Advocating for Your Health When Giving Birth

As a doula, one of the phrases I hear clients say the most is, “I need someone to advocate for me during birth.” When I ask them what that means, they admit they don’t really know. Expectant mothers feel that they need someone to protect them, but don’t necessarily know what or who they need protection from.

There’s good news, mama- you’re not looking for the same sort of protection that mother animals are looking for during birth (no one is going to eat you or fly away with your baby when you’re not looking). We’re really just looking for protection from the unknown, from overwhelm, and from making big decisions with little information.

You're the best possible person to advocate for yourself and you don’t have to be an all-knowing birth guru to do so. I’ve seen women of all shapes, sizes, ages, and backgrounds labor in a satisfying way that is authentic to their beliefs and values.

Afterward, these moms stare at their beautiful new babies with a magical look that says, “If I can do that … what else can I do?”

Step 1: Trust Yourself

When you think about birth, it’s important to view it in a realistic light. It's not like the movies and shows. There’s not going to be a huge gush of water immediately followed by screaming and running to the hospital, more screaming, and then pushing out a baby in three breaths.

You were designed to do this.

Birth is something natural that your body knows how to do. You don’t have to consciously know a single thing about it and that baby still finds their way out.

Step one is trusting that you were designed to do this. You have all of the necessary equipment!

The confusing part is that there isn’t necessarily a “normal birth”. Everyone gives birth a little differently. Some births will be long, some short, some easy, and some hard.

However, there is a flow when the natural birth process is uninterrupted.

Early labor usually begins with small surges through your uterus. These are spaced apart, giving you a chance to get used to the sensation of a contraction.

In active labor, those surges grow into a more consistent pattern of around one minute “contracting” followed by a few minutes “resting”. Each surge guides your baby to descend into the birth canal and spin around so that their head is in the perfect position to fit through your pelvis. Think of your contractions moving your baby down like a screwdriver and a screw, not a hammer and a nail.

When your baby's head has finally found that perfect position, it presses on the cervix and helps it to dilate to 10 centimeters. Now the surges are accompanied by low pressure resembling the urge to go to the restroom.

Pushing can be a few minutes or a few hours. When that urge to push is too much to hold back anymore, your sweet little baby comes out to meet you.

Step 2: Know what's important to you

You don’t need to know everything about giving birth, but you do need to know what is important to you.

This is the part where things get a little complicated. Sometimes we struggle with turning our brains off and letting our bodies take over. We overthink, and that’s where it pays to plan ahead.

If you can make some of the big decisions before labor even begins, you are already advocating for your future self who gets to hand the nurse a birth plan and keep your brain turned off while your body works. The fact that you're reading this article now means you are on the right track. Look at you, an intuitive mother!

Research can be fun. Start by talking to the people you know. Ask them about their birth stories and take note of anything that resonates with you, positively or negatively.

People are usually happy to share, but just be careful to guard yourself a little and know that you don’t have to give birth the way they did. You're going to do this your way!

Once you’ve heard the stories and made your notes, you can take the words that stand out to you and do some reading, both in books and online. You can reach out to a doula for a free consultation or make an appointment to write a birth plan together. You can even take classes, like from our friends at Birthsmarter, to get practical guidance for planning (and adapting when plans go sideways) for birth.

Things you might want to research for your birth plan:

Step 3: Assemble a Birth Team

Labor can be long for first-time moms. Your healthcare provider will likely encourage you to stay at home as long as you can before coming to the hospital. So your birth team begins at home!

Who will be by your side to help you get as comfortable as possible when contractions start waving? Is it a partner, your mom, a best friend, a doula, an aunt… all/none of the above?

Whoever it may be, make sure that they are familiar with your birth plan and the reasons behind those decisions. If they understand your reasoning, they will be better prepared to help you make informed decisions if the plan needs to change.

This person should be calm and nurturing so that they can help you rest your eyes, stay hydrated with small sips, and keep your calories up with light but protein-rich snacks.

Once you arrive at the hospital, you may see the doctor a couple of times, but the majority of your time will be spent with your nurse. Make sure your nurse knows the reasons behind your choices as well so she can help you stay as close as possible to your preferences.

Picking your birth team also means picking who you don’t want in the room. If someone is making you uncomfortable, it's imperative that they leave. I have seen mothers-in-law, nurses, and even OBs asked to leave. The energy always improves when you find someone who can provide a better doctor-patient relationship!

You are not obligated to mind other people's feelings during this time, and you can absolutely fire a member of your team. The great thing about birthing in a hospital is that you (or your insurance) are paying for a service, and if you’re butting heads with a service provider, there is a building full of other employees who can swap places with them.

Step 4: Just do you!

When you get to the hospital, most people wait to be told what to do because they really don’t know what they can do. But you can absolutely advocate for your basic needs and preferences.

What do you want to wear, eat, hear, smell, see? Aim to replicate your own safe space so that it almost feels like you’re giving birth at home.

Wear your own pajamas or nightgown if you prefer it over the hospital gown. Bring your softest pillow and coziest blanket. You can dim the lights and set out flameless electric candles, a star projector, or a string of fairy lights. Bluetooth speakers for music are great for drowning out beeping monitors and can keep your mind from racing.

No one can force you to do anything you don't want to do.

Listen to your body about what movements might be needed and try to move every 30 or 45 minutes. Ask for a birth ball or peanut ball and ask your nurse or doula if she can help you with any Spinning Babies positions for pain relief.

Eat when you are hungry and keep your electrolytes up. Your nurse will suggest that you stay on a clear liquid diet, but you are free to eat anything you want, unless you have had an epidural. If you have had an epidural, you can ask for tea, broth, jello, or popsicles.

If you feel you need to nap, do so, and don’t be shy to tell your nurse that you need privacy to sleep for a while.

Doing all of these things as you would in your own home will let your brain know that you are in a safe place for your baby to come out and can help you avoid a cesarean section (or c-section). These strategies can keep your labor from ‘stalling’ due to fear or tension and help your baby from getting wedged into an unfavorable position in the pelvis.

Does advocating for myself mean everything will go exactly as planned?

Birth is unpredictable. Advocating for yourself means that when changes arise, you and your team are aware of your values and you are comfortable in making an informed decision that still supports those values.

When in doubt, use your BRAIN: Benefits, Risks, Alternatives, Intuition, and Nothing. If you are told to do something you hadn’t planned on doing during labor, ask your doctor, “What are the benefits, what are the risks, and what alternative options do I have? ''

If the doctor or nurse's concern is not a major concern for you, you can ask them “What happens if I do nothing and continue with what I’m doing?” Remember, no one can force you to do anything that you don’t want to do, and you have a right to bodily autonomy.

In the end, labor is about bringing a baby safely into the world. Even if your birth doesn't go according to plan, being prepared and advocating for your health will create the best experience possible as you welcome your little one into the world.