Giving birth within the medical system has challenges. On the one hand, you may desire the safety and reassurance of birthing at the hospital. On the other, you believe birth is a natural process and don’t want to be coerced into unnecessary medical intervention. You may not want to birth in a hospital at all but were unable to find or afford a midwife, depending on where you live.
Regardless of why you are planning to give birth in the hospital, it will be important to advocate for yourself. Hospital policies and routines, may not align with your personal preferences and it might become necessary to speak up.
The first thing you can do to avoid the discomfort of saying no to your doctor is to choose a doctor whose ideas closely align with your own. On your first visit, ask questions that will help you determine whether or not your doctor is a good fit. If you have strong feelings about certain aspects of birth you need to know what your doctor thinks about those things. If your doctor doesn’t hold the same beliefs about birth as you do, or your intuition tells you that this care provider is not the best fit, find another doctor. Finding another pregnancy care provider may involve asking your family doctor for a different referral, or doing a little digging among friends who have had a positive experience with their care provider. You may even want to ask for recommendations on a local pregnancy forum. Even in places (like Canada) where choice of care provider is not often discussed, you still have a right to choose.
You can also ask questions about the hospital you will be delivering at. What is the hospital’s policies surrounding birth, infant care, and postpartum care? You may want to know the hospital’s cesarean section rate, if they require you to have an IV, and whether or not you will be welcome to eat and drink during labor. Your doctor or doula should be able to answer your questions about the hospital’s policies.
If the idea of saying no to a doctor makes you feel a little queasy, you’re not alone. Going against medical advice can feel oddly defiant in a society where doctors are authority figures. Instead of flat out saying no, there are ways you can say no to your doctor, without saying no.
“Can we have a few (5, 10, 15) minutes to discuss this privately?”
Depending on the urgency of the situation, you can request time to talk privately with your birth support people. Your partner, doula, and anyone else you have invited for support can help you weigh the pros and cons of any decision to be made. If you already know that you want to say no, use the time to find the right words to express your preferences.
If you’re unsure what you want, you can also use this time to put together questions for your doctor or the nursing staff. Have your partner or doula jot down all the questions you have so that you can gather more information to make a decision.
“What happens if we wait?”
A watch and wait approach can be an effective way to say no without actually saying no. This is especially useful if you aren’t sure you’d still say no under different circumstances. If the question arises again, you can ask for time to discuss and put together questions as mentioned above or even ask about waiting again.
“Can we try (insert alternative) instead?”
If there is something you know of that might have the same effect and that you would prefer, ask about it. If you don’t know of an alternative but would like one, don’t be afraid to ask your doctor, nurse, or doula for suggestions.
Combining the above phrases can be the difference between going along with an intervention you do not want and having the birth that you choose.
Sometimes an intervention is necessary, and by asking all of your questions you may decide that you no longer want to say no. That’s okay, too. You have to do what is best for you, your baby, and your birth experience.
Remember, no one gets to choose for you. You have a right to consent. You are in control. You decide what is best for you and your baby. No one gets to LET you do anything. You know your body best, and you should always let your intuition be your guide.
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Questions & Exercises
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