16. Ways to Recenter Yourself in Birth
In a world better than this one, you would be at the center of birth. Everything, from the people around you to the environment to hospital policy, would be working to better support you. Unfortunately, we don’t live in that world (yet!), but there are some specific shifts, skills, and strategies you can learn to tackle this massive, institutional-level problem as it relates to your own birth. Let’s dive in!
You are in charge. Remember that you are the final decision-maker when it comes to anything in your pregnancy, labor, and birth. You get to decide which of the recommended tests, procedures, and interventions you want. You’ve hired your care team for their clinical expertise and knowledge, and their job is to provide that to you. Then you get to take that, ask questions, dig into the research, consult yourself, and figure out what you want to do.
What can you do to remind yourself of this? Practice reframing statements. For example, if your provider says, “You will need to be induced on Monday,” you can rewrite that (out loud or in your head) as, “My provider’s recommendation is that I be induced on Monday.” Just changing the wording of what you’re hearing can remind you that they are giving you their thoughts, not an order. It’s the same thing with, “My provider won’t let me go past X weeks.” What your provider is really saying is, “It’s my medical recommendation that you not go past X weeks.” Apply the same technique with yourself too. I’ve heard people say countless times, “I have to be induced at X weeks.” When you change that to, “I am choosing to be induced at X weeks,” how does that feel? It might help restore power to you. Maybe you didn’t want to be induced, but after talking with your provider, consulting the evidence, and checking in with yourself, you’ve decided that that’s the best option for you. There’s power in claiming your choice. On the flip side, if it doesn’t feel right, that may be a sign you are not choosing something freely, in which case more consideration could be beneficial. There’s a huge difference in doing something you think is right for you even if it wasn’t what you hoped for versus doing something you don’t think is right for you because you feel coerced.
When you step into your birth space (in this case, I’m talking about hospitals specifically), remember that you still retain your human rights. You get to say “yes” or “no” to everything that happens to your body. This includes the biggest things and the smallest. You get to choose if you want to wear your own clothes or change into the hospital gown. You get to choose if you want a saline lock. You get to choose what kind of fetal heart rate monitoring you consent to. You get to choose if you want to lie in bed or walk around. Your care providers are responsible for informing you of your choices and walking you through the benefits, risks, and alternatives of each option. That way, when you choose something, you do so knowing the pros, cons, and alternatives.
In the spirit of honesty and actually giving helpful information, the fact that everything is a choice in the hospital setting is not going to be obvious to you. There are many, many reasons for this (the patriarchy, hospital bureaucracy, efficiency, liability, staffing issues, culture, hospital routines/policies/procedures, to name a few), so you have to translate requests for things into questions. Here’s what that looks like:
“Go ahead and put this gown on. Don’t forget to take off your underwear.” becomes, “Would you like to put this hospital gown on or would you feel more comfortable in your own clothes?”
“Hop up on the bed. I need to check you.” becomes, “I recommend another cervical check right now. Can I walk you through my thoughts on why and then you can let me know what you want to do?”
“We need to get your feet in the stirrups.” becomes, “I’m concerned about X problem because of Y. Are you comfortable putting your feet up in the stirrups so that I can manage it if it becomes an issue?”
A common thing I see in hospitals is people making the above statements without giving the why. The why is crucial! “I need to check your cervix” is different from, “It’s been four hours since your last check and we’d like to see if you are making cervical change,” is different from, “Your baby’s heart rate just dropped and isn’t coming back up. Can I check your cervix to see if there’s a cord prolapse because that would be a life-threatening emergency and we would need to act fast?” When providers always use the first wording, it becomes impossible to distinguish between an emergency situation, a could-be-urgent situation, and a we’re-doing-this-for-administrative-reasons situation. In all cases, you still have the right to say “yes” or “no,” but it would be a hell of a lot easier for you to make up your mind (and quickly, when needed!) if the rationale were always explained to you.
So how can you get the context for any directives made to you?
First, translate it into a question to remind yourself that you have to give consent or refusal for anything.
Next, ask if this is an urgent situation, so you know how much time you have to make a decision. If you have time, you can go through all of the steps below. If you don’t have much time, you might want to just ask about the reasoning and any risks.
Ask for the reasoning behind the recommendation. What information will this give you? What would you do with that information? Why is this recommendation being made?
Get clear on the risks. What are the downsides to this? How likely are those things to happen?
Find out about any alternatives, including doing nothing. Ask about the pros and cons of other options.
Share your concerns with your provider, so you can have a discussion.
Give your decision.
You should be at the center of your birth. You should be making the decisions, asking for additional information, and checking in with yourself. Even better, you should feel comfortable doing all of those things. Every time someone recenters themself in their birth experience, it paves the way for the next person to be centered, and the next, and the next, until one day that becomes the norm!