I worked in a law firm for 18 years before I gave it all up to become a doula and a yoga teacher. Yes, I’m way happier than I have ever been. That said I know a bit about advocating for yourself and getting what you want.
You can usually get what you want, but it may take some work and some practice to get there. Odds are you will most likely be negotiating with your Doctor or Midwife before the birth and with the nurses and maybe other doctors and Midwifes you haven’t met during your hospital birth. If you have a home birth, the need to negotiate will lessen considerably, which may be an alternative for you. But I regress. Let’s start with negotiating with the Doctor or Midwife for the birth you want. Now this is assuming that you have a normal healthy pregnancy. Even if you do have some issues with your pregnancy you can negotiate aspects of your birth and the care of your newborn baby after birth.
No. 1 (and probably the most important one) – You get more flies with honey than with vinegar.
First things first. You catch more flies with honey than vinegar. It may be a cliché but it’s true. Try to really work with your birth team (Doctor, Midwife and nurses). Use phrases like, “can we try?” or “do you think we could work on this together?” or even “I understand, but this is what I really want. How can we make it happen?” I’m sure you can add additional phrases as well. Bottom line, if you want something specific during labor, birth and the care of your baby, you may need to do some fast talking at some hospitals. Don’t be confrontational. It won’t help. Remember “honey” is better.
No. 2 Talk to your family about what you want for your birth and care of your baby. Put it in writing.
Make time to really talk to your partner and family about your wishes for your labor, birth and the care of your newborn baby. Make a birth plan. In your birth plan make sure you make a list of questions you want to ask the Doctor or Midwife. Take your birth plan with you when you go to your appointment. Have them written down on a piece of paper, so much easier than trying to read them on your phone, I promise. Bring a pen with you so you can write down his or her responses.
Some Doctors or Midwifes tend to not spend a lot of time with their patients. That means that right after they ask you how your doing, start asking questions. Be persistent. Don’t let the Doctor or Midwife leave without answering all your questions. If the answer is “no” or some other kind of negative answer like “I don’t know,” leave it for now and go home and do your research. The internet is a great place to start. If you have a doula ask them to help you.
No. 3 Discuss with your care provider regarding what you want for your birth.
Don’t take the first “no.”
Ask your care provider if they will work with you to get what you want. For example you want to be able to give birth on your hands and knees instead of your back. The Doctor says, “well, I don’t usually do that. I like to have my patient on their back.” You can ask why and try and get an answer. If it’s the same answer, try saying something like “do you mind if I try? I heard that it may be easier to give birth with less tearing in that position.” If the answer is still “No” do some research and bring the research with you next time you go back to the Doctor and reopen the discussion.
Make sure all your requests for your birth are on your birth plan. When you get a yes on a certain item that you want, make sure the Doctor or Midwife signs it off on your birth plan and adds your approved request to your chart. Their signature may be the ticket at the hospital to get what you want at your birth. And don’t forget to bring your birth plan with the signatures with you to the hospital. You may have to revisit all this and more when you get to the hospital.
No. 4 Bring a Doula!
An experienced doula has usually seen other families successfully negotiate in the hospital environment. She probably knows what's possible and may have some techniques for helping you "get to yes." She may also know the hospital policies so you know exactly what your up against. She can also help you with your family. Yes I’ve seen and heard about families getting into arguments while you give birth because of family issues. A doula is in your corner. She knows about “honey” and can be a vital part of your birth team.
For example, hospitals can require 30-40 minutes of continuous monitoring when a woman first arrives, with intermittent monitoring as an option after that time. The mom is usually asked to lay on her side in the bed for this monitoring, which can be hard for most women to do when they are in active labor. Sometimes the nurse will stay and hold the monitor device on her belly, so that she can still move with her contractions without losing the baby's heart tones on the monitor. But not always.
The Doula may have an idea on how to solve this problem. For example, she may ask the nurse if someone else like the partner may hold the device on her belly. The nurse agreed. She was able to get out of bed and still get the monitoring she needed. The partner was happy to help.
No. 5 Getting what you want at the hospital. Make the nurse your best friend and ally.
So far we have visited what to do at your car providers office and barely scratched the surface of what can happen at the hospital when you get there. Being your own advocate at the hospital is important. You’ve practiced with your doctor and now all this becomes real. You can do this. Remember “honey” is better.
Let’s say that your Doctors practice includes 5 other doctors. Depending on who’s on call at the time of your delivery, that’s the Doctor you get. Sometimes it turns out well. Other times the Doctor you don’t like for some reason is there to deliver you. You are dreading your birth. Now is the time to depend on your partner and your Doula (if you have one, if not get one today) to help you have the birth you want. Your partner is very important here. Make sure they don’t mind advocating for you and your newborn. This is essential so really talk about this. If your partner gives you a look like, "I don’t know" or is squeamish when there is blood, or when you are in pain, you definitely need a Doula.
The other person you need on your side is the nurse. Yes the nurse. She may be able to pull some strings for you, so you need her in your corner. She may be your best advocate. They know your doctor. They know what he or she likes and whether or not they will let you birth on your hands and knees.
Ask the nurse when you get there that is assigned to you about your doctor or midwife. (Just a side note. Midwives are way more likely to let you birth however you want. So you may want to look into having a Midwife if that’s important to you). Ask them about the likelihood of being able to birth in a different position besides your back. Ask them all the questions on your birth plan. See if she can help you have the birth you want. Your doula can definitely help here too. Use phrases like “how can we get the birth we would like to have?” “Would you be willing to help us out?” “It’s very important to us.” These phrases can be used for a lot of situations besides being able to birth in a position that you are comfortable in. It can be used to get what you want regarding care of your newborn, or being able to have skin to skin after a cesarean for example.
6. Bottom line, it’s your body, your birth and your baby!
Here’s some extra tips for you to consider during labor and birth at a hospital
If you don’t think your nurse will help advocate for you and your family, request a different nurse. It can be a little dicey sometimes, but if you feel strongly about it, don’t hesitate.
Get out of bed. You may think that your labor will progress just fine if you are lying in bed. It doesn’t usually work like that. Your labor will progress quicker if you get up and move around.
Ask how much you really need to be monitored. They may have portable monitors which will allow you to get out of bed and work on getting your baby into your arms quicker.
Make your hospital room your own. Turn down the lights, bring music, adjust the temperature, close the curtains, bring the electric candles and the essential oils. If you need a heating pad or ice pack, ask for one. (You may want to bring a heating pad with you. Some hospitals don’t have one.)
Ask questions about any procedures and then ask for time to think it over, then you can give them your decision. Obviously if it’s lifesaving, they will let you know. Other than that use your advocacy skills you have practiced.
You can do this. It takes a little bit of work, but you can learn how to be your best advocate for you and your newborn. Remember “you catch more flies with honey than vinegar.”
If you have additional questions or need to talk to me about being an advocate for yourself and your family, please don't hesitate to contact me.
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