Dear Doctor, L&D nurse and other hospital personel.....
Thank you for taking care of me during my labor and delivery. I wanted to communicate this information to you before I enter your establishment so that you may better serve me while I am there. All the signs on the walls say that this hospital's top concern is patient safety AND satisfaction. I am trusting that you as an individual are concerned about that also.
I have been pregnant for 9 long months. I am excited, scared and overwhelmed all at the same time. When I come in the door, please take that into consideration. I realize that I may be the fourth person you've taken care of today, but I really want a good relationship with you from the start.
This may be my first baby. I may have had a traumatic birth experience in the past. I could be a high need personality or extremely laid back. Either way, I will want your help and your support. I realize that when I come in, it is your job to get me through the admissions process which involves multiple questions. Please don't be upset if I wave at you to give me a moment or if my answers are short and curt. I am trying to work with my body and focus on my labor. I cannot possibly remember when I had my last tetanus shot, but I realize you have to ask and I will do my best to answer you when I can breathe. I will try to sign the forms, but I may have questions and they may just have to wait.
I want an natural birth. You may read my birth plan and chalk me up to one of the many women who come in saying this and end up getting the epidural anyway. I may be that woman, but please give me the benefit of the doubt. My desires for birth are extremely important. I don't get to do this day over.
I realize that there are medications available for pain and they are given to women all the time. I know that you see women use them frequently without issue, but I have researched the risks and the benefits and have determined that I will not use them unless the benefit outweighs the risk at that particular time. Do not assume I am trying to be a hero or trying to prove something to myself or others. I have deep convictions about why feeling the pain is worth it for myself and for my baby. If this is not a decision you made for yourself at your own birth, don't assume that you understand my mindset. I don't expect you to. I only ask that you respect what I am doing and be supportive.
I realize that every decision that is made affects my memory of this experience forever. I also realize that each intervention I agree to could and probably will lead to another. I will not take any decision lightly so please don't be offended when I ask for time to talk to my birth team or to just take in the information that I have been given. I am very aware that birth is unpredictable and that unexpected things can and do happen. I am open to changes in my birth plan. All I ask is that you present my options to me as the consumer and decision-maker. I do not want to be told what I am allowed to do and not allowed to do. At the end of the day, I will be paying the bill for this experience so just as you would not walk into a room full of your superiors and present them with your plan for their day, please don't do that to me. If you present my options to me in the spirit of informed consent, there should be no communication issues, and I am more likely to trust your judgement.
I do care about the health of myself and my baby. I would never want to jeopardize either. So when you come in to tell me that one or the other looks to be compromised, please be ready to present me with some data. Don't assume that I am being non-compliant when I question your recommendations. Simply explain to me clearly what the risks of the situation are and give me evidence based facts.
Speaking of evidence based, please don't act like I am a hippy earth mother just because I want to do things that ARE evidence based such as delayed cord clamping, eating and drinking freely while in labor, pushing in a position other than on my back, intermittent(not constant) fetal monitoring, no separation of mother and baby and skin to skin contact immediately. I realize you see a lot of tragic things, but unless there is a reason to assume my pregnancy and labor is not normal, I am assuming it is. Please support me in that. If you don't believe in evidence based practices, be ready to explain to me why that is. I have a right to know.
I may have some other members of my birth team besides my husband/partner. I may have a doula. I realize all doulas are different. You may have had a negative experience with one. But this is my birth and it is my right to have her there. I ask that you treat her with respect and if there is any issue with her behavior, please discuss that with me as I am paying for her services the same as I am paying for yours. Don't assume that my decisions have been influenced by her. The mere fact that I hired her should be a clue that I am a person who has done more than the average amount of research about birth. Since births where doulas are present have been shown to have better outcomes for mothers, I would think you would be completely on board. To my nurse, I have asked her to talk me out of pain medication. She has seen multiple women labor and knows that at some point I will probably ask for it. Do not assume she is torturing me. She and I have formed a relationship over the course of my pregnancy and I trust her. I have just met you and you do not know my deepest desires for this day. But she does. Please work together with her as part of MY team.
Lastly, if my birth plan changes and I end up with an intervention or a situation that I clearly did not want, acknowledge my disappointment. Validate my grief. Do not try to make me feel better by pointing out that I am safe and healthy and so is my baby. Of course, I am thankful for that. But my experience was important too, and it is normal to feel some grief over the loss of the birth I had hoped for. If you would just be sensitive to my feelings and support my process, then I will work through it much easier. Your acknowledgement of my disappointment will help me feel like I did all the right things and that you truly cared about my desires. I will be less likely to question myself and question my care providers if they do not dismiss my concerns. I may need to talk about the moments that my plan took a turn. I may need more details after the fact. Please give me that information. It is helpful to me as I move forward into motherhood. It helps me transition and adjust to the unpredictable role of "mom". I will feel more confident when you treat me with the utmost respect.
Thank you for hearing me. I hope that my birth will be everything I want it to be. I hope that you want that for me. I am on a journey, and you have been asked to come alongside me. Wherever that journey leads, I hope that we all walk away with a sense of satisfaction and of course, a healthy mom and baby.
