Advocating for the Birth You Want and Deserve
There is much to be said about having a voice. Regardless of what subject we’re talking about, having a say in the matter (when it concerns you and/or those you love) is paramount for many reasons. Feeling out of control, muffled or silenced leads to unnecessary anxiety, stress, worry and other complications that can only compound and make matters worse. Regarding pregnancy and birth, one of the most sacred topics that exists, we must have the boldness and confidence to advocate for ourselves, our baby(s) and others who may not have that level of courage yet.
Over the years, pregnancy, birth and even the postpartum stage has become quite the source of worry for many moms – especially first time moms, or those without a supportive inside-circle. This is really sad because at the end of the day, we all just want to know that everything is gonna be alright, don’t we? How can we muster up the courage to ask the hard questions, know where to find the right answers and ultimately stand up and take charge of what is absolutely our right to take charge of? I’m going to share a few things I’ve learned over the years from having nearly two decades of experience in this area. I started out weak, uninformed, impressionable and helpless and today I can confidently say that – while I don’t have all of the answers (who does?) – I feel confident that my past has shaped me and prepared me for where I am today.
We have two options in dealing with our past, we can allow it to hinder our progress and hold us down with the pain and regret of days long gone – decisions we feel were made against our best interest or that straight up harmed us – or we can use the past as fuel to move forward. Allow those hard lessons, difficulties and perhaps even the regrets to teach us some of the most valuable lessons we could ever hope to learn – and move forward with a new wind of confidence, reaching out to others just a few steps behind us to help them navigate where we once stood.
My Story in a Nutshell
I had my first son at 17, when I tell you that I had no idea what I was doing, I am not exaggerating. I didn’t have the slightest idea who I even was at this point in my life, and now I found myself facing the reality that I’d be bringing another human into the world. I didn’t know what birth looked like or, more specifically, that I could decide what birth looked like. I went to my prenatal appointments religiously, soaking up every bit of information they threw at me. I asked countless questions and took those answers to heart, believing that my caretakers knew what was best for me and my baby. Now, I want to add here that all of the prenatal and postnatal care I’ve received for all of my children over the years has kept us alive, safe and I am immensely grateful for it – but – would I have chosen to do things differently had I known that I had a say in the matter? I’d like to think so, yes.
Memories are fuzzy from 20 years ago, but I do know that I checked all the boxes of a good patient. I got all the tests, took all the vitamins and was induced when “the time was right” so that we would have a “predictable” birth. “This is just the way things are” was likely floating around in my mind, and without realizing it it became the norm. Breastfeeding wasn’t really discussed, and although I remember the nurse asking me if I wanted to “try” and briefly placing my new baby on my chest, I quickly gave up after frustration ensured (I know it wasn’t more than a few seconds, probably a shallow and painful latch and a fussy baby who wasn’t able to help himself). The kind nursing staff had a premade bottle of formula ready and offered it without hesitation, which I quickly accepted because that was easier and now anyone could feed him! “This is normal.”
9 years passed quickly and my husband and I decided to begin growing our family now that we were in a more comfortable place financially and relationally. Again, I didn’t really think too much about it, we knew how to make a baby already, what else was there? At my prenatal appointments, I quickly learned that I’d forgotten a lot over the past decade, and had to ask a lot of questions again. I was still an outstanding patient, checking all the boxes and jumping through all the hoops I was given. About halfway through my pregnancy, I remember a discussion at work about birth, and everyone was on the “take the drugs” team. I was mostly silent, but I do remember thinking what an interesting way to think about it, “is this normal?”
I looked into what exactly the drugs were, and suddenly an epidural wasn’t so attractive anymore. I brought it up at work that I think I’d pass on the epidural this time, “how bad can it be?” and I remember being laughed at, as if I were an ignorant child. “Why would anyone turn down the chance to have an easy and relaxing birth? That’s crazy Kel!” I heard various versions of this over the next few months, and perhaps even a few helpful comments slipped in such as “You’re going to struggle trying to go ‘natural’ in a hospital”. Well, where else would I go for having a baby? *shrug*
Long story short, they believed my daughter was “big” and talked me into induction at 39 weeks. Their reasoning was that larger babies are more difficult to deliver and the longer I wait the more dangers this poses to the baby, I won’t even tell you the things they said could potentially happen by leaving baby in there. Horrible stuff to say to an already fearful, hormonal mom. “Ok, so we have an exact due date” but I still want to do this thing without any additional drugs. No one told me that pitocin contractions are way more intense than natural labor, no one warned me that since the small drip they started me out on wasn’t advancing my labor quickly enough, they’d “crank it up” and cause super intense contractions that came on without that slow build that comes with going into labor when baby and body are ready. I was gobsmacked.
