Labor isn’t an exam to ace. It’s an experience to embrace. As monitors beep and questions arise, even a well-prepared parent can feel overwhelmed. Many midwives, who have witnessed countless births, will tell you that your voice is a vital asset in this crucial moment. Advocacy isn’t about debating with your medical team. It’s about ensuring clarity, obtaining consent, and establishing a partnership that allows you to welcome your baby in a way that feels right for you.
Currently, many hospitals are experiencing high demand. Procedures can shift unexpectedly. You might find yourself with different nurses, residents, or anesthesiology teams. This is where a few simple habits can serve you well. In this guide, you’ll discover strategies to utilize before contractions ramp up, how to pause hurried decisions, and phrases to use when you want more options. You’ll also find a brief list of instances when it’s wise to call for additional support. Perfection isn’t necessary; having a plan you can rely on during labor is what matters most.
Key Insights
Your Voice Matters
You hold the power to decide about your body and your baby’s care. While your partner, doula, or support person can advocate on your behalf, the conversation starts with you. The American College of Obstetricians and Gynecologists emphasizes that informed consent is an ongoing discussion focused on your values and preferences throughout labor.
Collaboration is Key
Your care team, which might include midwives, nurses, doulas, and physicians, all share a common goal: ensuring safety for both parent and baby. Clear communication aids your team in supporting you effectively. Concise requests are most effective during contractions.
It’s Okay to Ask for a Pause
Unless there’s an immediate emergency, you have the right to ask for a moment to breathe, pose a question, or consult a support person. Most decisions can benefit from a brief pause.
“Taking a moment to breathe is both a clinical and consent tool.”
Display Your Preferences Clearly
Prepare a one-page document in large font. Post it on the door or whiteboard where it’s easily seen.
Here’s a sample of birth preferences:
– I want a tranquil room with soft voices.
– I’d like to try changing positions, using water, and utilizing the peanut ball before considering interventions.
– Regularly offer pain relief options. I will signal if I want an epidural.
– I prefer intermittent monitoring when it’s appropriate.
– If a C-section is necessary, I’d like clear draping, the option for photos, immediate skin-to-skin contact, and support for early breastfeeding.
Your Advocacy Action Plan
1) The BRAIN Framework
When a suggestion is made, pass it through the BRAIN framework aloud or have your partner read it.
– Benefits: What are the benefits for me and my baby right now?
– Risks: What could be the risks or side effects?
– Alternatives: Are there other options that achieve the same goal?
– Intuition: What is my gut feeling about this?
– Now/Later: What happens if we take 10 or 30 minutes to decide?
The NICE guidance on intrapartum care emphasizes the importance of communication and the ability to make informed choices regarding monitoring, mobility, positions, and pain management during labor.
Sample script: “Can you explain the benefits, risks, alternatives, and can we wait a moment before we decide?”
2) Seek Clarity
Clarification reduces anxiety. Details empower you to make informed choices.
Script: “What is the purpose of this intervention, and how will we know it has succeeded?”
3) Use Micro-Pauses
Creating small moments of calm can help you formulate a response.
Script: “I understand. I need a moment with my partner.”
4) Clearly State Your Needs
You don’t need permission to change positions, dim the lights, or request silence.
Script examples: “I need the room to be quiet for the next few contractions.” “I need assistance rolling onto my side with the peanut ball.” “Please offer me water between checks.”
5) Establish Boundaries with a Plan
Staff are more likely to honor your boundaries when paired with actionable next steps.
Script: “Vaginal exams can be intense for me. I prefer fewer checks. Can we evaluate my progress based on my coping level, the baby’s heart rate, and my urge to push?”
6) Keep Consent Active
Consent is an ongoing dialogue. You have every right to revisit it.
Script: “I’m still comfortable with this plan. If anything shifts, please check in before proceeding.”
7) Involve Your Nurse Early
Nurses are your mainstay. They can help communicate your preferences to the entire team.
Script for admission: “Here are my top three goals. Can you put them on the board and help me ensure they are respected?”
Top three examples:
– Mobility and position changes whenever possible
– Consistent updates every half hour
– Only quiet encouragement with minimal small talk
Adaptations for Unexpected Situations
If Labor Stalls
Change your body’s narrative: consider taking a shower, slow dancing, or adopting a hands-and-knees position.
Inquire about options for movement-friendly monitoring or wireless devices.
Invite privacy. Fewer observers can enhance your oxytocin levels.
Script: “I’d like 20 minutes of quiet darkness to see if my contractions resume.”
If You Seek Pain Relief
Every choice is valid. Relief might come through medications, water, counterpressure, or even rest.
Script: “Please go over the pain relief options, including their timing and side effects, to help me identify what suits my current labor.”
If Induction or Augmentation is Suggested
Utilize BRAIN. Ask your team what they observe on the monitor and during exams.
Clarify the steps involved: cervical ripening, Pitocin, artificial rupture of membranes, and the evaluation of each.
Script: “What is the least invasive next step that still accomplishes our goal?”
If Informed You Are “Not Progressing”
Understand how your unit defines progress. Evaluate position changes, hydration, and rest.
Request a test period: try a plan for a specified duration, then reassess.
Script: “Can we attempt positions and hydration for 60 minutes, then evaluate our situation together?”
If C-Section is Recommended
Ask for clear explanations in simple terms regarding the urgency of the procedure.
Specify what matters to you: clear draping, music, having your partner present, immediate skin-to-skin if safe, support for early breastfeeding, and context as procedures occur.
Script: “Please walk me through what you’re doing, and help me stay connected to my baby.”
If the Room Feels Crowded
You have the right to manage your environment.
Script: “I need fewer people in the room. Who is vital to have here right now?”
“Consent is more than a signature. It’s a conversation that evolves as labor progresses.”
Support Roles that Amplify Your Voice
Partner or Support Person
Be the voice that echoes your desires. Hold the BRAIN card and pose the next questions.
Protect the atmosphere: keep the lights dim, maintain a cold water supply, and orchestrate the playlist.
Remind the birthing parent of their strengths: “You are doing an incredible job. Your breath is powerful.”
Doula
Doulas complement clinical staff. They provide continuous support, comfort measures, and guidance in advocacy, allowing you to focus within.
Your Midwife or OB
Request bedside updates at regular intervals. Scheduled check-ins can alleviate uncertainty.
If you feel dismissed, speak up.
Script: “I feel rushed. I need to understand the reasoning behind this decision.”
When to Seek Professional Help Quickly
Advocacy includes recognizing when to escalate concerns. If you experience sudden heavy bleeding, severe headaches with vision changes, chest pain, difficulty breathing, fever with chills, or an emergency is announced by your care team, follow their instructions and ask one person to stay at your side to narrate the next steps. After a rapid decision, you can always ask for a debrief to uncover what happened and why.
After Labor
The advocacy skills you cultivated during labor will carry over into the hours following birth.
Request uninterrupted skin-to-skin contact if both you and your baby are stable.
Seek assistance with the first breastfeeding latch if that’s your plan.
Clarify newborn procedures in advance. Whenever possible, you can ask for each step to be performed at your bedside.
If you had a C-section, ask about gentle recovery methods like timed pain management, early mobility assistance, and advice on lifting limitations at home.
Script: “Please explain the newborn checks prior to starting, and let us know what is optional today.”
Labor isn’t predictable, but your strength and influence are steadfast. Armed with a few grounding phrases, a visible preferences document, and a team that aligns with your goals, you can navigate the birth process with more calm and greater choice. Your voice is essential in this space.
