advocating in the birth space
Advocacy has been a hot topic in the birth world - as it should be. But what does advocating actually mean and how do you advocate for yourself or a loved one? Very simply put, advocating is supporting or defending a cause. In this case, the cause is a birthing person’s rights and personal preferences.
It can be challenging to defend your preferences to someone like a doctor who many see as an authority figure. And while OBGYNs are to an extent an authority on medicalized birth, they do not have authority over your body.
We make our best decisions when we feel safe and it’s hard to feel safe when you are being coerced or pressured. So here are a few tips to help you and your partner advocate for your wishes in the birth space.
Start with prenatal preparation. Do your research during or even before pregnancy so you are familiar with your options and have plenty of time to ask questions. Your provider’s opinion is not law. If you are unsatisfied with what your provider tells you, seek out a second (and maybe third!) opinion. Write out a birth plan/preferences and include your birth values. Discuss your preferences in detail at a prenatal visit with your provider, ask them to save a copy in your file, and bring multiple hard copies to your birth.
Practice helpful phrases and setting boundaries. The best way for something to feel natural is to practice. Role play difficult scenarios with your partner and/or doula before birth to get accustomed to asserting yourself and your wishes. Start using phrases like “my doctor recommends I do XYZ” instead of “my doctor says I have to do XYZ.” Keep affirmations handy like “The hospital’s rules don’t apply to me” and “I know what’s best for my body.” Practicing always feels uncomfortable at first, but you’ll get the hang of it!
Keep and redirect power. Hospitals have a hierarchy but luckily you stand apart from that! Ask for your providers’ first names and use them. For partners especially, adapt a power pose when speaking to providers. Get on the same level as your provider during discussions by either standing up to speak or inviting them to sit down. If you have a doula with you, introduce your doula to the providers and welcome the providers to talk freely to your doula. It is very common for hospital staff to refer to all birthing folks as “mama.” Redirect them with the birthing person’s name (ex. “Jamie, is it alright if Nurse Taylor takes your blood pressure now?).
Gratitude before confrontation. Before entering into a confrontation with a provider, first pause and ground yourself by taking two deep breaths. Begin in gratitude and appreciation. If there is a problem, state it in a neutral way with no adjectives. Finally, make an invitation for them to do things differently. For example, “Nurse Taylor, thank you for supporting us today, we appreciate your care. We noticed that when you walk in, your voice is louder than ours. Would you be willing to lower your volume?”
Fire your provider. If you find that you are unaligned with your OBGYN, midwife, or nurse, you can fire them. If you would like a different nurse, ask to speak with the charge nurse and request someone new who has experience supporting the type of birth you desire. You can similarly ask for a new OBGYN or midwife (in a hospital setting). If no other provider is available, let them know, “We will be alone until we need you. Then we will call you.” The provider also doesn’t need to catch your baby. You or your partner are perfectly capable of catching your baby.
If you are still struggling, keep these power words in your back pocket and when you use them, do so with confidence.
“No” or “I heard them say no”
“Stop” or “I heard them say stop”
“I do not consent” or “My partner has not consented to this”
“Please document my refusal” or “Please document my partner’s refusal”
It is worth considering the addition of a doula to your birth team if you anticipate wanting or needing an extra voice in the birth space. If you would like to learn more about how a doula can support you, please reach out!
