Prevent Mistreatment During Birth

A new study was released this month called, "Giving Voice to Mothers." This study sought to reveal people's experience of care during labor, birth, and postpartum. The study took in information from diverse populations in the United States, including many Black and indigenous people/persons of color (BIPOC).

Results showed that 1 in 6 people reported one or more types of mistreatment during birth, including loss of autonomy; being shouted at, scolded, or threatened; and being ignored, refused, or receiving no response to requests for help. The majority of these complaints were from people who gave birth in hospitals, and rates of mistreatment were consistently higher for people of color. 

As a childbirth educator and doula, and someone who has worked in the community of birthing people for 14 years, this information does not surprise me. I've witnessed mistreatment firsthand and I've read about and listened to many people describe situations of mistreatment. I do believe that people are receiving better care overall than a decade ago, but the fact is that way too many people are still experiencing poor care and treatment. Until hospitals and birth centers nationwide implement stricter quality control measures and improved performance measures, including addressing racist behavior, we will not see improvements.  

In the meantime, if you are giving birth in the near future, it's important to know what you can do to try and prevent or avoid mistreatment during birth. Of course, nothing is foolproof -- there's always a risk of running up against professionals with poor people care skills. But by taking some additional preparation steps and increasing your knowledge, you can learn to be a better advocate for the quality care you deserve. The following tips include a range of options, some free or almost free, and some that cost. 

Learn about your rights in childbirth. The more you know about your rights, the better you (and your partner and/or loved ones present with you in birth) can advocate for what you need. 

• How to: Read "The Rights of Childbearing Women" from Childbirth Connection. 

Learn about your choices in childbirth. Diana Korte and Roberta Scaer, authors of A Good Birth, A Safe Birth, said: “If you don’t know your options, you don’t have any.” If you aren't aware of the choices available to you in labor, birth, and postpartum, it is much more difficult to speak up and ask for something different. When you know about alternative options, including benefits and risks of each, you can have an informed discussion with your care provider, or you can more confidently accept or decline a procedure when presented with a decision. 

• How to: Read about birth choices on quality websites like Lamaze, Childbirth Connection, and Choices in Childbirth, and in quality books like Pregnancy, Childbirth, and the Newborn, Giving Birth with Confidence, The Birth Partner, and The Complete Book of Pregnancy & Childbirth. 

Take a childbirth class. A quality childbirth class will hone in on the specifics of the many choices you have in labor, birth, and postpartum, as well as teach you how to be an effective advocate for what you want and what you need, including communication strategies to use with nurses, OBs, and midwives.

• How to: Find a quality childbirth class that fits your budget and schedule. There are so many options! My personal recommendation is to find a full series Lamaze class near you that meets in person, or at least a childbirth class taught by a certified educator that meets more than once and in person. If you choose to take a one-day class or online class, be sure that it's offered from a certified educator, is based on evidence-based information, and includes email support for additional questions. 

Hire a doula. Unfortunately, hiring a doula is not yet something everyone can afford to do. The investment for a doula ranges from $500-$2000, depending on where you live. Sometimes, there are community programs that provide doulas for low-income families through the use of grant programs, scholarships, and donations. If you are able to do so, hiring a doula can be one of the most effective ways to ensure you have an advocate by your side throughout labor and birth. A doula will not speak to your providers on your behalf, but they will help you and your partner/loved one understand your choices and know when to speak up and when to ask questions. 

• How to: Search online to find doulas in your area. You can also use DoulaMatch to find qualified doulas. Schedule interviews and select a doula based on how well you feel they will meet your needs. To find a doula based on your income and resources, search "doulas for low income near me" to see if there are programs in your area. 

Request a different nurse. If you find that the nurse you've been assigned is not working out well based on bedside manner, personality, etc., you or your support persons can request to be assigned a new nurse. 

• How to: Visit the nurses station and ask to speak to the charge nurse or nurse manager and politely ask for a different nurse, if available. 

Mistreatment during birth is not completely preventable, but there are some things you can do to increase the possibility you will be treated with compassion and respect and in a collaborative manner. 

In what ways will you prepare for a safe and healthy birth?