You know what you want for your birth: to let your body do it's thing while having the unwavering support of a knowledgable, compassionate caregiver that is equipped to help you and your baby if the need arises (no matter how rare the odds).
You've done your research on all of the interventions that you can choose to decline, how to advocate for yourself, and how your partner can support you physically during your birth.
As your due date approaches, your provider asks how everything is going, and you are excited to share your natural birth plan with them, except now you're being told that it doesn't vibe with the hospital policy and your provider's "hands are tied".
It can feel incredibly disappointing to pour your heart and soul into planning and preparing for a birth that truly surrenders to your body's innate wisdom, just to be told that:
- the hospital “doesn’t allow that”
- XYZ intervention is “hospital policy," so it's required
- we can “try” but hospital policy has parameters on that
- if we do what you want, then you’ll need to *insert intervention here*
So what do you do?!
You explore your options,
& choose what feels best to you!
1. Find a new place to birth your baby.
It is true that regardless of where you birth your baby, you have basic patient rights that include the right to informed consent to all proposed tests or treatments and the right to decline that care even in the case of emergency, so long as you are alert, oriented, and able to legally give consent or refusal. The problem that many women face is that providers generally do not honor these rights while a woman is birthing her baby, and hospital policies are normally used as a default to justify this.
Many women spend time researching advocacy for humane treatment in birth, and hire doulas to help their voices be heard in a room of people who should already be prioritizing it - just to find that if the hospital (or birth center) policy opposes the wishes you have for your body, birth, and medical care, no amount of advocacy is going to change that.
If this is where you stand, it may be time to look into alternative settings. Maybe this means finding a different hospital, a birth center, or exploring home birth opportunities. You also have the right to request transfer of care to another facility at any time during your course of care, though your health insurance coverage likely has their own policies regarding coverage in this scenerio. If you're unsure of which birth settings best suit your birth plans, get in touch with independent doulas, birthkeepers, or fellow women who have had natural, unmedicated, hands-off births and ask which places and providers they would recommend and why.
2. Find a new provider.
Sometimes healthcare providers have personal policies for their care, and may disguise this as hospital policy even when it's not. Meeting with an alternative provider in the same facility can help clear things up so that you can decide if you jive with a different primary care provider better! If the problem is hospital policy, you’d need to search for a provider willing to respect your autonomy and patient rights over arbitrary non-evidence based guidelines.
If you choose to stay within that establishment, watch for “bait and switch” red flags, and be willing to ask lots of questions about the policies in place so that you can foresee any pressure to submit to interventions, and be prepared to make those decisions about your care with confidence. Remember, you retain the right to fire any nurses or physicians from your care at any time if you are unhappy with the care you are receiving.
3. Practice Advocacy & Hope for a Great Birth Team.
It’s never ideal to prepare for battle going into birth, but many women find themselves doing feeling like they have no other option. If you’re choosing to birth within a hospital system or with a provider that isn’t feeling supportive to your wishes and needs, it’s best to familiarize yourself with the physical and mental tools to help you get through it!
This can look like
understanding the hospital system and what to expect
getting a copy of your birth plan directly to the OB nurses as early as possible
keeping a copy of your birth plan in your birth space for easy reference
knowing your rights & review them with your provider during prenatal appointments
staying home as long as possible
knowing how to foster a secluded, quiet envirionment in the hospital
creating a solid support team (like your partner + a doula), & communicate regularly
It's important to birth where you feel safe, respected, and free to surrender to your birth process. Everyone wants the same fundamental outcome: a healthy mother and baby. We know that when it comes to birth, there is so much more to consider.
We are here to support you in preparing for birth & early motherhood with love and reverence, and to hold space for you in integrating your intiation into motherhood on your terms, in your own time, and in your own way.