Shared Decision-Making in Labor and Birth

Few milestones are more important than the birth of your children. It’s a time that can be exciting, joyful, and sometimes anxiety inducing. Giving birth might be your first interaction with the healthcare system. There are many decisions to make, from who to trust with your care (midwife or obstetrician), and where to birth (home, birth center, or hospital), to how you envision giving birth. Each of these important decisions can greatly influence the kind of experience you have. Creating a relationship of shared decision-making with your pregnancy care provider can help reduce stress throughout pregnancy, and during labor and birth.

What is Shared Decision-Making?

Shared decision-making allows you, the birthing person, to make healthcare decisions supported by your pregnancy care provider’s expertise and along with your values, desires, and innate knowledge of your own body. While there are some conditions or challenges that can arise during pregnancy, in general, pregnancy is considered a healthy state of being. How does that perspective shape your care during these 40 weeks? As a Labor & Delivery nurse, use these tips to partner with your pregnancy care provider for the best care and outcomes.

Find a Supportive Pregnancy Care Provider

A supportive healthcare provider can make a world of difference in how your pregnancy experience unfolds. Important aspects to question as you consider your choices:

1. Are they qualified to handle your level of care? Obstetricians, certified nurse-midwives, and certified professional midwives can manage low-risk to high-risk care in varying ways. Which one is right for your individual needs?
2. Do they listen to you? One of the most common complaints of pregnant and birthing people is the feeling of not being heard. Find a provider who you feel listens to your concerns, addresses them in a respectful manner, and validates what is important to you as a person.
3. Do they work with you in a way that meets your needs for pregnancy care? This goes beyond simple health checks and leans more into patient and provider preferences and needs. For example, if you’ve ever been a victim of abuse from a women’s healthcare provider, you would benefit from a provider trained in practicing trauma informed care. Is your baby breech (head up/butt down position)? Will this provider help you birth vaginally and help you avoid a caesarean surgery unless absolutely necessary? Is the provider trained, experienced and supportive of breech birth?

Educate Yourself to Empower Yourself

You are absolutely your own best advocate. How can you increase your confidence and ability to voice what aspects of pregnancy are important for you? By educating yourself! Education gives you the knowledge to understand what is and is not normal in pregnancy and birth, and which questions to ask. There are so many resources out there to further your understanding of pregnancy and birth! These can greatly increase your confidence and help you to ask the right questions, advocate for yourself in times of uncertainty, and seek additional clarification when needed.

Create a Birth Plan that Specifies Your Desires

Armed with the knowledge gained from a thorough childbirth education course, make a plan! Birth plans are excellent ways to facilitate clear and concise communication with your labor and birth team. They are especially helpful during a time you may not be equipped to explain it all! Formulate your birth plan ahead of time and discuss it with your provider during pregnancy — before labor begins. Talk with your provider about the things that are important to you and why. Ask your provider to share any limitations of the plan based on your own health situation, their skills or your preferred birth place.

Hire a Doula

Doulas are amazing labor support professionals who are knowledgeable about birth and skilled at advocating for pregnant and birthing people. They can be powerful stand-ins during challenging times to ensure that the issues that are important to you are clearly communicated when you might not be able to advocate strongly for yourself. These are just a few examples of how you can help facilitate shared decision-making with the full team supporting your labor and birth. It’s important for you to both understand what’s going on in your labor, and be an equal partner in the decisions related to your birthing body and baby. Such a culture of respect will empower you to be your most capable, confident, and strong self. Start your parenting journey on a supported and shared path.

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