Two years ago, I got the chance to interview my Aunt Dora on her birth stories. As a women’s studies major, she knew a lot about pregnancy, birth and postpartum and used her knowledge as guidance to have the birth that she wanted. She was lucky to have a grasp on the many different options that are possible with delivery, as well as the ability to decide how she wanted to approach each birth. Amidst all the details, she mentioned one thing that stuck out to me more than anything else:
“I made a list ahead of time…I made a list of my priorities and on that list I told them, ‘do not give me drugs, like don’t even offer them.’ I didn’t want mention of them. I wanted lowlights…I set the scene for what I wanted, so that they would know ahead of time how I wanted things and they would respect that, and they did...it was my first time being in labor and giving birth and I knew myself well enough—I was able to give it some forethought, and…that was a smart thing to do” (Lewis, Oct. 24, 2020).
A list, involving lowlights, no medications, and respect. For two years, her story has made me wonder why soon-to-be-moms rarely make a list of what they want or don’t want during labor and delivery. Flash forward to a few weeks ago; I’m listening to the first episode of our podcast, Ahma Need a Minute, and am reminded of the story as Shaniece, the guest, talks about her birth experience. She explains that her first birth was traumatic, and that what she received was not what she needed at that time, spotlighting the reality that birth is often just about the baby, when it should also be about the mother. Some, like my Aunt Dora, knew the reality and made their “list” to ensure that the birth would be about them as well. In many cases, however, moms are so concerned for their little one that they often forget to advocate for themselves.
When it comes to labor and delivery, professionals such as doctors, nurses, doulas, and midwives have expertise and insights that are crucial. However, at what point do their suggestions come at the cost of the mother’s autonomy? Mothers should be able to recollect their birth experience not just as something they appreciate because their baby was born, but also because they were sure that the birth experience accounted for their safety and wellbeing. Though it’s true that things can change quickly during delivery and that you may have to make tough, on-the-spot choices for you and the baby that weren’t in the original plan, it’s important for you to know how to advocate for yourself through birth and postpartum to ensure that you and your caregiver are on the same page.
Advocating for yourself takes time and patience, but it’s especially important and necessary for monumental, life-changing, health-affecting experiences like giving birth. Remember, giving birth is about you too, and as with anything else, it’ll be important for you to establish the foundations for you to be your best advocate prior to labor.
1. Know Your Options. During pregnancy, all those “guide to a healthy pregnancy” books will come in handy–but don’t forget to pick up the ones on labor, and especially those that outline all of your birthing options. It goes deeper than vaginal vs. cesarean; from monitoring to epidurals, inducing medications, episiotomies, and comfort measures, there are many elements that could influence your birthing experience. It’s OK to not know everything; rather, the goal is for you to have a general understanding of what you want prior to labor so that you can make an informed decision when the time comes. You’ll also be able to handle the uncertainties surrounding labor with more confidence. Things happen and oftentimes they are out of your control, but if you are knowledgeable about what might come your way, it can help you feel more ready and less overwhelmed with the twists and turns.
2. Create a Birth Plan. Based on your learnings, start crafting your birth plan: a written plan that outlines what you would like to happen during labor and delivery. By creating a birth plan, you can get a better understanding of what’s important to you, and also share your preferences with your care team and anyone else who will be with you during labor so that your experience can be the best it can be. Consider key questions like:
Also, create a list of everything that would make you feel most comfortable (and most uncomfortable) during labor. Do you want music, and if yes, what kind (for example: do you want your “Relax & Chill” playlist, or your “Productivity & Workout” playlist? Maybe you’d like to create a whole new one)? Would having a diffuser with your favorite scent help soothe you? The options are endless, but whatever you decide, planning and communicating your needs in advance and helping yourself envision and prepare a comfortable atmosphere will not only aid in the process of giving birth by making your priorities clear, but also make the experience as pleasant as possible for you.
3. Be Direct. This is your body, your baby, and your birth, and it’s totally OK for you to be direct with your care providers on what you want. No matter how scary that may seem, it will be necessary as beating around the bush doesn’t always succeed – and it is possible to be respectful and direct! Communicating your priorities clearly and in advance will help make the job easier for your care team, and also allow them to inform you and help plan for an alternative if they foresee any issues.
4. Ask Questions. Your care providers are professionals who are committed to your wellbeing – and you should lean on them as a resource! It’s OK to not have all the answers when you go into your appointments. If you’ve crafted your birth plan but you’re still unsure of something (like whether or not to get an epidural) and need to chat with your care provider, you’re still a good advocate for yourself – you’re actually being your best advocate because you’re acknowledging the limits of your knowledge and seeking an expert’s opinion. Some women may feel strongly about some aspects of their care, and that’s amazing! But if you don’t, and still want to learn more and practice shared decision making, that’s good too.
