So you are planning a VBAC, waterbirth, intervention free birth, maternal assisted caesarean or other non-standard option. You’ve done your research and decided that this is the absolute best option for you and your baby. You let your care provider know that this is your plan…and you’re told no. “Sorry – but that’s against our policy” or “I’m not comfortable with that” are the most common reasons for a care provider to say no. You’re devastated. But take heart – you still have options!
1) You can go along with whatever your care provider says. The main benefit with this course of action is that you don’t have to argue or fight. You won’t have to worry about bait and switch. You’ll know exactly how your birth is going to go.
The downside is that you’ll know exactly how your birth is going to go – how your care provider wants it to! This means that you will miss out on what you want for your birth. Another downside is that the care provider will start to truly believe that how they want your birth to go is more important than how you want your birth to go. And it will make it harder for the next woman to argue for the birth she wants.
It's important to choose a care provider who supports the type of birth you want - otherwise you are likely to get the type of birth they want you to have. Image courtesy of Wikimedia Commons.
2) You can argue / negotiate. You can argue your point. Share research with your care provider and let them know that you are well informed on the topic. You can also share with them the AMA position statement on maternal decision making which is exceptionally clear about a woman’s right to make choices that her care provider is not comfortable with.
The negotiation option is probably the hardest and most emotionally draining. It leaves a lot up in the air and even if you reach an agreement you just don’t know if your care provider will stick to it. But you may plant a seed in their mind, encourage them to do more research on a topic or to start to think more about how to provide a better service for their clients.
3) You can simply smile and nod, ignore the issue and plan to show up and do what you want anyway. This has the benefit of not fighting throughout your pregnancy. It also means that you only need to explain yourself once. Unfortunately that once will be while you are in labour. Not an ideal time to be holding high level negotiations. Many hospitals will panic if you simply rock up and then go against policies without warning. And panic and birth don’t mix.
4) You can hire a doula to help you out. A doula can be just the boost of confidence that a woman and her partner need. A steady voice of reason – reminding you of your options, to ask questions, to follow your instincts. But a doula’s role is limited. She cannot talk to your care providers on your behalf and she can never give medical advice. A doula can’t protect you from a less than great care provider.
An independent midwife can be a great support. Image courtesy of Wikimedia Commons.
5) You can hire an independent midwife to support you. An IM can be a great help. Providing your pre-natal care thereby helping you to avoid the drama of the unsupportive care provider. She can help boost your confidence and if she has practising rights at the hospital can help you negotiate your birth plan and keep unsupportive care providers out of your birthing space.
The downside is that this option is an additional cost – I’d say in many cases it’s worth it, but the cost can be prohibitive for many families.
6) You can call Maternity Choices Australia (MCA) and ask to have a consumer representative come along and help you negotiate. MCA have developed relationships with most hospitals and can assist in reminding them of their obligations to respect your legal right to informed consent and refusal of medical treatment. They can help you to feel confident, know the right words to use and have the political knowledge to negotiate strongly and tactfully. A brilliant option for most women! The only downside is that consumer reps are people with personalities – it can be luck of the draw whether you “click” with yours and whether they are able to provide the assistance that you want.
7) You can change care providers. If you have hired a private obstetrician then you can simply un-hire them and seek the services of someone else. If you are in the care of a public hospital you can speak to the head of the ante-natal clinic and ask to be appointed someone who will support your birthing plans. If the issue is a hospital policy rather than an individual you may wish to refer to some of the points above. Or you may wish to hire an independent midwife and birth at home. Or explore the option of freebirthing.
The most important thing to remember when your care provider says no is that you don’t have to take it lying down. YOU are in charge. It is your birth after all. Your baby, your body, your choice and your responsibility.