First of all, you have more rights in a hospital while giving birth than you probably know. Most women have no idea what is allowed, what to ask, or what to assume. That’s ok though because I am going to lay it ALL out for you so that you are so prepared, and so in control.
So here is what you should know legally: it is your body, it is your baby’s body. You really are in control. You have the right to refuse any treatment and walk out of the hospital or birthing center at any time.
Consent papers
From the beginning, when you get those consent papers they want you to just glance over and sign? Don’t. Actually, look carefully through them and cross out the things you don’t want to sign for, (Yes, you can do that) and add in things that are a must (you can do that too)…Then sign. They will have the right to refuse your service if something is just absolutely against their policy, but for the most part, they will comply with your wishes or work with you to facilitate them.
Informed Consent
Doctors many times will just assume that if you’re not asking questions it’s because you already know, and because they have to be efficient with their time, they won’t explain things they don’t have to. So don’t be afraid to ask too many questions. Ask about the risks and side effects of IV drugs, an epidural, or a C-section. Ask about the complications and benefits of breastfeeding or formula feeding. Ask about their specific hospital’s C-section or forceps rate. Whatever is important to you. Ask about their policy for premature babies or complicated labor. And then you get to decide whether or not you give consent. If you don’t consent they can’t legally force you into any care regime. You might have to leave or get a new provider. But most doctors are very reasonable, and I think you are too. There is a reason you want your birth at the hospital, so trust their knowledge and experience, chances are they want to help you achieve your birth plan as well. They must give you the full information without holding back anything they think might scare you. This increases mother satisfaction greatly; knowing what you’re signing up for when you decide on something, is extremely important.
*Emergency disclaimer
If your life or the child’s life is in immediate danger, your care provider does not have to go into a full analysis of what they are doing, with the risks/complications/side effects, etc. This is a good reason to speak to them beforehand about all of their policies and procedures. (and do a little googling at home)
Machinery
The hospital may, without reason, begin hooking you up to an IV drip. This is because you need to stay hydrated. The problem is once you are hooked up you don’t have a lot of movement. Not moving or having the best positioning in labor, can lead to various other interventions, and then those lead to even more interventions. It’s best just to say no to anything that’s not necessary. Just drink water and keep your freedom of movement. If you can’t trust yourself to remember this throughout labor, have your partner, doula, or nurses remind you.
Constant fetal monitoring can also have the same effect. But it is usually done when the mom is high risk for one reason or another. If they don’t have a reason, opt-out. Another thing to note is that when reading your contractions on the screen, you may be confused to see them spike very high when you barely feel it, or barely raise when it’s been the worst one yet. The monitor does not in any way measure the intensity of the contraction. It measures duration only, the spikes are nonsense. Don’t pay attention, you’re doing great!
Staff
Doctors aren’t going to be with you through each contraction, and for that matter, neither will nurses. Nurses will be more available, but they typically have several patients they’re taking care of and will be in and out. Doctors, on the other hand, will probably only show up in time for pushing and will take care of you in this climactic moment. This is another reason to get a doula, a doula is solely focused on you and doesn’t have an entire floor to provide care for.
If you aren’t getting along with a particular nurse for whatever reason you can ask for the head nurse, then tell this head nurse you’d like to replace the current one you’re not getting along with. Most nurses know this is nothing personal, birthing moms are particular. Maybe the nurse is too happy and it’s annoying you, no problem, switch them out.
Another thing that can sometimes scare moms is when a herd of nurses comes in all in one moment and are fussing around the room. This doesn’t necessarily mean something is wrong, and there’s no reason to get anxious unless they tell you there’s a reason. Often if a floor isn’t very busy the nurses will all just hang out together and do their clinical duties in a group. If it bothers you, you can always ask that the room remains quiet and only one nurse in the room at a time.
After Birth
After birth, you can refuse anything you want to refuse. That goes for vaccinations, circumcision, washing, eye ointment, vitamin K shot, etc. I strongly suggest you don’t just tell them not to do something because it sounds scary, but do your research and speak in depth about anything that sounds bothersome to you with your doctor before your birth. Typically, the hospital will give you between a few minutes to an hour before they whisk the baby away to be washed and observed for complications. You can let them know if you want the baby to stay with you and get that important golden hour of ‘skin-to-skin’. They will let you know if that is dangerous or not for your child’s specific physical state. The hospital may have you release them from liability if you choose this or any other deviance from standard care. You may also decide you want to feed the baby as it shows signs of hunger, and not on the feeding schedule of the hospital. If you know the newborn’s early signs of hunger* then this is fine with hospitals as well.
All in all, as much as you can, communicate with your provider beforehand or bring your doula to your appointments with you to make sure that you are fully heard, understood, informed appropriately, and advocated for. It definitely helps to have your unbiased, focused doula at your birth for this as well. She can make sure you are understanding everything and that you are giving your consent before moving forward with procedures. Have a plan, but be flexible because it will probably change a little. Birth is a little crazy like that.
*Waiting until a baby screams to feed it can lead to a constantly screaming baby, which is very tough on a new mother. Catching the earlier signs helps the baby understand it doesn’t have to always scream to be fed and it won’t until it gets very hungry – like in the middle of the night. It will make the distinction instead of crying as a first resort. This is a very small thing you can do, that can make a world of difference.
Note: This article is intended as general information only and is not intended to serve as legal advice or as a substitute for legal counsel.
