Why is it so hard for women in labor to say "no"?
"No, I won't let you use the vacuum extractor on my baby."
"No, I won't come in for an induction when the non-stress test says my baby is fine."
"No, I don't want to be confined to the bed on the baby monitor. Use a doppler instead."
"No, I am not giving you permission to cut me."
I've noticed that, more and more, women need to be strong advocates of their choices when giving birth. The challenge is that giving birth can feel vulnerable. Women can be nervous or exhausted or even afraid. Standing up for your choices is a challenging task in labor, especially in the face of opposition.
Consider Sonia. It's her first baby. She's done prenatal yoga, is healthy and has great confidence in her body's ability to give birth. She goes into labor naturally. She labors while taking walks outside the hospital. Baby is close and she makes her way back to her room. She feels like pushing! During her pushes, the doctor suggests making a cut to speed up the birth. Sonia didn't want to be cut. She had expressed this clearly to her doctor during prenatal visits. But, now she is in pain and overwhelmed with the intense pressure she feel from baby's head descending into her birth canal. She looks at her doula, panicked! What should I do?, she gasps. Her doula doesn't want to speak for her. She wants to give Sonia a voice. She replies, "stick to your plan"! Sonia takes a deep breath and tells her doctor: "We are sticking to the plan!". Just a few minutes later, Sonia's baby boy is born, her husband is singing a "blessing" song and Sonia feels elated that she gave birth without compromising her choices. Her tearing is minimal.
It wasn't easy but Sonia said "no" to an episiotomy. With the support of her husband and doula, she was able to be an advocate for her choices.
There are so many things that can happen to make women lose their courage to say "no". Maybe the hospital staff is using the baby's well-being to scare mom. Maybe some moms are too exhausted to speak up. Maybe they don't have enough information to feel confident about their choice. Or perhaps women simply don't understand that they have the right to say "no".
But, setting boundaries and saying "no" is an important part of taking charge of your birth experience. When giving birth in a hospital setting especially, there is a good chance that you will have to use the word "no" in order to stick to your beliefs and choices.
Saying "no" is possible and even necessary at times. For one thing, I've come to realize that saying "no" starts during your pregnancy. It's so important to inform yourself so you can begin to tell your care provider what you won't accept at your birth.
Yes, I just said "won't accept".
We tend to tiptoe around the issue of saying "no" by telling pregnant women that they need to be flexible and realize that their "birth plan" is just a guide and that their experience could deviate from their plan at any time. While it's good to remain flexible, to me this tells women that their plans or values probably won't stick. Many times, women abandon their plans at the hospital lobby doors. But, most women's "no's" or preferences at birth don't involve life-saving procedures.
If you're expecting a baby and have some preferences or some "no's" on your list, practice setting those boundaries now. Tell your health care provider about your values and your "no's". As with Sonia, some doctors will still try and lead you off your chosen path. If your support team is aware of your desires, they can encourage you to speak up in vulnerable times. Use this time during pregnancy to inform yourself and ask questions about hospital policies, doctor's intervention rates and beliefs. Also, know your rights. In my province, I have the right to refuse care from any nurse or doctor. It may take a lot of courage to exercise this right, but it would be worth it if you had, for example, a nurse who was sabotaging your birth plans or opposing your non-life-threatening wishes.
You can do it. You can say "no". The empowering nature of birth doesn't just come from your body's incredible strength and ability to birth a baby, it comes from your voice and your words!
Wishing you an empowered birth!
*Image credit: http://www.freedigitalphotos.net/images/view_photog.php?photogid=1738