Self-advocacy during pregnancy, labour and delivery

Your Choices in a Busy NHS 

We have all seen the headlines. Midwife and Nursing Strikes. A stretched NHS. I am speaking to an increasing number of women voicing concerns about how the state of healthcare might affect their maternity care. At a time that can already be anxiety provoking, this is understandably adding an additional burden for mothers to be. Here are my top tips on what to consider, and on how prepare for your birth with advocacy and maintaining control.

Will my birth plans have to change?

The first thing to reassure women about is that safe staffing levels will be maintained even in the face of strikes. Maternity services are considered emergency services and will be prioritised. In order to maintain safe staffing levels however, it could be that staff are redirected away from areas such as birth centres to labour wards. It’s also possible that there may be some disruption to home birthing teams. 

It is there for important to keep your birth plan fluid and open so you can adapt based on current service pressures. This does NOT mean you have to be a passive participant in your antenatal care and birth plan – speak to your antenatal team and ask lots of questions so you fully understand what’s going on and your choices so you can make an informed decision. You want to understand all the risks and benefits of each choice that related to your personal circumstances and pregnancy. Advocating for yourself will help you feel more empowered and ultimately lead to a more positive birth experience. 

Do get help if you need it! 

Please do not let the current pressures and concerns around maternity care stop you from seeking help or support if you need it. If you have concerns about your pregnancy or baby, speak to your GP, midwife or Maternity hotline number. There is always someone you can speak to and/or see if needed. 

Do think about ambulance services – maternity emergencies are high priority calls and will have fast blue light response (normally 8 minutes). However, for non-life-threatening emergencies, and if possible, it may be quicker for you to make your own way to the hospital. 

Why Advocacy is Important 

Childbirth is the most natural process in the world, but there will be difficult choices you need to make along the way and potential curveballs you weren’t expecting. Advocacy through antenatal care, labour and delivery will help you keep in the driving seat and in control. Here are my top tips for self-advocacy:

1. Ask questions, questions, questions. If you aren’t sure about something, or something is making you feel comfortable, do not be fearful about asking LOTS of questions and you can say No. Knowledge is power and you should feel you are informed about all the risks and benefits to every decision you have to make. 
2. Take a birth preparation course such as NCT or hypnobirthing course. Education leads to empowerment. 
3. Have a birth plan outlining your wishes, but be prepared to be fluid and adapt to any surprises on the way. Plan for these surprises, think about all the possible scenarios and what you would like in those situations. Write it down, make sure your birth partner, doula, midwife and doctor are all aware of it. 
4. Form your support team – assemble your support team around you and establish yourself as the leader with it. This may be a doula, midwife, partner or family member. Make sure they understand all your wishes. There may be times during your delivery where you can’t think or speak clearly and you will need someone to step in and be your voice. 
5. Speak up about pain – no one except you gets to decide your pain level and pain tolerance. If you need more pain relief – speak up.

Read more about avoiding labour anxiety in our recent blog by Doula and Hypnobirthing Teacher, Rosie Gray. Read the blog here.