I held out for quite awhile, but eventually begged for the epidural, and let me tell you that anesthesiologist could not get there fast enough for me! As far as the “side effects” go, again, they forgot to mention that pitocin causes more intense contractions and pain, but they also forgot to mention that the epidural (which sometimes helps and sometimes, in my case, barely helps) slows down labor, which in turn has them cranking up the Pitocin drip and it was a never ending cycle for the better part of 12 hours. Towards the end, I was exhausted and still feeling quite a bit of the intensity of contractions. It didn’t help that I was laying on a very moderately inclined bed on my back and had IV cords and monitors everywhere. Cervical checks were continuous and reminded me of the slow progression and really had me feeling defeated. I was offered a C-section multiple times and thankfully I had enough sense – even in my desire to be done with all of this – to know that it was major surgery that I did not want! I thank God that a random midwife who I’d never met happened to be on staff that day, she came into the room like an angel and told me I’d feel better if I got up. Moving was the last thing that I felt like doing, but it truly was my saving grace. She got me up and on my hands and knees for some time which really moved things along. It wasn’t long before someone realized that I was now fully dilated and ready to push. To my back I went – ugh! My daughter was born shortly after and thankfully, other than ripping an IV out of my hand in the chaos of it all, it was very uneventful – mom and baby were healthy and I had several nurses show me how to properly hold my breast and offer it to her properly.
Shortly after my daughter was born we had some diaper issues with our disposables, which caused me to ask questions in a natural mom group I was in on Facebook. Instead of being recommended a different brand of disposables (what I wanted) I was recommended to join a cloth diapering group (thank God!) I learned so much more than the benefits of cloth diapering from that group, and I’ll be forever thankful for that bunny trail – it led me where I am today. To go into everything I’ve learned in the past 9 years would be an entire book, but some of the most valuable things I’d come across were:
- The chemicals in disposables and wipes
- The chemicals in baby soap, laundry detergent and pretty much everything that mainstream media is selling us to use in and on our bodies and homes!
- The ingredients of jabs and how they can cause adverse reactions (ranging from mild, such as eczema to deadly)
- How much the food we eat truly affects us
- How much junk is in our water system
- How many “supplements” and “vitamins” are full of synthetic trash and adding insult to injury
- The benefits of a fever and how unnecessarily medicating with tylenol or motrin can prolong healing and cause more harm than good
- That to have a truly natural birth required a plan and proper execution (I didn’t learn about truly using my voice and being in charge when it came to the medical staff until much later)
- The unnecessary and harmful practice of circumcision, history behind it and why it’s still practiced today
- So much more…
Fast forward to 2 years and some change later and we found ourselves expecting a son! From the moment I found out that I was pregnant I knew I wanted to do things differently. I can’t remember how I found out that Birth Centers existed, perhaps it was in one of the books I read on natural childbirth, but a quick Google search revealed that there was one within a 30 minute radius from us – I was ecstatic! After meeting with the midwives and discussing what my care would look like, I was thrilled and looking forward to this new chapter in our lives. I read many books, watched a ton of videos, took a course on Hypnobirthing and wrote up an official Birth Plan.
Everything went almost perfectly, but unfortunately I did end up having a significant vaginal hematoma (he was born with one elbow up and over his head, which caused the tear) and had to be transferred to a local hospital. This look hours to realize, as I was in a significant and unusual amount of pain – I couldn’t even walk – and everyone blew it off as “the feeling of having a baby naturally” until the head midwife came in and realized something just wasn’t right – duh! This was a really scary and unfortunate experience as icing on the cake of my beautiful natural water birth. Until that moment everything had gone off without a hitch, and for that I am thankful.
After my surgery and being separated from my newborn baby for hours – thankfully even though he was given some formula, we went on to successfully breastfeed for almost 3 years! Again, I attribute this to the amazing postnatal care I received, we even got a house call from one of the birth center Nurses, Peggy, who I adore to this day! Overall the experience was a very positive one, but it left me slightly afraid if we should decide to have another baby in the future. “Would I be considered high risk now since I was transferred?” “Could I still birth at the birth center?” “Did I even want to, after the way things were handled?” etc. This all was dismissed over the years as we didn’t find ourselves with the desire to have more babies for quite some time, although in the back of my mind I always wondered if I’d ever “have another chance” at a natural birth with a peaceful and restful period following, instead of emergency surgery.
