No is a Complete Sentence.

Let’s talk self-advocacy…

Lately I’ve received a lot of messages, and have seen questions on social media, where a pregnant person is asking for research and data to argue a point (or prepare to argue a point) with their care provider.  This was a huge mistake that I made during my pregnancy and my hope is to address this as simply as possible so that I can help others avoid unnecessary anxiety.

If we trust our care provider and are on the same page about our wishes from the very beginning, the likelihood of disrespect and confrontation is much lower.  This is why building a trusting relationship with our care provider and keeping an open line of communication is so important.  I find that there are two common reasons why many of us find ourselves in this defensive position: 

1. We never really researched and interviewed care providers to be sure that we were on the same page.  So many of us continue with our OBGYN as usual when we become pregnant without considering whether they hold the same values that we do about birth.
2. We’ve had a previously traumatic experience and have an underlying distrust of care providers. Unchecked, this can lead to iatrophobia, which is a fear of doctors that can cause anxiety and panic. 

No is a complete sentence.  It’s that simple.

Arguing your opinion is counter-productive and unnecessary. No is a complete sentence. Your care provider is there to answer your questions and provide information and support, NOT to convince you of anything.  But we are all human beings, and sometimes personal bias creeps into the equation, even when we have done everything in our power to create and maintain a healthy relationship.  So how do we prepare for those circumstances without living in fear or anticipation that it will happen or that we will have to fight or argue our point? 

There is a reason why this is such a common concern.  As humans, our immediate response to confrontation is fight or flight.  When perceiving a threat, we always react in one of these two ways, but just as I mentioned in this post about facing our inner tigers, sometimes all we need is to find our inner truth and know how to respond confidently.  Because some tigers feel very real but are only in our heads.  We have the choice to react or respond. 

So what do we do when we are feeling pressured or unheard by our care providers?  How do we respond without reacting?

• First, take a deep breath — bringing your attention back to the breath helps bring you out of that fight-or-flight reaction and grounds you so that you can respond appropriately.
• Ask any questions you may have, but if you already know your answer, “Yes” and “No” are both complete sentences.
• If you don’t feel heard, calmly reiterate that you understand your options, you’ve made a decision and you don’t wish to discuss it further.  This normally gets the point across.
• If you still don’t feel heard, ask the provider to make a note in your chart.  Whether you are saying “no” or you feel that symptoms aren’t being addressed or taken seriously, a care provider will almost always pay closer attention or take a more serious look if asked to document the encounter. 
• If you have done all of the above and the provider continues to disrespect your personal choice, calmly dismiss yourself and find a new provider. 

I want to stress that finding a new provider should be your very last resort.  And that brings us back to finding a provider you trust with your choices from the very beginning.  The provider-client relationship is the most important part of your pregnancy.  Just as I advise all of my clients to interview 2-3 doulas before making a final decision, I also suggest they interview multiple providers at the beginning of their pregnancy.  If you’re not sure about how to interview a care provider or what questions to ask, I have a printable PDF that can help you get started.

If you’ve experienced previous trauma and need more thorough communication throughout your experience, consider choosing a smaller practice where you have a better opportunity to get to know your provider during your pregnancy.  Tell your care provider that you have had negative experiences before and that communication and understanding are important to you.  Hypervigilance is a sign of anxiety, and if you find yourself in the position where you trust your provider, but are inclined to prepare for every possible situation where trust could be breached, this is something that needs to be addressed sooner rather than later.  If we don’t unpack our trauma, it will follow us into our births, especially if that trauma is care provider related.  Hire a doula, find a therapist who specializes in pregnancy and postpartum, and face your paper tigers now so that you can better recognize them as they are when you are in labor.