It’s your body. It’s your baby. It’s your birth.
By Paris Maloof-Bury, CNM, RNC-OB, IBCLC & LaShea Wattie Haynes, MEd, MSN, AGCNS-BC, APRN, RNC-OB/EFM
The care you receive during pregnancy, birth and postpartum can affect how you feel about yourself. Sometimes you might feel pressured to “go with the flow” and not complain. A healthy baby is what matters, right? Wrong. Nobody loves your baby more than you do—of course, you want a healthy baby! In the rush of activity during birth, your pregnancy care providers may not stop to listen to you or to ask for your permission to touch and care for your body. You deserve to be treated with kindness, listened to, have your questions answered and your requests acknowledged. When women receive respectful care, their babies do better. Stress from poor treatment can increase the risk of complications for women and babies. Consider the following tips to receive respectful care as you interact with your pregnancy care team.
Choosing your healthcare provider
Do your research and read reviews before selecting a healthcare provider for your pregnancy and birth care. Midwives specialize in supporting normal birth; one of their primary philosophies is “Listen to Women.” Read more about midwives here. Obstetricians are physicians who are experts at managing high-risk pregnancies. Obstetricians may view labor and birth as medical events rather than normal processes. Whomever you choose, you should feel respected, comfortable asking questions, and receive timely and appropriate feedback. Often your insurance may determine your range of choices for providers and the provider you choose may determine your birth place.
Choosing your birth place
Most hospitals offer childbirth classes and tours to provide information on their practices and birth options. Check online for the hospital’s statistics for Cesarean birth, breastfeeding rates, and customer service scores. For more information, read our article Choose Your Birth Environment.
Informed consent means your healthcare provider reviews the risks, benefits, and alternatives of any treatment or intervention they recommend. This includes even “routine” procedures, like sweeping your membranes, breaking your water, or cutting an episiotomy.
Patient autonomy is defined by MedicineNet as “the right of patients to make decisions about their medical care without their health care provider trying to influence the decision.” You have the right to learn about your care and choose or decline what is recommended, and the right to decline care in one instance but accept it in another. It’s your body, your baby, your birth, and your choice.
Unless there’s a medical emergency, healthcare providers should ask permission before touching your body, especially before vaginal exams. Vaginal exams can be physically uncomfortable; and for women who’ve experienced sexual abuse, they can also be emotionally triggering. These exams should only happen with your permission. You have the right to stop the exam if you change your mind or it becomes too uncomfortable. Your consent must be continuous, and you can revoke it at any time.
Dignity and modesty
Dignity and modesty are basic things to ask for and may be as simple as having a blanket to keep you covered. Most of us feel more confident when we wait to undress for an exam until after talking with our healthcare provider, and most of us find that we remember more of what we discussed with our provider if we have our clothes on during the conversation.
Privacy and confidentiality
Your healthcare provider shouldn’t ask you personal questions in front of your family or friends without your permission. Ask your family and friends to step out if you want to keep the information confidential.
Racism and bias are real and can impact your health
If you experience discrimination based on your race, ethnicity, religion, sexual orientation, gender identity, or medical philosophies, either choose another provider or tell your provider directly about your concerns.
What’s in a name?
Your name is part of your identity and should be used correctly. If healthcare providers have difficulty pronouncing your name, ask them to write it out phonetically in your chart. Unless you’ve given someone permission to do so, using “terms of endearment” can be belittling. You can correct people if they mispronounce your name or call you “honey” or “dear”.
Pregnant women and their families are from many racial, ethnic and cultural backgrounds. Historically, people of some races, ethnic and cultural groups were called disrespectful names in order to belittle them. Women have also been referred to in disrespectful terms. Healthcare professionals should always address you by your preferred name, rather than using casual or slang terms.
Respectful care means you’re treated with dignity, empathy, and compassion regardless of your race, ethnicity, gender, socioeconomic status, or reproductive history (pregnancies, miscarriages, abortions). You’re in charge of your medical care and have the right to informed consent and refusal and autonomy every step of the way. If you ever feel that something isn’t right, speak up! It’s the health professional’s job to listen.
By Paris Maloof-Bury, CNM, RNC-OB, IBCLC and LaShea Wattie Haynes, M.Ed, MSN, AGCNS-BC, APRN, RNC-OB/EFM
Paris Maloof-Bury, CNM, RNC-OB, IBCLC is a certified nurse-midwife and lactation consultant at Sutter Health in Davis, CA. LaShea Wattie Haynes, M.Ed, MSN, AGCNS-BC, APRN, RNC-OB/EFM is a system clinical nurse specialist for labor and delivery and mother/baby for 7 birthing centers in her healthcare system.