Welcome back to episode three of Your Birth Bestie podcast. I am so glad you are joining me for this episode all about self advocating and having an empowered hospital birth. It is probably the most important topic to talk about because, as a woman, you want your doctor to respect your choices and help you work through difficult decisions on your own terms.
It seems so daunting to feel like you have to “fight” the hospital system in order to get what you want, and honestly… I think why so many of the moms I’ve worked with have fear and anxiety when I first meet them. It’s the fear of the unknown and being overwhelmed on where to start that usually causes this.
So… this episode is for you if you’re pregnant or maybe hoping to be soon and planning your hospital birth. You’re probably still figuring out what do you want? What can you even have or what is “allowed”? And how to be sure you have the best shot at making your birth dreams a reality!
We’ll get into this, but before we do… go ahead and download the free workbook at bethconnors.com/workbook (the link is in the shownotes too) so you can see all of the possible decisions you will have to make or questions you’ll have to answer during your hospital stay. Knowing what you want is the first step, but I do want to go a bit deeper and give you tangible ways to advocate for yourself and avoid the cascade of medical interventions that is unfortunately, so common in the hospital.
So this is definitely a great resource to have as you’re navigating this hospital birth journey.
Hey there! I am Beth Connors, a midwife and mom of 2, but also, Your Birth Bestie. In this podcast, we’ll dive deep into everything you need to feel confident, prepared, and in control from baby bump to delivery room. From practical tips to personal stories, we’ll cover it all so you know exactly what to expect every step of the way. Let’s get into it!
If you know me, I’m a people pleaser, spent most of my life going with the flow and trying to blend in, a lot of the times afraid to speak up because I cared too much about what other people thought of me.
I feel like so many things changed though after I had my first baby. I obviously became a mom for the first time, but I also had a really terrible first birth experience. After learning more about birth to become a labor and delivery nurse and a midwife, and witnessing what other women were experiencing in the hospital… and I’m talking about the amazing, autonomous, empowering births that I thought oh my god… I had choices? I realized I could’ve prepared differently and been in control? So why didn’t I! Why didn’t I speak up during this important moment in my life?!
I can tell you at least three reasons why…
First, was the power dynamic between me and the nurses and doctors. I definitely felt talked down too and information was watered down to oversimplify what was really happening. Like I talked about before.. My doctor said “let’s just break your bag of water now. You want to meet your baby sooner right?!”-- completely going over why he recommended it or what the risks were. It was an easy “yes, I guess” kinda thing. I had no reason not to, I thought? But I didn’t have all the information. Which leads into not having the right information or lack of enough information.
So many moms are not aware of their rights or what choices are available during childbirth. And if you don’t know what questions to ask or what to expect, it is so much harder to advocate for yourself. And even if you think of a question, there can be the fear of asking a “silly question” in the moment--which really there is no such thing honestly ask me any question you’d like, I’d love to talk about it. But the hospital can be a scary environment because it feels sterile and intimidating with lots of doctors and equipment… you may just feel too overstimulated to ask a question and are just trusting and hoping things will be good if you go with the flow. And this reminds me of another reason actually… and a really important one actually. It is that hopefully you have trust in your medical provider. But you might trust them so much that you want them to make the decisions for you and your baby… and while this is of course a good thing, it can also lead to moms not speaking up if you’re concerned or if you feel like something is not going the way you wanted it to.
And for me, being a new mom, not having ever met the doctor delivering me before or obviously the nurses or anyone I kinda just trusted the process and went with the flow. I didn’t want to be seen as a “difficult patient” and it didn’t take much convincing for me at any point for them to speed up my labor with interventions.
It’s terrible looking back for sure, but at least I know what went wrong and I was able to change for my second birth and also help so many moms have better births or get it right the first time, which is so amazing!
