The all-time most popular post on Giving Birth with Confidence is an article written four years ago by Lamaze Certified Childbirth Educator Jessica English, CD(DONA), BDT(DONA), LCCE, FACCE, and owner of the thriving doula and childbirth education business Birth Kalamazoo in Michigan. The piece is called, "Six Tips for Gentle But Effective Hospital Negotiations." To date, it has been viewed 33,715 times! As it turns out, families really want to know how to communicate with health care providers so that their preferences are respected and their priorities are understood!
As a doula and childbirth educator myself, the most common concerns I hear from moms are, "I'm worried about how I will make decisions in labor and knowing what questions to ask," and "Will the doctors/nurses let me do XXXX?" Working with medical staff -- nurses, doctors, midwives -- can feel intimidating. Their role is a position of authority and expertise, and it's easy to feel like you're part of a parent-child relationship. But research shows that even the best parent-child relationship is guided by mutual respect and understanding! Realize that you too are an authority -- of your body and your baby -- and even though you may not have extensive medical education, you do have the right to ask questions, receive fully informed answers, and assert your rights and preferences.
Excerpted below are highlights from the original blog post, along with updated Giving Birth with Confidence commentary (indicated by >> and in italics). In addition to reading below, I encourage you to hop over to the original post where you will find examples under each tip.
By Jessica English, CD(DONA), BDT(DONA), LCCE, FACCE, with commentary from Cara Terreri, CD(DONA), LCCE
Hopefully you're able to choose a birthplace that largely supports your goals for birth, but if that's not possible, here are some suggestions that might make negotiating easier.
>>Straight away, the author points out that the best and most effective way to get the birth you want is to choose a birthplace -- hospital, birth center, or home -- that supports your preferences and practices according to best evidence. Here's an excellent resource with tips for choosing the best birthplace for you.
1. Talk it out beforehand, and get it in writing. If something is particularly important to you, talk it over with your midwife or doctor at an office visit.
>>This is where your birth plan comes in handy! Remember, a birth plan is not so you can "plan" your birth with a play-by-play script, but rather an exercise in learning about the many options available and stating the preferences that are most important to you and your partner. It's also the perfect tool to start conversations about choices with your care provider. Learn more about preparing a birth plan.
2. You'll catch more flies with honey than vinegar. I suggest to my students that they are firm but very polite when working with the staff. Is continuous monitoring the policy at this hospital? Nurses, midwives and doctors are just people. A gentle approach is usually received much better than angry demands, and you're more likely to get what you want.
>>This couldn't be more true. If you go in expecting a fight, you'll likely find one. But if you go in expecting to be treated with respect and be prepared to deal with it if you aren't, you'll put yourself in a much better frame of mind. If you've tried the "kill 'em with kindness" approach and it just isn't getting you anywhere, request a different nurse. The nurse assigned to you may be having a bad day, or perhaps your personalities don't mesh. It's ok to ask for someone else.
3. Brainstorm. If you can get your nurse or provider working with you, they may start to take ownership of your ideas. Try asking for their help to brainstorm a problem. If they respond with reasons why something won't work, you can always throw out a phrase like, Let's try together. When people are part of the process they generally respond better than if you simply list your demands.
>>Generally speaking, nurses, doctors, and midwives are on your side -- they too want to see the safe and healthy birth of a baby, and they too want to make sure you have a good experience. Sometimes, though, they can lose sight of how their actions, words, or an intervention can impact your experience. If you can frame requests and questions as if you're in it together, you're more likely to work as a team, which benefits everyone.
4. Bring a doula. An experienced doula has usually seen other families successfully negotiate in the hospital environment. She probably knows what's possible and may have some techniques for helping you get to yes.
>>Doulas are invaluable when it comes to helping navigate the hospital maternity care experience. If you absolutely cannot or do not want to have a doula at your birth, consider taking a quality childbirth class, which will cover decision making communication tactics. A childbirth class is also important even if you do hire a doula, too.
5. Don't stop at the first no. If you're asking for something outside routine hospital policy, the first answer you receive will probably be no. Expect that first no, and be pleasantly persistent, using all the techniques mentioned above.
>>This is like how the squeaky wheel gets the grease -- except in this case, the super kind, team player gets what she wants in labor and birth.
6. Remember, it's your body, your birth and your baby. If it comes down to the line, remember that no one can force you to do anything or accept any intervention that you do not want. Shared decision making requires your consent. It can be intimidating to have professionals in scrubs and white coats telling you to do something, but if there is no clear safety reason for the request, it is always your right to say simply and clearly, No. After all, it is your body, your birth and your baby.
>>One thing I always tell families is that health care professionals are working for you, not the other way around. When it comes to care in childbirth, you do have choices and rights.