What is self-advocacy?
Everyone wants a healthy mama and baby at the end of pregnancy. But how you experience your maternity care also matters. Whether your pregnancy is straightforward or needs more medical help – if you give birth in a hospital, a birth center, or at home – you are entitled to health care that is respectful, compassionate, and scientifically accurate. Being your own advocate is an important way to make sure you receive this type of care and to feel empowered throughout pregnancy and birth.
So, what does self-advocacy in maternity care mean? Many things. It means asking questions and raising your concerns. It means speaking up for care that is evidence based and free from bias or racism. It means connecting with resources like doulas and childbirth education. It means demanding help when you need it and asserting your right to be the decision-maker for your body. Self-advocacy is about having a voice to express your wishes and to call out anything that feels wrong. A physically healthy mama and baby are critically important. But they are not enough. Support, respect, and communication are also vital for every pregnant person.
What are your rights?
Advocating for yourself begins with knowing your rights. This is not being pushy, difficult, or confrontational. So, don’t hesitate to protect your health and wellbeing.
- You have the right to informed consent and refusal of any medical treatment or procedure. This means that providers must tell you about anything they want to do, explain the risks and benefits, and wait for your decision. Entering a hospital is not informed consent. Neither is signing a form under pressure or without understanding it first. Unless you are unconscious, no one can touch your body without your permission.
- You have the right to equal treatment, meaning you should not face bias, racism, or discrimination from any care provider.
- You have the right to health care that is based on science and medical evidence, not convenience, policy, or a provider’s preference.
How can you begin to self-advocate?
Self-advocacy can start any time during your pregnancy. Here are some steps toward taking an active role in your care.
- Knowledge is power. Learn about pregnancy, labor, and birth, and what to expect during each stage. Ask your provider all your questions. They should listen and explain without rushing or dismissing you. Be aware of complications and the warning signs of serious conditions. Stay in tune with your body and trust your gut if something feels wrong.
- Explore your options. Research available hospitals, birth centers, obstetricians or midwives. Ask providers about your preferences and concerns, including C-section rates, their views on un-medicated birth (if you want one), vaginal birth after cesarean (if you want one), induction, and other interventions.
- Bring back up. If possible, bring someone you trust to your prenatal visits and your labor/delivery to help support and advocate for you. Speaking up for yourself can be difficult if you are being rushed or during physical pain and discomfort. A knowledgeable and experienced doula can be a great resource to remind you about questions, help get clear answers, and talk through options.
- Make a plan. Create a plan with all your birth preferences. Share it with your provider to make sure they are on board and with any new providers during labor. Remember that birth can be unpredictable, and your plan may need to change. Whatever happens, you still have options and decision-making power. Also plan for the postpartum period since you may need help with recovery or complications.
When do you need to self-advocate?
The time to advocate for yourself is whenever you need help or support, feel confused or anxious, or if you receive care that is disrespectful or inaccurate. Maternity care providers have different policies and practices, and not all are evidence based. Here are some common questions you might need to ask.
- Can I have a vaginal birth after cesarean (VBAC)? – If you had a C-section in the past, you may be able to give birth vaginally next time. Medical research has shown that VBAC is a safe option for most people and it’s often successful. It can be hard to find care providers and hospitals that support VBAC, so if this is your goal, be persistent.
- Is my baby really too big? – Pregnant people are frequently told that their babies are too large to carry to term and an induction or C-section is necessary. In reality, less than 10% of newborns are considered “big” at birth. Ultrasound estimates are often wrong, and inducing labor has not been shown to be safer for mother or baby.
- Can I eat and drink during labor? – ‘No eating or drinking’ is a restriction many people face during labor, because of the risk of choking if you need emergency surgery. Actually, this is extremely unlikely, and labor is hard work! If you need to fuel your body, there is no medical reason not to eat or drink.
- Can I labor and push in different positions? – There is a lot of evidence behind using movement and physical positions to help manage labor and birth. But many people are encouraged to stay in bed and push lying on their backs or slightly propped up. You should labor and push in any position that works for you, including standing upright, on hands and knees, or squatting.
What if you can’t self-advocate?
Self-advocacy is powerful, but sometimes circumstances can’t be controlled. If you felt unsupported during pregnancy or had a traumatic experience, this does not mean that you failed. Many people, particularly women of color, face systemic issues in maternity care that they can’t fix or avoid. Preventing birth trauma or malpractice is not your responsibility, and if you experienced them, you deserve support and accountability.
Interested in how a doula can help you self-advocate? Learn more at meetmae.com.