You have the power to shape your birth experience. Labor can feel overwhelming with flashing monitors, new faces, and urgent decisions. Even with the best intentions from your care team, it’s easy for your preferences to be overlooked. Understanding informed consent means you know what is being proposed, why it’s necessary, your alternatives, and the potential outcomes of waiting or declining a procedure. Remember, you can change your mind at any moment.
You don’t need to know everything to lead your care effectively. Establishing a few reliable habits can help you slow the pace enough to make informed choices. According to the American College of Obstetricians and Gynecologists, informed consent and shared decision-making are the standards in obstetrics, emphasizing that your preferences should steer the process.
Here are five constructive, supportive ways to ensure your voice is central before, during, and after delivery. Each suggestion includes specific phrases you can use and actions your support team can take to empower you.
1. Start every decision process with three essential questions
Why it helps: Clear, direct questions help slow down the process and invite straightforward explanations, allowing you to make choices rather than simply complying. Try this: When your clinician suggests something, ask: What is the goal of this intervention? What are the benefits and risks for both me and my baby? What are my alternatives or what happens if we wait for 30 minutes? If time is tight, you could say, “Please give me the brief overview.” Informed consent, as defined by MedlinePlus, means your clinician explains the benefits and risks, alternatives, and potential outcomes of waiting or opting out, allowing you to decide. Use this phrase: “I want to know more. What is the goal, what are the benefits and risks, and what options do we have, including waiting?” Partner cue: Your partner can set the stage by saying, “We’ll use our three questions now,” and jotting down the responses in your birth notes.
2. Develop a consent script for each exam, medication, or procedure
Why it helps: Routine care can sometimes feel automated. A simple script ensures that consent is sought and verified every time, even for repeat procedures. Try this: Before labor intensifies, share with your team, “Please ask for consent before any vaginal examinations, medications, membrane sweeps, catheter placements, or monitor adjustments. Remind me of what you’re doing and why.” Use this phrase: “Before we proceed, please explain what you’re recommending, why it’s necessary, and what my choices are so I can give informed consent.” Partner cue: If someone approaches without prior approval, your partner can say, “One moment, please. We need a clear explanation of consent first.”
3. Create a “decision huddle” and establish a “pause word”
Why it helps: These huddles offer a structured way to regroup, while a pause word interrupts the flow during non-emergency situations. Try this: Inform your team that you will call for a 60-second “decision huddle” when a decision feels significant or rushed. Everyone should pause non-urgent tasks, face you, and one person will summarize the choices. Choose a neutral word like “yellow light” that indicates a moment to stop while a choice is made. Use this phrase: “Yellow light. Let’s gather for a decision huddle. Please summarize options A, B, and C, including what occurs if we delay.” Partner cue: Your partner can watch for any signs of urgency and call out “yellow light” if you seem unprepared.
4. Assign advocacy roles to your support team
Why it helps: Labor is intense, and having trusted individuals manage logistics allows you to focus on birthing and being heard. Try this: Before the big moment, assign specific roles to your support people. One might manage the environment (adjusting lights, music, and ensuring the door is closed), another could track your preferences and scripts, while another takes notes. Decide who will ask, “What does the monitor indicate, and how is my baby responding?” and who will inquire, “Is there a less invasive option?” Use this phrase: “Partner, your role is to confirm that consent has been requested. Doula, your responsibility is to suggest position changes or non-medicated strategies before any procedures when appropriate.” Partner cue: Keep a small card with questions and the pause word visible on the bedside tray.
5. Request real-time narration of care steps, especially during pushing and afterwards
Why it helps: Live narration positions you as an active participant, preventing unexpected events and ensuring your consent is reaffirmed during the third stage and the immediate postpartum phase. Try this: Ask your team to communicate directly with you rather than about you. Phrases like, “I’m going to check your cervix now if that’s alright,” “I recommend starting an IV and here’s why,” “Your baby’s monitor looks stable,” “I’ll guide your perineum now, would you like warm compresses?” or “After the baby arrives, we plan for delayed cord clamping; does that still sit well with you?” Use this phrase: “Please explain each step and confirm my agreement before proceeding with any actions involving me or the baby unless it’s an emergency. If the plan shifts, please inform me about the changes and their rationale.” Partner cue: During repairs or any procedures on the newborn, your partner can ask, “Could you clarify what you’re doing right now and what options we have for pain management or timing?”
Crafting a simple consent plan you can print
Birth preferences page: Create a page that includes your top priorities, your three questions, your pause word, and your consent script. Keep it easily accessible on the tray.
Daily check-in: At the change of shifts, request the new team to review this page. Say, “This is how we communicate quickly. Thank you for adhering to it.”
Postpartum follow-through: Maintain the same approach for newborn care, feeding support, pain management, and discharge decisions. Your voice remains paramount.
Common scenarios and example scripts
Vaginal exams: “I prefer exams only when the information will lead to a change in the plan. What will this exam reveal, and can we postpone it?”
Continuous monitoring: “What reasons support continuous versus intermittent monitoring in my situation, and will I have the freedom to change positions with either choice?”
Induction or augmentation: “What methods are you recommending, what are their benefits and risks, and what’s our strategy if my body requires additional time?”
Assisted delivery or cesarean: “Please walk me through the reasons for this choice, the immediate and longer-term considerations, and what support I will have for recovery. Is there any adequate time for us to review our options safely?”
Newborn procedures: “Please explain each procedure step before commencing. We would like skin-to-skin contact right away, and we will confirm the timing for vitamin K, eye ointment, and weighing.”
Labor is a collective effort. By establishing clear communication habits in advance, your team can connect with you more effectively and articulate plans in ways that resonate. You deserve transparent and compassionate care. Your voice matters in the delivery room; it is not an extra—it is essential.
