Advocacy in Childbirth: How to Make Informed Decisions Without Fear
If you’re pregnant and starting to realize just how many decisions come with birth, you’re not alone.
Maybe you’ve already been asked about induction “just in case.”
Maybe you’ve been handed options that felt rushed, confusing, or overwhelming.
Maybe part of you wants to trust the system—and part of you wants to trust your body, too.
Advocacy in childbirth doesn’t mean being combative or difficult. It doesn’t mean rejecting medical care. It means being informed, respected, and supported in making decisions that align with your values.
Story Time…
One of my favorite advocacy stories is from a strong mama who navigated a medical induction with complete grace and strength. Her induction began with a bang when her body had a strong reaction to a medication called Cervidil (this is a common medication administered in inductions to soften and open the cervix). Almost immediately, her body began contracting so rapidly that the medication had to be removed. While this was definitely the best option, she was so disappointed because the only other option the doctor offered was Pitocin. I simply asked the doctor to give my clients some time to consider their options and make a decision.
While we talked and brainstormed, my clients’s body continued contracting. All of the sudden she was laboring beautifully with no need for further induction medication. Although her doctor was not the most encouraging or supportive, this mom simply said “I will revisit the conversation about Pitocin in 6 hours.”
And what do you know…that baby beat the conversation about Pitocin by a whole hour! Simply delaying further intervention by saying “Not right now.” Gave her the time and space she needed to have her baby.
At SoulSpark Birth Services, I believe advocacy is about creative solutions and effective communication. Advocacy is not combative confrontation. “Birth time is not battle time.” as one of my favorite doula mentors always says. Advocacy is about ensuring you feel confident, grounded, and heard—whether you’re planning a physiologic birth or navigating medical interventions.
What Advocacy in Birth Really Means
When we talk about advocacy in childbirth, we’re talking about three simple but powerful things:
1. Taking Ownership of your Autonomy
Advocacy begins with education and personal responsibility. Your average OB appointments are 5-7 minutes long. These appointments will not teach you everything you need to know about childbirth. Honestly, they barely scratch the surface. How much preparation and research did you do for your wedding day? For your home or car purchase? Are you ready to put this kind of time, energy, and preparation into your birth?
If you walk into childbirth without a solid foundation of education, you will find yourself floundering.
2. Asking Questions
You are allowed to ask:
• Why is this being recommended?
• What are the benefits and risks?
• Are there alternatives?
• What happens if we wait?
And really any other questions you can think of!! Curiosity is not resistance. It’s informed decision-making.
3. Having Your Values Respected
Every family has different priorities—physiologic birth, low intervention, emotional safety, trauma-informed care, flexibility, or a blend of all of the above. Advocacy means your preferences matter and your voice belongs in the room. It is what is required and ethical for your care team and providers to take these into account.
Informed Consent in Real Life
“Informed consent in birth” isn’t just a phrase—it’s a process.
True informed consent means:
• You are given clear, honest information
• You understand the benefits, risks, and alternatives
• You have the time and space to decide without pressure
How to Slow Down Decision-Making
Unless there is a true emergency (which is incredibly rare), most decisions allow for at least a pause. Even a moment to breathe and ask questions can make a difference.
Helpful Questions to Ask
• Is this urgent, or can we take a moment?
• What are my options right now?
• How does this affect my baby and my body?
• What happens if I choose something different?
Informed consent is not about saying “no.” It’s about saying yes with clarity and confidence.
Common Moments Where Advocacy Matters
There are many points in labor where families are asked to make fast decisions. Some of the most common include:
Induction
Understanding why induction is being recommended and whether waiting is an option. This is one of the most important decisions that you will make in your birth. The blanket induction usage in the US is astounding. It has even changed the average gestational age at which babies are born. And…it has not improved outcomes!
Pain Management
From unmedicated techniques to epidurals, advocacy means choosing what feels right for your body and birth. This will be so different for every woman, every birth, and may even change as your birth unfolds.
Positioning
Laboring and pushing positions can influence comfort, progress, and how supported you feel. Hint hint, staying in the bed on your is the last thing you should do while birthing your baby.
Continuous Monitoring
Knowing when continuous monitoring is medically necessary—and when intermittent monitoring may be an option. If you have not seen it, check out this NYT article about continuous fetal monitoring. It will really blow your mind.
Pushing
Understanding coached versus spontaneous pushing and what supports your body best. This will definitely differ depending on the pain management options that you use. There is a time and place for coached pushing, just like any other intervention. However, it should NOT be the norm, and it most definitely is.
Cesarean Conversations
If surgery is recommended, advocacy ensures you understand the reason, urgency, and what choices you still have for your experience. Cesarean birth IS birth. It deserves the same love, care, and respect that a vaginal birth does. If you live in Virginia, there is a wonderful new law that requires hospitals to allow doulas in the OR for cesarean birth support. NOW lets see that happen in MD and DC!
None of these decisions are “one-size-fits-all.” Advocacy creates space for personalization.
How a Doula Supports Advocacy
This is where doula support becomes such a powerful part of the birth team.
As your doula, I come equipped with many advocacy tools to ensure that your rights are respected.
Creating Space for Discussion
I help slow things down so you can process what’s being offered. Reminding the care team of your wishes and preferences, even if you are sleeping!
Translating Medical Language
Birth can feel like learning a new language in the middle of labor. I help clarify what’s being said so you can truly understand your options. We are experts at ensuring the nurses and doctors do not talk over you!
Helping You Feel Confident
Sometimes advocacy is asking a question. Sometimes it’s saying, “I need a minute.” Sometimes it’s simply trusting your instincts. I’m there to remind you that your voice matters. We are all conditioned to “be the good girl” and “follow the rules.” However, what we should be following is our intuition and inner knowing.
At SoulSpark Birth Services, advocacy is at the heart of everything we do.
We believe in:
• Non-judgmental, grounded, evidence-based support
• Honoring physiologic birth while fully respecting the role of medical care when it’s needed
• Supporting families through every path birth can take—with compassion, nuance, and deep respect
I serve families across Washington DC, Maryland, and Northern Virginia, offering education, emotional support, and steady presence during one of life’s most powerful transitions.
You don’t have to choose between trusting your body and trusting medicine. You deserve both.
Ready for Empowered, Informed Birth Support?
If you’re looking for thoughtful, compassionate advocacy in childbirth—support that centers your autonomy, your values, and your voice—I would be honored to walk this journey with you.
Whether you’re early in pregnancy or preparing for your birth soon, SoulSpark Birth Services is here to help you feel informed, confident, and supported every step of the way.
