Over the last two weeks, I’ve features articles that speak to some of the significant problems in perinatal health care. The system is very much in need of an overhaul. But until then, there are numerous ways that pregnant and postpartum women can advocate for more emotionally-attuned, empathic care.

I encourage all my pregnant and postpartum clients to draft a list of ways they would like their medical care providers to interact with them which are supportive of  their emotional needs and bolster their mental health. I refer to this as their Pregnancy/Postpartum Bill of Rights.  Yes, it’s strong rhetoric but the language is intentional as I often see women who are reluctant to advocate for themselves. They don’t want to be difficult, they don’t want to offend, they want to be “good patients.” Consequently, they feel disempowered and their emotional wellbeing suffers.

The Pregnancy/Postpartum Bill of Rights, is not about “being difficult” or challenging your medical team. On the contrary, it’s essential to work with providers who you trust and feel confident in. This is simply a tool to help empower you to speak up, state your needs, and take an active role in your care.

So, what exactly goes on a Pregnancy/Postpartum Bill of Rights? Below are some examples from my work with several different clients.

  1. Barring an emergency, I have the right to talk to my medical providers about decisions made during labor and delivery. I have a right to understand what is happening to my body and to have ongoing communication with my doctors and nurses.
  2. I have the right to ask questions when my doctor gives me directions about how to manage my diet. I can and should consider my eating disorder recovery in how I manage my nutrition during pregnancy and my doctor should too.
  3. I have the right to have my emotional needs considered throughout my pregnancy. I can prioritize my mental health and wellbeing and my providers should too.
  4. It is my right not to breastfeed, and to ask for my postpartum care team to support me in that. I can also ask them to take my baby to the nursery if I want them to.
  5. I can ask for extra support and reassurance during this pregnancy from my medical team. I am allowed to ask for sensitivity around my history of loss. I am not being difficult if I need extra appointments to feel reassured that my baby is O.K.

I highly recommend sharing this list with your medical providers, partner(s),  and anyone who is supporting you during pregnancy, labor, or postpartum. If you find it difficult to assert your rights with your treatment team, you may find it helpful to rehearse what you’d like to say beforehand, or have your list with you to refer to during all appointments. It may also be helpful to engage a partner or family member to help advocate for you.

Working with a birth doula is another wonderful way to have an additional advocate in the room who can help create space and time for you to have these conversations with your medical team. I also recommend if you are working with a large OB/Midwifery group to schedule a non-medical appointment with the provider you trust the most to discuss your rights and wishes.

A final note. While all women and families should be able to assert their “rights” around their pregnancy and postpartum care, we can’t overlook the role of privilege in having choices in your care. This is deeply problematic and representative of the many ways in which poor and marginalized women and families suffer in our current healthcare system.