7 years after our son was born, we were about to find out! After a loss due to an Ectopic Pregnancy, which left me heartbroken and questioning if we were even supposed to have another baby, we found ourselves pregnant with a little boy. After holding my breath for the placement ultrasound and seeing that he was, indeed, in the correct place, I began the preparation for a natural birth again. We originally considered a home birth, but some circumstances that shall remain unspoken veered us away from that direction and we chose the middle of the road option, the birth center again. I read all the same books over again, took a Hypnobirthing refresher course, drank the Red Raspberry Tea, ate the Dates, packed my birth bag with oils, a playlist, etc… basically, did all the things and was really feeling confident and excited for the day I’d go into labor. At 39 weeks life threw us a curveball, Levi suddenly flipped breech – mostly unheard of this late in the pregnancy – and we were told by the birth center that I should go to the hospital and schedule a C-section immediately.
This was devastating to someone who wanted more than anything to have that natural birth that I so meticulously had planned for. When I tell you that we tried everything – I mean it. Hypnotism, visualization, cold peas up top and warmth down below, music and talking, Moxibustion, Acupuncture, Inversion Table, Spinning Babies, Chiropractic Care – all. the. things. He wasn’t moving. I contacted a few midwives and even a doctor in Philadelphia who was known for delivering breech babies – but without enough time to mentally prepare myself – and after receiving warning from one of the midwives who attended a breech birth and lost the baby, I was too afraid to go forward with a breech delivery… I looked into having an ECV – External Cephalic Version – and although it sounded painful and had some risks associated with it, I decided that it was less risky than major abdominal surgery, and after much prayer we went in for it. He was successfully flipped, with a lot of pain on my end, but ultimately he flipped right back to where he was, so the C-section was scheduled for that evening.
I was reminded – by an atheist friend none the less – that if I really believe what I say I believe (in God, and yes I do) that everything happens for a reason. And I believe that down to the very bottom of my heart, so that sentiment alone has brought me peace. I’d be lying if I said that a small part of me felt robbed, like that elusive experience of a natural birth, complication free, was stolen from me. I look around and see others bragging about their experience and to this day find myself experiencing pangs of jealousy, which I quickly put into perspective and check, but I’m only human. I do occasionally think back and wonder what if I’d went for a breech birth. But What Ifs and If Onlys keep us living in the past and that prevents us from moving on, so those thoughts are very far and few in between these days.
Levi is now 2, and we are expecting baby #5, and I’m going for a VBAC. Come to find out, none of the birth centers anywhere close to our home will take VBAC clients, because that’s absolutely considered High Risk in their medical terms and I get it. So, I’ve decided to interview lots of providers until I find exactly – or as close to – what I want for this birth. I have a confidence that I did not have before. I have the courage to speak up and the verbiage to take control of the situation. I know that ultimately, this is my birth, my body, my life and my baby and with some simple word shifts and posture, I’ve found that the providers I’ve spoken to – the one’s worth discussing with, anyway – receive this information clearly and appreciate the boldness, courage and initiative I’ve taken in my own birth experience. I want to encourage anyone out there who is really feeling unsure, unsteady, afraid or just lost – you are the advocate for yourself and your baby. No one else can do what you can do. You must step up and take the reins, you must educate yourself, do the legwork, create a plan and don’t back down. You’re going to get some weird looks, you’re going to get some odd responses, you’re probably going to get your feelings hurt – or perhaps hurt someone else’s (hopefully unintentionally)… but, this level of boldness and courage is paramount to having the birth you want – the life you want. No one can take this away from you, but no one can give it to you either – it’s in your hands.
This is a quick “conversation cheat sheet” that I’ve used to interview multiple providers too see if they’re a right fit for this pregnancy and birth. I recommend opening with these questions, and I’ll give you some more pointers and verbiage along with the specific questions and statements as well.
Conversation Cheat Sheet
I always recommend opening with the following. Any time I’m interviewing someone, regardless of the reason, looking to hire them for services, etc I always use a similar opening. It’s cordial, concise and can be appreciated for so
“Hello, my name is _____ and I’m looking for a provider for my prenatal care and birth. I do have a few opening questions to address, as I don’t want to waste either of our time, if you don’t mind.”
“This is my ___th pregnancy and will be a VBAC1 (Vaginal Birth After 1 Cesarean). I have a few questions before we set things up, some non-negotiables I’d like to discuss.”
[At this point, the receptionist may be able to answer your questions, may transfer you to a nurse/midwife/OB or may need to schedule a future phone/telemed/in-person appointment to have your questions and concerns properly addressed – I recommend continuing with this process until you’re able to have your questions answered and have a solid understanding if this is the practice you want to continue with. *There is nothing wrong with “shopping around” for a provider. I felt guilty doing this previously, and I believe one reason was that I was kind of shady about it – I didn’t tell each provider my intentions from the get-go and I’d set up my initial intake appointment, filling out all the paperwork and regurgitating the same information over and over. Now, I open with this information so that: neither of us is wasting our time and so that they understand the nature of my inquiry and that I mean business – I’m serious about these non-negotiables and am informed enough to know that I have other options – there are plenty of “fish in the sea” so to speak – when it comes to providers.]
