With so many different procedures available, it can be hard to know how to make informed choices about birth interventions. A lot of times, people wonder if they even have a choice, when their provider recommends a certain intervention. For example, these are some scenarios that have occurred in my interactions with clients and other pregnant people, just in the last week:

• A woman who is 39 weeks pregnant goes to the hospital with contractions, but the hospital staff determine she is not in active labor. She calls and tells me that they are keeping her in the hospital overnight and will break her water and start pitocin the next morning. She is not sure why this was recommended. “Do I have to be induced?” she asks me.
• A pregnant young person is nervous about going to their next OB-GYN appointment because they have heard they “have to” have an internal exam, which they do not want.
• A client is in labor and sitting uncomfortably in bed, in the same position as when the nurse first set up the fetal heart monitor. When I suggest that she might be more comfortable standing up, she says she didn’t know if she was allowed to move.

All of these are common situations and conversations. Every day, health care providers make recommendations and follow procedures that matter to your birth outcomes and experience. It is important to understand your rights as a patient and a person giving birth, and to make informed choices about these birth interventions.

“Do I Have to Do This?”

The simple answer to this question is no. You are in charge of your birth. You don’t have to do anything you don’t want to. This is your birth, your body, your baby. While there may be valid reasons to follow a health care provider’s advice, you should receive all the information to make your own decisions. Even if you previously agreed to something, you have the right to change your mind.

In fact, the American College of Obstetrics and Gynecology, which is the professional body for OB-GYN doctors in the U.S., has this to say:

Pregnancy is not an exception to the principle that a decisionally capable patient has the right to refuse treatment, even treatment needed to maintain life. Therefore, a decisionally capable pregnant woman’s decision to refuse recommended medical or surgical interventions should be respected.

Sometimes, medical providers do not fully explain the reason behind their recommendations, or you do not fully understand their explanation. In order to be able to make the right decisions for yourself and your baby, you need to ask questions.

Knowledge Is Power: Understanding Interventions

When it comes to birth, an intervention is always your choice. An intervention is any action taken to change or improve a situation. Sometimes a timely intervention can improve your health or your baby’s and even save lives. Other times the situation is not a disorder, but rather a discomfort or inconvenience, such as a long, slow labor. Whether the situation needs “improving” enough to outweigh any potential risks or discomforts of the intervention is up to you.

Not all interventions are necessary, but neither are all interventions bad. You have the right to say yes and the right to say no.

Furthermore, you have the right to ask questions about benefits and risks, and to weigh them up for yourself.

And you have the right to keep asking questions until you understand the answers and have enough information to decide. This is the process of informed consent, and we use it to make informed choices about birth.

It’s helpful to learn about the process of labor and birth and common interventions. This way, you won’t have to make a hasty, uninformed decision in labor. A great way to do this is by taking a childbirth education class. You can sign up for one of our upcoming 2-hour classes and empower yourself to make informed choices.

Asking the Right Questions: Use Your BRAIN to Make Informed Decisions

Doulas often use the BRAIN acronym to help get the information you need to make informed choices. BRAIN stands for:

• Benefits: how will I or my baby benefit from the recommended procedure?
• Risks: what undesirable outcomes might occur if we agree to the recommended procedure? how likely are those outcomes?
• Alternatives: can we try anything else instead of or before this procedure?
• Intuition: what does your gut or instinct tell you is the right thing to do?
• Nothing: what would happen if we don’t do anything, or if we wait a while longer to decide?

You can use this thought process to gather the information that you need to make your decision. Weighing up the benefits, risks, alternatives, and intuition will help you make an informed choice about all kinds of birth interventions.

Building a Birth Team That Honors Your Choices

A great step you can take during your pregnancy is to build a birth team that supports your choices. The people you choose to be with you during this important time should respect your decisions, listen to your needs, and help you create the best birth experience possible.

Here are some ideas to consider when building your birth team:

Choose a Care Provider Who Respects Your Birth Preferences

Your care provider—whether that’s an obstetrician, midwife, or family doctor—will play a significant role in your birth experience. Have open, honest conversations about your birth plan. Ask questions about your provider’s approach to interventions and how they will support you during labor. Listen to their responses and how they made you feel.

• Did you feel like the provider listened to your concerns?
• Were they open to having an honest conversation about your preferences?
• Did they explain things in a way that you could understand?

If you don’t feel like this provider will listen and support you the way you want, look for someone else.

Seek a Birth Doula to Help Clarify and Support Your Choices

A birth doula understands that the process can feel overwhelming, and they will help you feel confident in your choices. When there are difficult choices to make, they are there to support you, and help you ask the important questions. They also offer guidance based on your personal birth preferences. This caring support will help you feel strong and empowered, ensuring you feel acknowledged and respected throughout your birth experience.

Involve Your Partner or Support Person

Your partner, family member, or close friend can be an integral part of your birth team. They should be fully informed, comfortable with your birth plan, and clear on how they can support you. You can also take a childbirth class together to build confidence and ensure they can help advocate for your needs.

Don’t Hesitate to Ask Questions and Set Boundaries

Assembling a birth team that honors your choices is not just about selecting the right professionals. It’s also about setting clear boundaries and ensuring your voice is heard. Ask questions and request information whenever you’re unsure or feel uncertain. Make sure your birth team understands and respects your boundaries. For example, you may have preferences about who should be in the room, how much information you want to receive, or what kinds of interventions you’re comfortable with.

As you approach your birth, remember that this is your journey—your body, your baby, your choices. It’s normal to feel uncertain at times, but you are never alone. You have the right to ask questions, seek the answers you need, and make the decisions that feel right for you. The right birth team can help create an environment where you feel safe, empowered, and heard. This experience is yours to navigate, and you deserve to have it unfold in a way that aligns with your values and wishes. Trust yourself, trust your instincts, and know that you have the strength and knowledge to make informed decisions about birth every step of the way. Your birth is an incredibly personal and transformative moment—embrace it with confidence and peace of mind.