Because you can have an amazing hospital birth, even though you’ve probably seen all the hospital birth haters giving it a bad reputation. Traumatic experiences with horrible doctors and midwives and neglectful nurses are all we hear. But I am here to remind you that isn’t the only experience you can have and surely doesn’t have to be the norm. Think of your OB as the medical expert who is meant to GUIDE you through your journey, and absolutely not control it. You get to make all the decisions. So hopefully that in itself is reassuring and empowering.
So there are several ways I want to share about taking control of your hospital birth and becoming your best advocate. I learned the hard way with my first, but didn’t let it happen again and I definitely don’t want you to either!
Okay! Starting with clinic visits because it’s the first step that impacts your birth.
Be sure to have a supportive provider from the start (not the most important thing though, so don’t worry if the person you love isn’t on call for your delivery… that happens but the prep you do will be something you have and it literally won’t matter who is there for you, it’s just a bonus
Before appointments prepare questions beforehand and jot them down in your notes app on your phone. Then be sure to ask as many as you need to at your appointment, one important question being – what should I expect at the next visit? This way you can prepare for any recommended tests or ultrasounds and talk it over with your partner and make decisions before being put on the spot completely at the visit
I thought it might be helpful to do a rapid fire list of some of the decisions in clinic you’ll need to make.
First trimester ultrasound also known as your dating ultrasound at the time of your first appointment. It’s standard usually. Do you want this? What genetic testing do you want if any? Are you okay with having an anatomy ultrasound at 20 weeks where they look over baby very carefully head to toe If your pap smear is due while you’re pregnant, do you want it collected or wait until postpartum?
Taking blood is standard at the first or second appointment and then at 28 weeks along with the diabetes screen where you take the sugar drink. Does that all sound good to you?
What are your thoughts on cervical checks? Typically you’re asked around 38 weeks.
Do you have a pain plan for labor? Make sure you know what is all available to you in the hospital… labor tub, peanut ball, birthing ball, TENS unit… things like that
Are you okay following recommendations for induction in pregnancy? When would you be okay scheduling an induction if needed?
Know the visitor policy
Thoughts about circumcision
What are you plans to feed your new baby?
There are so many topics that will come up, that it’s nice to have a heads up when your provider will ask about these things, so that in the moment you can get all your questions answered too.
The free resource at bethconnors.com/workbook is a list of questions just like this all about labor, birth, and your newborn, to think about before being admitted into the hospital. It’s not meant to be overwhelming, just a good way to make sure everything is covered while you prep and be prompted to do additional research, ask more questions, and make sure you are totally prepared!
During your pregnancy also ask your provider about standard hospital practices, c-section rates, and their thoughts on supporting physiologic, natural, low-intervention birth. You usually can get a good vibe with their answer. Like if they say, “I don’t get why you’d want to go through all that pain when there’s the epidural…” yeah that would be a red flag if you’re trying to have an unmedicated birth. It’s usually pretty obvious.
Next, gaining your confidence is important. This can be done with education like online birth courses, but even if you don’t know anything about birth and didn’t prepare as much as you wanted to, PLEASE know you have a voice, you can and should ask questions, and you must give informed consent before anything is done. It’s basic but it’s worth mentioning for sure.
Confidence can also come from knowing you have rights and getting the permission to be the “difficult patient” and quesiton everything because of these rights! No more going with the flow and trying to blend it, because childbirth is so much more than a healthy baby and you deserve the birth you want! A few of these right are that: (it’s a list of like 6 things so stick with me here for a minute!)
You have the right to choose a midwife or doctor, OR SWITCH to another at any time during pregnancy or even your delivery.
You have the right to information about benefits, risks, and costs of the procedures and alternative options (this does include doing nothing at all).
You have the right to accept or refuse anything and you can also change your mind at any time.
You have the right to freedom of movement during labor.
You have the right to uninterrupted contact with your newborn from the moment of birth. Whether there is advanced care your baby needs in the NICU or the hearing screen before discharge, your partner or someone you delegate has the right to go with baby wherever they go to be sure your wishes are continually met.
You have the right to bodily autonomy and self-determination. It’s as simple as saying “yes” or “no”. You may have a reason. You may not. Either way it should be respected because you have this right.
