How to Advocate for Yourself During Labor and Delivery: A Guide for Expecting Parents

As you prepare to bring new life into the world, being informed and confident in your ability to communicate your needs is key to ensuring a positive birth experience. In this blog, we’ll discuss practical steps for advocating for yourself during labor and delivery and why it’s essential for both you and your baby’s well-being.

Why Advocacy Matters During Labor and Delivery

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Labor and delivery are deeply personal and transformative experiences, and while your medical team, midwife, doula, and non-birthing partner are there to support you, it’s crucial to be your own advocate. Chances are you’ve envisioned this moment as your little one developed over the course of your pregnancy and there are ways to ensure a more positive experience.

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Advocating for yourself allows you to:

• Ensure Your Birth Preferences Are Respected: Whether you want an unmedicated birth, can’t wait for your epidural, or want to deliver in a specific birthing position, planning ahead will help with communicating your preferences and will help your care team better support your vision for birth.
• Make Informed Decisions: In the moment, unexpected changes can arise. Being your own advocate ensures you have the information needed to make the best choices for yourself and your baby.
• Feel Empowered: Advocacy and planning can reduce anxiety, increase your sense of control, and lead to a more positive birth experience.‍
• Minimize Unnecessary Interventions: Clear communication can help avoid procedures or interventions that may not align with your birth plan.

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1. Start with Well-Informed Birth Preferences (aka a Birth Plan)

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One of the most powerful tools in advocating for yourself is a written document outlining  your preferences for labor, delivery, and postpartum care - often known as a birth plan. A birth plan or birth preferences guide helps you express your wishes and ensures everyone involved in your care is on the same page. If you’re working with a birth doula you will have a dedicated time to sit down, include your partner or support person who will be with you during labor and delivery, and discuss your plans and wishes. If you’re not working with a doula it’s ideal to spend time considering and crafting your preferences in your second trimester so that you can discuss with your OB or midwife.  

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What to Include in Your Birth Plan:

• Labor Environment Preferences: Would you prefer a home-like environment with dimmed lights and calming music? Do you want intermittent monitoring instead of continuous? Clarify these labor preferences with your care team in advance so that you can ensure everyone is on the same page. It will also give you an opportunity to confirm whether your hospital or birthing facility can accommodate your preferences as policies vary.
• Pain Management: Whether you’re open to or prefer to avoid pain relief options like epidurals, nitrous oxide, or breathing techniques, make pain management part of your plan.
• Medical Interventions: How do you feel about medical interventions such as Pitocin, episiotomies, or forceps?  While things may not always go to plan,  expressing your preferences in advance can guide your care team while you’re in labor.
• Birth Environment: Who do you want present in the room, when you’re in labor, delivering, or postpartum? Whether it’s your partner, doula, or a family member, including these preferences creates a supportive and stress-free environment.
• Newborn Care: Decisions around newborn care, such as skin-to-skin contact, delayed cord clamping, and breastfeeding are important to include in your birth plan.

It’s beneficial to think of your birth plan as a guide, remembering that flexibility is key. Labor and delivery doesn’t always follow a set script, and the ability to adjust while maintaining your voice is the goal.

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2. Educate Yourself on Birth Options and Rights

Knowledge is power, and understanding your rights as a patient and the various birthing options available can empower you to make confident decisions during labor.
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Some of the most common birth options include:

• Birthing positions (back-lying, all fours, squatting, side-lying and others)
• Eating and drinking during active labor
• Medical interventions around fetal monitoring and pain management.

As a patient, in a hospital or birthing center, you also have the right to be treated with dignity and your preferences respected to the extent that they are medically safe and reasonable. 

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Rights of birthing parents include:

• Informed Consent: You have the right to be informed about any procedure or intervention and to give or withhold consent.
• Refusal of Care: You can decline any treatment or procedure, even if recommended by your healthcare provider.
• Personal Preferences: You have the right to choose where and how you give birth, including the type of pain relief you prefer. Advance communication is key so you know whether your preferences fit within the capabilities of your birthing location and the scope of your provider. 
• Access to Support: You have the right to bring a doula, partner, or loved one into the delivery room to support you and help you advocate for yourself at every step.
   

