Patient-Proof Yourself for Your Hospital Birth

Last week I wrote about the necessity of choosing a provider and place of birth that already deliver the kind of care you want to receive.

If you want directive obstetric management, you’re in luck. It’s the default mode of maternity care today.

But if you want the hands-off midwifery model of care, it may be thin on the ground where you live. Or you may have special circumstances that dictate obstetric management. Or you may believe in natural birth in theory and would like to try it, but you’d feel more comfortable birthing in a hospital just in case and want medical pain management to be an option.

If you want to keep birth as natural as possible, yet you find yourself giving birth in a place and with a provider that doesn’t usually do natural birth, you don’t have to give up. Instead, “patient-proof” yourself.

I wrote last week about the insidious effect of hospitals on the people who enter them to receive care. Hospitals, with the best of intentions, turn people into patients: passive, compliant. This may be appropriate when you’re sick. But a birthing mother is not sick. To “patient-proof” yourself means to build yourself up so that you can resist becoming passive and compliant in the hospital.

Here are the steps.

1.  Know your rights and assert them.

They are simply this: it is your body and you are in charge. You have a right to bodily integrity: they can’t do anything to you without your express permission. Furthermore, you are allowed: to move, turn down the lights, have more pillows, drink, eat, ask questions, birth in the position of your choice. You are allowed to say no: to induction, augmentation, vaginal exams, IV’s, artificial rupture of membranes, being told to stay in bed, birthing on your back. You do not need to ask permission.

2.  Believe in yourself.

Take a moment to reflect on the most influential people you know. What makes them so persuasive?

My children taught me that nothing is as persuasive as a belief in oneself. I noticed that some of my no’s they accepted easily. Others they seemed to think were open for debate. I realized that my conviction is what made the difference.

Once I saw that truth, I saw it everywhere. People sense wobbliness. If they have a preference of their own and know you aren’t sure of your preference, they’re going to try to persuade you to accept theirs. People also sense firmness. When they do, they tend to respect it. (You may have to sign a form that you are going Against Medical Advice, but it will be respected).

This is one reason that mothers who have already given birth are so particularly powerful:  they already know they can do it.

In order to build up your belief in yourself I recommend:

  • Immerse yourself in positive birth stories. (I wrote about this here). Read them. Watch them. Ask mothers to tell you theirs. This also means strenuously avoiding negative birth stories! Yes, it’s true that bad things happen sometimes in birth. But the effect of a fearful story on your psyche is outsized and profound. Fearful stories are not just more information for you to consider. They are damaging to your well-being.
  • Think of yourself as a mother. What words, images and feelings come to mind when you think, “mother”? What words, images and feelings come to mind when you think, “patient”? Lead with your mother energy in all your interactions with the staff. If an intervention is proposed, pause and say to yourself, “I am a mother!” Then draw yourself up and get the information a mother needs to make a decision she believes in.

3.  Believe in your body.

As your body knew how to conceive and gestate this baby, it knows how to birth. Nature has honed this design over millennia to be healthy and safe for the vast majority of mothers and babies. Your doctor has a responsibility to present a compelling medical case of dysfunction before asking your permission to interfere with it.

To build up confidence in your body, I recommend spending time each day connecting to your body and your baby. Try a daily practice of deep breathing, ten minutes morning and night, followed by ten minutes of feeling and visualizing yourself playing with your baby. This practice will build up your sense of yourself as an authority on your body and your authority as the mother of your baby. This sense is an important counter-balance to thinking of yourself as someone’s patient.

4.  Have a team of people who believe in you: your partner and your doula.

We are social animals. We continually look to others to validate our experience of things, to support us or challenge us. Your partner has a role to play in sharing the emotions of the birth. A doula has other roles. She balances the weight of authority in the room. Her presence influences how you are perceived and treated by your birth attendant. It has an even more profound influence on you, how you see yourself and interpret your experience. In addition to the psychic benefit, she is trained specifically to offer effective emotional and physical support to birthing women. I’ve written about the benefits of doulas here.

To adopt these patient-proofing practices means you are taking responsibility for your care. When you do you will elicit more respectful and compassionate care from your care providers, which will set you up for a more healthy hospital experience.

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