Why You Need an Advocate at your Birth

You are great at researching, you know your options, you LOVE your medical provider, and you might even have your birth plan ready to go, so why would you need an advocate at your birth?

Labor Progress Depends on It
Childbirth requires a delicate dance of hormones that, if disturbed, can slow down or even stall the process. Stress and fear are very good at disrupting the birth processes. You might be thinking that you’re good at checking your emotions and that you won’t have any trouble controlling them. That very well may be true, but remember those hormones that keep labor going? They also cause emotions to be very raw making any kind of conflict seem impossible to navigate.

Provider Issues
Stop! Before you skip this part because you love and trust your provider, it’s important for you to know that the way your provider acts during prenatal visits is not a great way to gauge how they will be in the birth room. Also consider, if you’re planning to give birth in the hospital, you’re going to be interacting mostly with the on-shift nurses and could potentially be receiving care from a provider you haven’t met.
Issues that you might run into are:

• Advice not based on evidence.
• Being denied pain relief when it’s requested.
• A disruptive birth environment. An example would be nurses chatting about their private lives in your birth room.
• Continuously being asked the same question in hopes that you’ll change your mind.
• Complete disregard for your birth plan.
• Not allowing time to make decisions.
• Performing exams or other intervention without expressed consent.

I assure you, these issues are not rare, and happen to smart, educated, prepared people.

Postpartum You Will Thank You
Up to 45% of women have reported experiencing birth trauma according to a 2018 study (Read the full study here). This can result in postpartum depression, anxiety, rage or even psychosis. These mood disorders can quickly turn what was hoped to be a joyous and treasured time into a nightmare. 
Doulas, often utilized as birth advocates, have been shown to increase general satisfaction with the birth process (more info on that here). One could make the connection that higher satisfaction would lead to lower instances of trauma.

What Does A Birth Advocate Do?

A good birth advocate is one that can remain clear headed when things get emotional and uncertain and one that is not employed by the hospital.

The work of a birth advocate starts during pregnancy. Your advocate will make sure you know your options and that they know what you want from your birth experience. This way when your baby’s birthday arrives, your focus can be on giving birth, and you can know that your advocate has all of the information they need.

Once you’ve arrived at the hospital, and every time there’s a shift change your advocate will make sure nurses know what your preferences are. If a situation arises where choices need to be made on the fly, your advocate will ensure that you’re given the information, time, and privacy to make your decision minimizing pressure and coercion.

Lastly, your advocate can be your voice. In the case that you’ve made your wishes clear, your advocate can remind staff of your decision as many times as necessary and request that it be noted in your chart so it is on record.

In the event that something happens during your baby’s birth that went against your wishes, your advocate can help you navigate reporting a complaint to the hospital. While this doesn’t change things for you, it can help people in the future who may use the facilities you chose.

How To Find A Birth Advocate
Not all doulas will advocate for you. Many are transparent about this. Others, you’ll have to ask before hiring them. Ask what their philosophy on advocacy is, what their role is in these situations, and for examples of how they’ve advocated for their past clients.

At Birth Your Way, we help you to prepare for birth by helping you to build a birth plan that can be shared with your birth team, that way at your birth we already know your preferences and can help you reinforce what you've already shared with your team.
​
The Bottom Line
Having an advocate in the birth room can greatly improve your childbirth experience and ensure that your patient rights are being respected. Doing your due diligence can mean the difference between a traumatic birth and a magical one.
Megan Neal of Birth Your Way is passionate about advocating for her doula clients. Megan studied with Birth Advocacy Doula Training among several other organizations. She has experienced her own hospital and home births, and her ultimate goal is to help people have positive childbirth experiences and reduce their chances of suffering with postpartum mood disorders.