*Listen, I understand the fear when it comes to speaking up for yourself and advocating for the birth that you want and deserve – but think of the alternative. I’ve bowed to pressure many times from perhaps “well-meaning” medical providers in many different fields (medical, dental, dermatological, etc) and it’s always left a bad taste in my mouth. Not only was my desired outcome not achieved, I felt a loss of control – like I wasn’t at the helm of my own ship. Now, I know that God ultimately is at the helm of my ship, but that’s not what I’m referring to. We cannot let our medical – or life – choices fall into the hands of someone who doesn’t have to live with those choices.
“Here are some of the things I’d like to discuss, and see if you’d be willing to support me.”
“This is going to be a VBAC, I do not want another cesarean. Will you support me for a VBAC?” (some women I know have used the medical term Trial of Labor “Will you support me for a trial of labor?” – and while this is the term most medical providers would use as well, and shows your competency as far as lingo and prior research is concerned – the word trial indicates that it’s just that – a trial. And while, yes of course it is – I believe that our verbiage is so important. Our thoughts are physical matter in our brain. What we say to others is important, sure – but what we say to ourselves is even more so! “I am not trying this, I’m DOING THIS! (*ROAR*)” Use your discretion here and use the verbiage that feels right to you and your current situation. [Most providers who are willing to do a VBAC are going to assess your probability of a successful VBAC based upon your medical history and other risk factors. Depending on the reason you had a previous C-section(s), you may be lesser or higher risk – in higher risk cases – “Trial of Labor” may be the better choice of words.]
*I want to add something else here, and honestly this should probably be numero uno. You know how they say first impressions are everything? It’s true. Most people can “catch a vibe” or decide if they jive with you in the first few seconds – or minutes – of meeting you. Have you experienced this? I recommend following your gut here, it’s rarely led me wrong. If you get a bad vibe from entering a building or meeting a provider, it’s probably not for you.
After you’ve gotten that first line of conversation handled and found out that they do, in fact, support your wishes for a Natural Birth / VBAC / whatever your initial request was – it’s time to present your case. At this point, when you pull out your little notebook or index card, you may be told that you can “submit your birth plan” in your document files for them to look over, but remind them that you want – and need – to know their policies on some important key points here before continuing. What’s the sense in giving them your life story, medical history and even getting examined if you’re not going to stay with this particular practice? Again, you’d be wasting your time and theirs. This is why it’s important to make yourself clear on the initial phone call/intake that you have some questions and concerns prior to becoming an established patient at their practice.
The following are some things you may want to ask about. Most of them concern Birth Center / Hospital Policies and some may even be found on the practice’s website beforehand. It never hurts to get clarity on them though, and absolutely make sure they are included in your Official Written Birth Plan (more on that in another post).
- Delayed Cord Clamping
- Immediate Skin to Skin
- How many people / who can be in the labor room / delivery room with me? (Spouse, support partner, doula, children? This looks different for everyone and every location – make sure you ask ahead of time what the particular facility allows!)
- Lights / Music / Aromatherapy
- Option for water laboring / birth?
- Eating / Drinking during labor
- Free movement / positions
- Minimal progress checking / Monitoring (PICC line is usually required at most medical facilities for quick access “just incase” and should cause minimal disruption)
- Hands-off approach / Free Birth with support there if needed / requested
- Attire – you likely won’t want to wear that stuffy hospital gown – you’re not having a medical procedure, you’re giving birth for goodness sake! – Are you free to wear your own “gown” or whatever you wish?
- Postpartum Stay Length – Many birth centers discharge you hours after delivery – many hospitals range from 24 hours – several days
- Do you or do you not want Student / Attendings to observe or participate?
- Will you be able to call the midwife / OB of your choice when it’s baby time or do you get “whoever is on call”?
- Whatever else is a non-negotiable for you. Any questions or concerns you have that could “make or break” your decision to employ this specific provider
Don’t feel bad for asking these questions. Don’t ever forget that this is your birth, your baby and your life. Don’t forget that these providers are working for us, not the other way around. Don’t forget that doctors, nurse practitioners & midwives are human, thus fallible, and while they’ve got a degree, practiced for years and have extensive medical knowledge – that doesn’t mean they always know what’s best – you know your body and your baby best. Don’t forget that, as wonderful as it is to have modern medicine when absolutely necessary, birth is typically not a medical event and has been happening since the dawn of time – it’s how our race has continued on thus far!
I hope you found this useful and if you have any further questions or would like to see anything added to this post / list, please comment or send me a message – I’d love to hear from you!