• Miranda Kelly

Communicating in Labour

The medicalization and colonization of childbirth practices has shifted the locus of control from expectant parents and families to medical professionals. Colonization has attacked our agency and literacy of our own health, bodies, and the physiology of childbirth. Pregnancy and birth present us with new opportunities to (re)claim sovereignty of our bodies and assert ourselves as decision-makers in our medical care.


There is no “one-size-fits-all” for birth. There is no right or wrong way to birth. Each person’s birth choices will be a personal decision based on factors such as:

  • past experiences with birth;

  • past experiences with medical care;

  • past experiences of trauma;

  • pre-existing and pregnancy-related health conditions;

  • cultural, social, and lifestyle factors;

  • geography, finances and access to care;

  • one’s relationship with one’s health care provider;

  • family;

  • knowledge about childbirth and options; and

  • support during labour and birth.


Your health care provider should provide you with the best available information on the benefits, risks and alternatives so you can make an informed choice. Informed consent is your right to choose or refuse medical treatment and/or interventions. You may also withdrawal your consent at any time if you change your mind.


Practicing assertive communication when speaking to health care providers can be challenging at first, but is worthwhile to expectant parents as informed decision-makers in their own care and that of their child(ren). Assertive communication skills are helpful not only through pregnancy and labour, but for the rest of our lives.


Sometimes, it can be hard to find the words to express yourself in a clinical setting, especially if you are experiencing pain or stress. Here are some words that may help you:


Preferences

  • "I would prefer..."

  • "I want..."

  • "Here is my birth plan."

  • "I want to try..."

  • "I want to avoid..."

  • "I'm comfortable with..."

  • "I'm not comfortable with..."

Saying No

  • "No"

  • "Not right now"

  • "Stop"

  • "I need more time to decide"

  • "I'm not ready"

  • "I need time to discuss with my partner/family/support person"

  • "I hear you. My answer is no."

  • "I do not agree."

  • "I disagree."

  • "I do not consent."

  • "I withdraw my consent."

  • "I refuse."

"I feel..."

  • "forced"

  • "bullied"

  • "unsafe"

  • "pressured"

  • "coerced"

  • "threatened"

  • "vulnerable"

Clarification

  • "I would like more information"

  • "I don't understand"

  • "Please explain it again"

  • "Can you repeat that?"

  • "What are the benefits?"

  • "What are the risks?"

  • "What are the alternatives?"

  • "I would like a second opinion."

  • "I would like to speak to a different nurse/doctor/midwife."

Body Language

  • Shake head

  • Refuse to move

  • Ignore the request

  • Use silence

  • Make eye contact (if this feels okay to you)

Rights

  • "This is my choice."

  • "I have the right to..."

  • "I understand and accept the risks."

  • "I will sign an "Against Medical Advice" waiver"

  • "I would like to speak to the Indigenous Patient Liaison."

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