Advocacy during labour and the postnatal period.

Birth - it’s perhaps the greatest and most transformative moment of your entire life. It’s also the most difficult and frightening you may have ever experienced.

Whether you give birth in the hospital, at home, an operating room, or in a warm bath or shower, labour and birth can be an arduous process. Almost inevitably, there will be choices to be made. Also, inevitably, it’s probably not going to go exactly as you had imagined, planned, or expected.

You have the right:

To be treated with dignity, cultural sensitivity and respect at all times. To choose your place of birth. To choose your caregiver/s and to change your caregiver/s at any time. To choose who will be present at your birth and to ask others to leave.

Compassionate, respectful care comes from many kinds of providers - midwives, LMC's, obstetricians, family physicians and nurses and in settings including hospitals, birth centers and your home. But, according to a recent international survey, up to one third of women experience some trauma during birth, which means that at some point during their labour, they felt that their emotional well-being or even their or their babies lives were under threat.

And according to another report, one in four women who underwent either an induction or a C-section reported experiencing pressure from a health professional to do so. While some birth trauma is created by poor care, some trauma “just happens”, even with five-star care.

Why Advocacy Matters

Birth may be the most natural process in the world, but that doesn’t mean there aren’t difficult choices to make. Questions about where you want to give birth are likely to be settled before the baby comes.

Other decisions made need to be made during your labour.

Knowing how to advocate for yourself ( and having your support team advocate for you too) equips you all with the tools you need to protect your right to change your birth plan when and if you need it. At the same time, advocacy ensures that you are not pressured to submit to procedures you don’t want, procedures that you feel might not be best for you or your baby.

Informed consent

Informed consent means that you will be informed of and be given the opportunity to understand whatever is happening to both you and your baby. The people who have the medical knowledge and clinical experience should always give you all of the information you need, so you can make an informed decision about your care. This goes for all of the aspects that surround pregnancy and birth, from whether or not to undergo certain testing, accept an induction, or consent to interventions during labour. Informed consent is not “Hey we want to do this, is it ok? It’s more of “We recommend this and here is why, what is your decision?” It's your right to ask questions and it's ok to ask questions.

Birth trauma is often considered to be a physical injury, but it can also be psychology. It could be not being listened to, respected, or communicated with, and most women will say it's both.

A lot of the women I speak with perceived that this was often an issue with understaffing or burn out, rather than blaming hospital staff or their LMC's.

Some mentioned that if their LMC or health care provider had just spent a little more time checking that they were OK, or asking if they had questions, it would have made all the difference to starting a conversation.

Trauma is subjective. Some women will have life-threatening births and go on to be fine, while others may have what looks like a straightforward birth and experience distress.

Own your health and listen to your body

• You know your body better than anyone else, so listen to it!

• If something does not feel right, speak up

• If you are concerned, it's ok to seek a second opinion

• If you receive inadequate care, make a formal complaint

• Pay close attention to your body, your baby, and how you feel at all times - especially during postpartum and ask for help and during this time, it’s especially important to advocate for yourself by calling your healthcare provider immediately if something doesn’t feel right.

Feel free to breakup at anytime

• Breakups are never fun, but making sure you’re getting the experience and care that you want and deserve is far more important

• If your medical team is not making you feel heard, if you don’t trust their abilities, or if the chemistry is not there, it is more than okay to find someone else

• Remember: you should never have to settle when it comes to medical care

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Birth Trauma Aotearoa is a Registered Charitable Trust working in the birth trauma space across Aotearoa New Zealand.
We work towards an Aotearoa where all women, birthing people and their whānau have the opportunity to experience safe, respectful, nurtured, birth and where whānau have easy access to effective and equitable support and treatment following trauma and injury.