Culturally, women have been taught to go with the flow, to not speak up, and not to go against the grain and/or authority. The culture in many parts of the world is rapidly changing, but there is still so much work to do to unravel and change the narrative.
Around the time of pregnancy and childbirth, pregnant people encounter many situations with care providers during which there are opportunities to speak up, whether to ask questions or to decline a procedure. This is important to recognize, since unfortunately, many care providers perform outdated and unnecessary routine procedures in the course of prenatal and childbirth care, and in many cases, they are done without informed consent. Below is a shortlist of routine procedures that often are presented as required, but usually are not. It is your right to question, to ask for time and/or more information before deciding, and to say no.
Cervical check - If you want a cervical check, either during a prenatal appointment or in labor, that's fine. And also, know that a cervical check is not medically necessary and can be declined. The results of a cervical check can be misleading and unhelpful, plus they are uncomfortable and introduce bacteria unnecessarily.
Wheelchair - Often, upon check in at the hospital in labor, you will be offered and encouraged to ride in a wheelchair to the labor and delivery unit. Hospitals do this primarily for liability. However, you do not need to ride in a wheelchair and can assert your desire to walk on your own if that's what you prefer.
Hospital gown - Hospital gowns are given as standard protocol upon being admitted. You are not required to wear a hospital gown. If you prefer to wear your own gown or clothing, do so! Many people find wearing their own clothes more comfortable.
IV - Also frequently given routinely upon being admitted in labor is an IV. Some hospitals will routinely start fluids while others will request an IV port be placed in the event medication or fluids are required. Routine fluids outside of medical necessity are not required and can cause issues for parent and baby. Learn more about routine IV fluids in labor. An IV port is less invasive and allows for freedom of movement, but may still be something that is undesired -- talk to your care provider about their policies and alternatives.
Laying in bed - Upon checking in at the hospital in labor, most people assume the logical next step is to lay down in bed. After all, it's the centerpiece of the room! But many people in labor don't find laying down flat on their backs a comfortable way to experience contractions. The great news is you don't have to lay down in bed upon getting to the hospital! Even if monitoring is required, you can sit, stand, lay on your side, move around -- find what's most comfortable for you and carry on laboring.
Monitoring - Speaking of monitoring, this is another place for you to ask questions and make decisions. If you aren't being induced, on pitocin, and don't have an epidural, you do not have to be monitored continuously. Most hospitals require a 20 minute monitoring period every hour. And even when you are monitored, there are ways to remain mobile despite monitoring. Some hospitals even offer telemetry monitoring units for use in the tub or shower. Talk to your care provider about options and your wishes.
Breaking your water - Artificially breaking your water happens in many labors, and while it can sometimes be helpful to progress labor, it is not without risks and is not always helpful. Learn about the risks vs. benefits of this procedure and be sure to ask questions and discuss alternatives if it's suggested.
Rules against eating and drinking - While many hospitals still maintain this rule, referred to as "NPO", not eating and drinking during labor is not an evidence based practice. Learn more and talk to your care provider and the place where you plan to give birth. Eating and drinking during labor will help give you the energy needed to sustain your efforts over a long period of time.
Question, question, question - When in doubt, ask questions. If something doesn't feel right in your gut, or if you need time to make an informed decision, talk to your care providers, ask questions, and seek additional information.
TagsInterventions Informed Consent Evidence based care Routine Interventions