I’ve worked with pregnant women for over 17 years and here’s one thing I tell every one of them: In Labor and Delivery, you’re not just a patient you’re a customer.
Truth: Many of my patients have at least some ideas of what they want their L&D experience to look like, but when it comes down to it, they’re afraid to ask questions & end up struggling to voice their opinions or state their desires.
I call this “Authority in the Room.” You might have some strong ideas of what you’d like to happen, but you lose your voice when you’re not the authority in the room.
The truth is that most labor & delivery decisions have pros & cons. If you’re not presented with options but are just told what to do, that’s not informed consent. You are a CUSTOMER, not just a patient, & it’s not rude to ask questions, be given a list of pros & cons, or ask for time in making a decision (unless it’s truly an emergency situation).
This can be done kindly & should be received with respect.
Some things I’ve found helpful:
If you have strong opinions about what you’d like to happen during L&D, talk to your provider about it AHEAD of time at a prenatal visit. If you have questions about a certain intervention, let them know. If you know what you want (i.e., “I don’t want to deliver on my back”), then let them know before you’re in labor. When you arrive, make sure every nurse you see also knows your wishes. Make sure your partner also knows your wishes so they can advocate for you when you’re exhausted & reiterate what you want.
If presented with an intervention you weren’t fully prepared for, you can always ask to talk to your partner about it privately, taking some pressure off deciding on the spot. Or ask to wait X amount of time to see if the intervention can be avoided (assuming it’s not an emergency).
Things may happen during L&D that you can’t control. Your birth plan might go a different direction than you had hoped. But we can do our best to control the things we can control & hold the plan loose for the things that are out of our control.
Remember, you are a customer. Don’t tell me that birth isn’t business—it absolutely is. If you’re unsatisfied with the care you’ve received, you most likely have options to choose another provider/facility.
Have you struggled to state your wishes in the past? What has/hasn’t worked well for you?