Asking questions can also be beneficial in labor. In moments when things are moving fast and you’re unsure of what’s going on, speaking up for yourself can be intimidating; but asking questions is a great and respectful way to understand what’s happening and stay informed of everything happening to your body. Beyond asking “what is going on?,” you can ask questions like:
5. Appoint a Support Person. Of course, being clear and direct and asking all the right questions might be easier said than done, especially when you’re in the thick of it; this is why we recommend that you appoint a support person to accompany you along your journey, from pregnancy to beyond. The pains, stress, and emotions of pregnancy and labor may hinder your ability to be direct or recall what you prepared for in the weeks leading up to this moment. This person (whether a partner, family member, doula, or friend), should help establish your priorities throughout pregnancy, be familiar with your birth plan, be able to talk cooperatively with medical staff, and advocate for you if you are unable to. And if there needs to be changes to your birth plan for any reason, your support person will be able to comfort and assure you that everything will be okay.
6. Listen to Your Body. Due to the nature of the birthing experience, it’s quite possible that things will quickly change, even with thorough planning, communicating, and practicing. Luckily, the female body was made for this, so alongside all of the knowledge you have obtained leading up to this moment, tune into the signals that your body is sending you. Voice your concerns to the care team if you feel that something is remiss, and leverage your support person if you feel that your concern isn’t being heard.
When it comes to ensuring maternal health, the postpartum period is often overlooked, when in fact this “fourth trimester” can affect your mind and body the most; so when people come knocking, it will be helpful for you to understand how to assess your limits and communicate them.
1. Research the Hospital’s Resources in Advance and Leverage Them. If you’re like the vast majority of women giving birth in a hospital, your first postpartum moments will also be in the hospital. As you recover, receive care, and prepare to return home over the next day or two, think about what would make you the most comfortable and how you can best leverage your hospital’s resources. Some components to consider are:
Care options vary by hospital, but having an understanding of all of programs your hospital offers postpartum and leveraging them can be immensely helpful when it comes to having an extra set of hands in those first few days, learning how your body works, and ensuring that you and your baby are healthy and ready for this next step in life. Don’t be afraid to ask for what you need. This is your time to take advantage of the knowledge and care that professionals can offer in the first crucial days.
2. Set Boundaries. Forty weeks and who knows how many hours later, you’ve finally given birth, and settled at home. Here’s a friendly reminder: there is no need to attend every event or allow everyone to visit. Mentally and physically, you’ll need to conserve as much energy as possible so that you can focus on your recovery and bond with your newborn. There will be time later, so don’t feel obligated to leave the house just yet or say yes to every visitor – at this moment, do what is best for you and your family. Leverage your support person to be your "agent," to manage external communications and help alleviate stress.
3. Ask for Help. Caring for a newborn, especially as you’re still healing, is no joke, and sometimes all you need is a little help. Despite what you may see on social media, no one goes through motherhood alone like it’s a walk in the park. It might be initially difficult to acknowledge that you need a hand and ask for it, but doing so doesn’t make you a bad mom – in fact, it makes you the opposite: a good mom who sets herself up for success. Advocate for yourself by requesting assistance when you need it, so that you can receive the care and the guidance you need to start your motherhood journey with gusto.
4. Know Your Worth. Sometimes, we are our own worst critic. Our brain has a mind of its own, so no matter what it may be telling you, remember that you are an amazing, resilient woman who is worthy of relaxation, help from friends and family, and happiness. Our self-worth is often misunderstood as the compilation of things we have and haven’t done in life, but if that’s what your mind is telling you, here’s a reality check: you’ve just given birth, which is a tremendous feat that should not be overlooked. So, snuggle with your newborn, let your partner, friends, family, or a professional help out with the chores while you take a moment for yourself, and indulge in a hot meal, because you are worthy and deserving of it all.
5. Trust Your Gut. Continue leaning into your instincts. You were made for this. Know and believe that if something seems off, you’re likely right, and that if your baby needs something, you’ll know. Most importantly, if you feel that something is wrong, believe and advocate for yourself as you would for your little one. Postpartum symptoms, both physical and psychological, are nothing to push away. Your health is of utmost importance, and trusting your gut will ensure that you stay healthy –both in the short and long terms.
Advocating for yourself can take various forms. Whether you do so by writing a list of everything you want for your birth, learning to speak up, or asking for help, it will be important to have a strategy or two that works for you and an open and informed mindset willing to adapt to any changes that may come your way. Birth and postpartum come with many changes and uncertainties, but with preparation, you can approach with certainty that you’re equipped with the right information and support.