Do’s and Don’ts in Labor & Delivery (a.k.a. Getting What You Want, Kindly)

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Birth plans. Epidurals. Natural Childbirth. Doulas. Induction. Cesareans. And more…

The list of decisions about birth goes on and on…

More women are becoming dissatisfied with the status quo in American maternity care, and are asking for something outside the norm for the hospital where they plan give birth. Naturally, this might make for some conflict between a birthing mother and her care provider and nursing staff.

Conflict.

There. I said it. Right out loud.

There might be conflict in the labor and delivery room when a mother is giving birth. I am not writing this post to tell anyone how to avoid conflict, but how to manage it in a healthy way, so that the birth experience is not characterized by the conflicts that arise, but by the solutions everyone involved is able to come to.

Here are some do’s and don’ts that may help you in the labor and delivery room to self-advocate effectively, while creating a human connection with the nurses and provider caring for you and your baby.

DON’T: Expect care providers or nurses to offer much in the way of comfort during labor.
It is not the responsibility of a care provider or nurse to make a birthing mother comfortable. Their first priority, and indeed, their entire job, is the safety of mother and baby. Period. Your comfort is a distant second to safety, and that’s exactly the way it should be.

DO: Hire a doula to offer you comfort and support.
Your comfort is the entire responsibility of your doula. Period. That is all that she is there for. Emotional, physical, and informational comfort and support are her expertise. You will not be disappointed if you lean on a doula for this need.

DON’T: Make demands.
This only causes a heightening of conflict. If you want something different than protocol, shaking your fist and demanding it is not the right tack. You might get your way, but you may not end up getting the best care if you treat the nurses as if they were there to grant your every wish.

DO: Ask for exceptions.
Think about it. How would you feel if a stranger came to your house, and began to dictate to you how to load your dishwasher, feed your kids, or fold your towels? You would be offended. This is what we do when we demand our way in labor. When you want something outside protocols, try this: “I understand that this is your normal protocol, but I need you to make an exception for me this time. Thank you.” This invites conversation and cooperation, and is less likely to put a nurse (who is technically your advocate) on the defensive.

DON’T: Be rigid.
Refusing to budge on the smallest things is unfair, especially when you are asking for things outside the box. Remember, you are a rare breed to these nurses. Asking them to step outside their norm is a big deal. Respect that.

DO: Be flexible.
Compromise is the name of the game. For example, here in Colorado Springs, a Hep lock buys you pretty much anything you want in most of the hospitals. It helps them to see that you are reasonable, and that you understand why they do what they do. It makes them far more open to your requests and out-of-the-box needs.

DON’T: Wait until you are in labor to make your birth plan known.
It is completely unreasonable to spring a birth plan on unsuspecting staff and providers. You can’t count on appointment conversations to be remembered, simply because of the sheer volume of patients a hospital-based provider might see in any given month. Not to mention the fact that you are likely to have a care provider you’ve never met catching your baby!

DO: Discuss everything on your birth plan prentally.
Write your birth plan early, in second trimester, and tackle one issue at a time in those 7-10 minute appointments. Discuss the benefits, risks, and alternatives ahead of time, and really make sure you and your provider are on the same page. If they are willing, have them sign it–this doesn’t make it a legal document, but it proves to the staff and on-call doc that your care provider is on board with all your requests.

In short, it pays to be kind. Always be kind. You never know what kind of day your nurse or care provider has had. You have no idea what is going on in the room next to you. I am not making excuses for bad or disrespectful or hurried care. I want to remind you that everyone in scrubs is a human being, just like you. There is rarely a reason to walk into a labor and delivery ward with guns blazing. Even if you had no other choice in your care. The ones providing it are just as human as you are, and if you can leave them feeling respected and understood, you are helping to pave the way for the next woman who wants out-of-the-box care.

It may be your birth, but it has ripple effects. Whether it’s for the positive or negative is, at least in part, up to you.

How do you handle differences of opinion in your care? What are the most diplomatic ways you have used to self-advocate without a situation erupting into WWIII?

Grace & Peace,
Tiffany

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