When we speak about Maternal Health Awareness in this country, we know that strong self-advocacy can be an integral factor in improving outcomes. While it may be daunting to speak up in a medical setting, it is actually easier than you may think. As a birth doula, it is my goal to help teach these skills.

Below are some of my best tips:

  1. Think about the type of care you wish to experience and identify what you need in terms of communication, listening, information and resources from your care team.

When you take time to identify what you need you will be more prepared to take steps to find that type of care.  For example, if your provider always seems rushed and hardly gives time to your questions, you can start self advocacy by writing your questions down on a notepad and letting your doctor know you have written questions you need addressed at the end of the visit.  Women and parents who experience more supportive care in pregnancy and childbirth have more positive emotional and psychological responses to their birth experience.  

  1. Remind yourself that you have a right to respectful care and communication.  

Many people unknowingly devalue themselves and unintentionally internalize negative beliefs about self advocacy.  Some parents are afraid to be “high maintenance” or “difficult” patients for fear of irritating or angering their healthcare providers.  How you see yourself greatly affects your desire and confidence to advocate for yourself.*  You matter and your birth experience matters.  Asking your care provider to slow down, explain your choices and help you truly understand what is being recommended for you, is the beginning of informed decision making.

  1. Get educated on childbirth and on the way your birthplace routinely operates.  

Learning about childbirth and childbirth practices at your specific birth place will help you make more informed choices.  You will be more prepared for what is ahead of you.  Feeling safe is an important part of trauma prevention and a more positive birth experience.  

  1. Ask open ended questions! 

Unless you want a yes or no answer, asking open ended questions will help you learn more about why a procedure is being recommended and why certain interventions are offered.  Here are some examples of open ended questions:  “What are all my options?” “Can you tell me how you manage inductions in this practice?” “How much time do I have to make this decision?” 

  1. Get support! 

A doula or childbirth educator or community birth worker can be a great resource in self advocacy training that is tailored to your specific needs, especially if  you are in an unsupportive environment or when you have to find a new provider because of poor communication and care.  Sometimes the road block is not the care team, sometimes it can come from us and our own fears, cultural beliefs about patient doctor communication and how we perceive what it means to be a “good patient.”  In any case, training is out there and self advocacy can be learned in a supportive, personal way.  

*Source: Listening to Mother’s Survey Report 2013, Section 4 Choice, Control, Knowledge and Shared Decision Making


Barriers to Communication with Prenatal Care Providers We asked mothers if they had ever held back from asking their provider questions for any of three different reasons. Many indicated that they had because their provider seemed rushed (30%), because they wanted maternity care that differed from what their provider wanted (22%), or because their prenatal care provider might think that they were being difficult (23%).

Carmen Oates
Carmen Oates
Carmen is passionate about supporting women in childbirth, and captivated by the miracle of new life. Originally from Nicaragua, Carmen immigrated to San Francisco with her family when she was a little girl. Through her family’s challenges, she learned the power of supporting and being supported by others and comes from a family of strong, creative and resilient women who have inspired her to love people. She earned a bachelor’s degree in English from Santa Clara University and a master’s degree from the Wheaton College Graduate School where she studied spiritual formation. She has ten years of experience supporting births at home, in the hospital and at free standing birth centers. She is a DONA certified birth doula with extensive experience coaching families as they prepare to welcome their babies. Carmen is dedicated to helping families understand how to find family centered care, learn self-advocacy, become more confident in their decision making abilities and learn to value their role in creating a positive birth experience. She is also trained and experienced in postpartum follow up and debriefing difficult or unexpected birth experiences.