that they will prioritize your needs during labor and delivery? Ask questions, and if you don’t receive answers, or don’t like the answers you do receive, it’s time to consider finding a new provider.
Tip #2: Be Clear About Your “No’s”
I know a lot of women who have a hard time saying “no”. Saying no to a medical professional can be particularly difficult because of the skewed power dynamics between provider and patient, especially when you are in a vulnerable position (such as being in labor!). Remember that you are allowed to decline anything, at any time, without needing to justify your actions. More often than not, when a woman declines something, she follows it up with an explanation or justification. Here’s an example: “No, I don’t think I want to have an epidural because I don’t like needles and the thought of having a giant needle inserted into my spine isn’t really appealing to me! I’ve also heard that sometimes the epidurals don’t work anyways. My cousin had an epidural, and she was really itchy for hours, so I don’t think that’s something I want to do”. A better way to communicate this is saying, “No, I am not interested in an epidural and do not wish to be offered one unless I explicitly ask.” Why should you phrase your wishes this way? When you are up-front about your boundaries, you effectively close the door to any discussion about procedures and interventions that you may not be interested in. Every woman should enter her provider’s office with a birth plan that clearly highlights her boundaries. Make sure that every person on your birth team is aware of your hard “no’s” and stick to your guns. It is a lot easier to advocate for yourself when you are up-front about your needs and boundaries.
Tip #3: Become Familiar with the B.R.A.I.N Method
The B.R.A.I.N method can be useful not only during labor and delivery, but during prenatal visits as well. Any time that your provider recommends a procedure or an intervention, I recommend busting out your notes on the B.R.A.I.N Method and asking some questions before making a decision.
Once again, I will use the epidural as an example, and we will use the B.R.A.I.N. method to ask important questions.
B- Benefits: What are the benefits of receiving an epidural?
R-Risks: What are the risks of receiving an epidural?
A-Alternatives: What are the alternatives to receiving an epidural?
I-Intuition: What does my intuition tell me about receiving an epidural?
N-Nothing: What will happen if I choose to do nothing instead, and do not receive an epidural?
One of the most effective ways that you can advocate for yourself during labor and delivery is to ask for a few minutes to consider your decision. For example, if your doctor recommends an epidural, you can say “Thank you for the recommendation. I am going to take a few moments with my birth team to discuss this decision”. Do not allow yourself to be rushed into making any decision you are not sure about! The B.R.A.I.N method is a quick and effective way to gather all of the information you need to make an informed decision.
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