So many times, I hear women say things like:
"My doctor won't let me go past my due date. He/she says I have to be induced."
"I want to try for a VBAC, but my provider says he/she won't let me try for a vaginal birth and that I have to schedule a c-section."
The list could truly go on and on...
Statements like these and the power struggle in pregnancy care that they illustrate lead to feelings of inadequacy, failure, fear, discouragement, anger, and powerlessness on the part of the birthing woman. Many feel that they can't or shouldn't question their caregiver because their education and experience must mean that their way is the right way. It is dishearteningly common to see a one-size-fits-all attitude in the medical model of pregnancy care, where providers apply the same model of care to each patient, regardless of their individual situation. The result is often a barrage of unnecessary tests and procedures, scheduled Cesareans and inductions, and a birth experience that leaves the mother feeling dissatisfied, disappointed, even robbed of a highly personal and important experience.
The truth is, pregnant women can question their caregiver and they absolutely should. In every other aspect of medical care, we expect nothing less than informed consent on the part of the patient. We have them signing surgical consent forms confirming that the procedure they are undergoing has been explained to them in a way they could understand. We discuss all available options, including those which are less invasive or non-surgical, as well as the risks and benefits of each. We engage their participation in their own care, even asking them to mark their own surgical sites. If we can expect this for medical and surgical patients, why can we not also expect it for pregnant women?
If more women felt empowered to advocate for themselves during their pregnancy, labor, and birth, we would surely see improvements not only in the national birth statistics, but in mothers' overall satisfaction with their experience. We would also likely see a decrease in the troublingly-high Cesarean rate in the Unites States: in 2019 (most recent data), the CDC reported that a staggering 31.7% of deliveries were accomplished via Cesarean section (https://www.cdc.gov/nchs/fastats/delivery.htm). Women today are taught that pregnancy is a condition which requires medical supervision and possibly surgical intervention, when it is the exact opposite. It is a natural, instinctual, primal experience that the mother and baby were intuitively made to navigate. Patience, watchful waiting, and support are often all that is needed.
Childbirth Connection, a non-profit organization working to improve maternity care through research, education, and advocacy, put together a list of twenty rights to which all childbearing women are entitled, but which many do not exercise because they are unaware of them. I have summarized them here, but highly encourage all women, their partners, families, and caregivers, to visit the link below. It provides detailed information and a downloadable resource about The Rights of Childbearing Women. Through education and advocacy, we can continue to work toward a collective goal of normalizing pregnancy and birth, and empowering women to take the lead in this important and sacred endeavor.