3. Build a Supportive Birth Team

Your birth team is your greatest ally in advocating for your needs. Choose a team that aligns with your values and respects your autonomy. Be open and understanding with your partner and trusted support persons. Discuss your preferences with them well ahead of labor and delivery and be empathetic with them; chances are, they’re feeling nervous and anxious about the baby's arrival too.

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Who Should Be on Your Birth Team?

• Midwife or OB-GYN: Whether you choose a medical doctor or midwife to deliver your baby, choose a provider who listens to your concerns, respects your birth plan, and supports your choices.If you’re experiencing a higher risk pregnancy, you may see a maternal fetal medicine (MFM) specialist. 
• Partner or Trusted Support Person: Whether it’s your partner or another close support person, having someone who knows your preferences and can speak up on your behalf is invaluable.‍
• Doula: A doula provides emotional, physical, and informational support throughout your labor and delivery. They can help remind you of your preferences and act as an intermediary between you and the medical team.

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4. Practice Mindful Communication

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During labor, clear communication is key to ensuring your preferences are heard and respected. Being in labor can make it challenging to articulate your needs, so preparing ahead of time, and practicing, can make a big difference.

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How to communicate effectively with your birth team:

• Use Simple, Direct Language: When advocating for yourself, short, direct phrases can be easier to manage during labor. For example,  “Please explain the risks and benefits.”
• Ask for Time: If a decision needs to be made, it’s okay to ask for a few moments to process the information or discuss it with your partner or doula. While emergency situations can occur where decisions need to be made quickly,  many decisions in labor are not emergent and  you can take time to consider options. Your team can help distinguish which situation you're in. 
• Request Clarification: If you don’t understand a term or procedure, don’t hesitate to ask for clarification. A good care team will take the time to explain.
• Use Positive Language: Frame your preferences in the positive—“I prefer to avoid Pitocin unless absolutely necessary,” rather than, “I don’t want Pitocin.” This keeps the conversation collaborative and encourages two way dialogue with your care team.
• If this feels like a lot to remember, you can rely on the acronym BRAIN - benefits, risks, alternatives, intuition, and next/ nothing (what happens next/ what happens if I do nothing?). 

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5. Be Open to Flexibility Without Compromising Your Values

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Birth is unpredictable, and sometimes your preferences may need to shift due to medical circumstances. Advocacy doesn’t mean rigidly sticking to a plan; it means staying informed and involved in the decision-making process. The key is knowing which aspects of your plan are most important to you and being open to adjustments where necessary.

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When making your birth plan, it’s important to consider how you’ll react when things don’t go to plan. Build in flexibility while staying true to your own self advocacy through these steps: 

• Prioritize Your Preferences: Identify which aspects of your birth plan are most important to you (such as who is present during the birth) and which ones you’re willing to be more flexible about.
• Stay Calm and Centered: Practicing mindfulness or relaxation techniques during labor can help you stay calm and communicate effectively, even if things deviate from your plan.
• Continue Asking Questions: Even if a change is necessary, ask about alternatives and the reasons behind any medical recommendations. This keeps you involved in the process.

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6. Lean on Your Doula for Emotional and Physical Support

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A birth doula can be an essential advocate for you, offering emotional reassurance, physical comfort, and guidance through each stage of labor.

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How a Birth Doula Supports Your Advocacy:

• Emotional Support: A doula can help keep you calm, focused, and empowered to speak up for yourself.
• Physical Comfort: From helping you change positions to providing massage or counter-pressure, your doula can offer non-medical pain relief that aligns with your preferences.
• Information and Guidance: Doulas are knowledgeable about the birth process and can help clarify medical language, ensuring you’re fully informed at all times.

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7. Reflect and Debrief After Your Birth

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Advocacy doesn’t end when your baby is born. Reflecting on your birth experience and debriefing with your doula, partner, and healthcare team can be an important part of your postpartum journey.

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Reflecting gives you the opportunity to process your experience:  birth can be intense and emotional. Taking time to process what went well and where you felt supported can bring closure and healing. Reflecting on your advocacy during labor can also  boost your confidence in future healthcare situations, helping you feel more empowered as a new parent.

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Advocating for Yourself is Empowering

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At Partum Health, we believe that every expecting parent deserves to feel empowered, informed, and supported throughout their pregnancy, labor, and delivery. Advocacy is about making sure your voice is heard and your choices are respected. By preparing a birth plan, building a supportive birth team, and practicing mindful communication, you can create a birth experience that honors your needs and values.

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