If something doesn’t feel right, ask to speak to the charge nurse or get a second opinion from another provider.
To be your best birth advocate, it’ll make so much difference if you can fully trust the birth process, even if it feels scary at first. Once you have this mindset and are all in, there is so much clarify with speaking up for each of your birth goals.
If you’re worried that you trust birth to unfold as it should, but your nurses might not agree, one thing you can do is direct them to review your birth plan. Say something like, “Have you had a chance to read my birth plan? I want to be sure we’re all on the same page as things progress.” It’s a super easy way to first start talking with a new nurse if shift change comes, or something like that, and they can get to know you and your wants… but also puts you at ease hopefully too.
Another BIG important thing I want you to listen too if you’ve gotten pulled away to do something else… is preparing for how you re going to say “no”. Your doctor may say “Okay, we need you to do ___” or “It’s time for ___ now?.... But how will you calmly and confidently react?
For someone like me who doesn’t like conflict like this, I have a script you can follow! It’s called the B.R.A.I.N tool… Because even though you can just say “no” and decline, you might not want to because of course you want what’s best for you and your baby so you’ll probably be consdiering more questions to ask to be sure the right choice is made for you. Each letter in this acronym stands for a question to clearly communicate what you want and your concerns.
What are the benefits?
What are the risks and how do you plan to manage them?
What are the alternative options available to you and how do they compare?
What does your gut say?
What would happen if you did nothing and allowed birth to unfold without the recommended intervention?
Maybe you’ve heard of this before… but a few bonus questions to ask too are:
Is it considered “routine” or is it medically necessary?
Why is this necessary?
How long do I have to make this decision?
On a scale of 1-10, how strongly do you recommend that I do this?
Or in the instance where you go to OB triage and they want to admit you in early labor… you can ask:
What will change for me once I am admitted?
What will happen if I delay getting admitted and come back?
So you always have the choice
And the very last thing I want you to consider is what steps are you willing to do to prepare…and just as a warning, your hospital birth course is probably not the answer. And by probably I’m willing to say 95% of those courses are just not giving women the info they need… I can tell you from personal experience that is so true.. Spend your time and money somewhere else, or at least look into it a bit more because there may be a class out there that surprises me, so I don’t want to ever say never…but there’s other stuff out there!
Just be sure you’re getting ALL of the info on what to expect during pregnancy, what to expect throughout labor from the moment it starts through your entire hospital stay, and definitely beyond with postpartum transitions and newborn care/feeding.
Ideally a comprehensive course that includes everything from birth mindset, physiologic birth, making informed decisions, legal rights and advocating for yourself, prenatal tests, labor options, comfort measures, stages of labor, c-section options, labor complications, postpartum planning, involving your partner, eliminating birth fears, nutrition, and of course I could keep going because there is just so much beneficial info to know!
There are so many things that are beneficial for new moms preparing for birth, and things I wish I had known before my first birth, and also so many common questions I get from moms daily, which is why I am in the process of creating my own comprehensive hospital birth course so all the info and resources are in the same place from someone that has the same outlook on birth as you.
And if you’re looking for something like this, but haven’t found the right fit, my new, course will be available in July and I’m so excited for you to dive into the modules, handouts, and checklists! You can find more details at bethconnors.com/birthcourse and get on the waitlist. I’ll send you a personal reminder when the presale starts on May 22nd for a 50% off discount that week only!
It is seriously all the info you need to feel ready and confident to have an amazing hospital experience. Because when you’re educated, you are so much more aware and have better control over your experience. You can think about what you want and don’t want, and consider possible decisions to make during pregnancy and labor that are educated and that you feel good about. It makes everything less scary the more informed you are and I would be so thrilled to help you in this journey!
Thanks again for tuning in to this episode of Your Birth Bestie podcast! Don’t forget to click the link in the show notes to grab your spot on the waitlist and subscribe to the show to hear more each week about how to have an autonomous hospital birth experience. I appreciate you so much for being here and will see you next time!