Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood
You have a lot of rights. Essentially, you have the last word on every facet of your care, and you don’t have to do anything your care provider suggests if you feel it’s the wrong call. But that’s where the water gets murky. Although you should be the key decision-maker during your pregnancy, childbirth, and postpartum experience, the people around you — specifically, your medical care provider — often hold ample sway in how things unfold. Intentionally or unintentionally, these people may manipulate your decisions based on legal or timing considerations, a hospital’s (possibly outdated) culture, or their personal biases. Fortunately, there are ways to get around this — the first being to know your rights. These include the following . . .
The Birthing Mother’s Bill of Rights
- The right to receive thorough information about any intervention being recommended: You have a right to ask your care providers questions until you’re satisfied with the answers and feel you have enough information to make an informed decision. They should explain — in easily understandable terms — the risks and benefits of anything they’re recommending. You can also ask what information is evidence-based and what is just coming from their personal experience. And you can ask about the cost of everything, down to the stool sampler they’re offering you in that little white cup.
- The right to request options: If you’re unsatisfied with a proposed course of action, you can ask for other options.
- The right to turn down interventions: After receiving all the information, you may feel that an intervention is unnecessary. If this happens, it’s your right to turn it down. While you might not be a medical expert, you are an expert on what feels intuitively right for your body and baby. If everything in your being is screaming “No!” you get to listen.
And just because you (likely) signed a consent for care form when you were admitted doesn’t mean the care providers don’t have to obtain your permission before moving forward with any procedure.
The following are procedures that my clients are usually surprised are not obligatory:
Vaginal exams: While it can be nice to know how dilated you are, it’s not an essential part of childbirth. So you don’t have to let anyone perform a vaginal exam if they make you uncomfortable.
Heparin lock: Many hospitals strongly encourage women to accept a heparin lock — a catheter that is placed in a vein with a drop of heparin to prevent blood clotting and is then locked off — so they have an open vein should they need to hook you up to an IV. But you don’t have to agree to it.
- The right to ask for a second opinion and/or change care providers: If you feel your care provider isn’t providing all the information or is leading you in a direction you feel uncomfortable with, ask to see another care provider. While the current care provider might push back, you’re doing nothing wrong by making this request.
- The right to move around. If you want monitors, tubes, IVs, and so on removed so you can freely move around during labor, you can ask hospital staff to remove them. Your care provider might recommend staying connected to certain apparatuses because of medical needs, but they can’t force you to do so. You also have the right to get into the position of your choice when delivering your baby.
- The right to privacy: No one gets to decide who is in your birthing space but you. If you want someone to leave the space, they have to comply, even if they work there. I once was a doula for a mother who felt unsafe around her OBGYN. When the baby was being delivered, she demanded that he leave and send in the on-call midwife. He was beside himself but had to do what she said.
- The right to know who is in your birthing space. You have the right to know the identity and qualifications of any person in your birthing space.
- The right to check out of the hospital. I’ve worked with many women who didn’t know they could check themselves out of the hospital “against medical advice.” If you don’t feel like you’re being treated well, you can leave the hospital and check into a new one. The hospital won’t make this easy, but what you’re doing isn’t illegal.
- The right to receive records. You have the right to request copies of your medical records at any time, and to receive a comprehensive explanation of the contents.
- The right to speak with hospital administration. If you feel your rights are being violated, you can ask to speak with a supervisor.
- The right to be treated like the empowered, intelligent woman that you are. No one has a right to talk down to you, or make you feel like you’re not equipped to make well-informed decisions about your body and baby. If someone treats you without respect, you can turn around and demand it.
Note: Demanding your rights in some of these situations may require you to go against your care provider’s recommendations. If the doctor feels strongly enough about a recommendation, you may be required to sign a document confirming your choice to refuse care.
What to do
In addition to understanding your rights, there are numerous ways to ensure that you have care providers who not only honor your rights but encourage you to stand up for those rights. And if you end up being cared for by individuals who don’t respect your rights, despite your valiant efforts (it happens to the best of us!), here are some tools for those situations:
- Find a care provider who believes in “patient autonomy.” See “Essential Tips for the Journey” on page xx for more information.
- Create a thoughtful list of birth preferences. I love me some birth preferences. Not only are they a golden opportunity to pour positive intention into your birth experience, but they also allow you to clearly state how you expect to be treated. While all care providers should be well informed of your rights, your birth preferences serve as a clear reminder of what those rights are, and which ones are of particular importance to you.
- Hire a doula. While most doulas won’t be your voice during birth, they can be the Birthing Angel on your shoulder, letting you know if someone is not honoring your rights. They can also provide ideas for how you and your birth companion can advocate for those rights.
- Take two childbirth preparation classes. If you’re planning on giving birth in a hospital, I recommend taking both the childbirth prep class offered by the hospital and a class not affiliated with the hospital. I encourage you to take the hospital class first to gain insight into the hospital’s birth culture and what rights you might have to advocate for. This class is largely for recon, and I suggest keeping a running list of questions and concerns about information shared there.
Then, take this list to a childbirth preparation class that’s aligned with your personal birthing philosophy — for example, HypnoBirthing or Lamaze — and share it with the instructor. The instructor can likely help you determine whether there are any red flags that suggest you should find a new hospital, or provide guidance on how to navigate aspects of the hospital’s birthing culture that might go against your own. Both classes will likely help you become more informed and equipped to have an empowered birth experience.
• Be clear when refusing treatment. If you ever need to go against your care provider’s recommendation, make it explicitly clear that you’re doing so. You might even need to request they provide verbal confirmation that they understand your decision.
Research the laws in your area. Because each state has their own laws when it comes to childbirth, it’s wise to email the American College of Obstetricians and Gynecologists Resource Center at resources@acog .org and ask for guidance finding the most up-to-date regulations for your state.
Fortify your courage. Advocating for your rights can be difficult, especially in the face of a strong-willed care provider adamant that you follow their lead. But you are so much stronger than you realize, and pushing yourself to call on that innate power during one of the most important experiences of your life will likely transform the experience. Listen to this guided meditation to tap into your inner power source: yourserenelife.wordpress.com/birthing-rights/.