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  • Emily McMichael

Advocacy During Labor and Birth: I'm Pregnant! Where Should I Begin?

Updated: Jul 31, 2022


You're pregnant! Congratulations! After finding out the good news, your next thought was probably: "I should find a provider." Selecting your medical team for your upcoming birth is one of the first steps you can take towards having the birth you desire.


However, many people stop after this step. Some believe in leaving their birth story for the universe to create. This is a wonderful thought--the universe beautifully weaving together your birth story. But, unfortunately, so many birth stories are ones we would rather not hear. Why is that? Birth today is not a simple function of what nature has in store for you and your baby. There are so many players in the arena when we think about influences on your labor and birth: you, your partner, your preparation for childbirth, your medical provider, others on your birth team (e.g. doula, nurses, etc.), your birth place, and more. This reality is why advocacy during labor and childbirth is so important.


Okay, so back to choosing your medical provider. Check! One big step already accomplished when it comes to advocacy. Now that you've done that hard work, you have the rest of your pregnancy to see if this provider is a good fit for you, your family, and your upcoming birth. I encourage my students to view their time with their medical provider as an extended interview period (kind of like how a family might have a nanny for a week or two before officially hiring them to care for their children). Get to know your provider. Is this the person you want to be interacting with on one of the most important days of your and your baby's lives?


Some questions you might want to consider include:

  • How do they make you feel during office visits?

  • Are they rushing or spending their time with you?

  • Are they intentional about asking for your opinion and questions about things?

  • Do they thoroughly answer your questions?

  • Are their answers to your questions aligned with your ideas about your birth?

  • What is their cesarean rate? What about their episiotomy rate?

  • What is their VBAC success rate (if applicable to you)?

The visit where you will learn the most about your provider is the one where you discuss your birth preferences with them. More on this later. Understanding your birth preferences is one of the most important starting steps for advocacy during labor and birth.


And what should you do if your answer to any of the above questions is less than satisfactory to you? It's simple. Fire them! Okay, okay, that sounds a little extreme. But, really, you are hiring your medical provider (and paying them a ton of money, I might add). You can easily and simply switch providers at any point during your pregnancy (even during the last weeks or days). That may sound stressful, and it can absolutely be a challenge to get to know a new provider. But, I can promise you this: changing a provider during pregnancy is less stressful than attempting to birth your baby with a provider who makes you uncomfortable, doesn't support your choices, or who has an unnecessarily high cesarean rate. Having a medical provider on your side who supports you and your wishes for birth can make a world of difference during the birth of your baby. And once you find this medical provider, office visits will feel less like an extended interview and more like a time to build a relationship and prepare for your birthing time.


We have so much more to talk about when it comes to advocacy! Next up: Discovering your Birth Preferences (and why they matter when birth is unpredictable).


Emily McMichael, M.Ed., CD(DONA), AAHCC, HBCE, CLC, LLLL


Oh, and by the way, your body was made for birth.

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