Having a high-risk pregnancy and being a woman of color, I wanted to advocate for my maternal care. Here are tips I learned that can help you feel confident and allow you to gain control as you get ready to welcome your baby into the world.
Few life experiences are as emotional or tumultuous as pregnancy and giving birth. From the pregnancy test to labor, women are poked, prodded, and filled with emotion as they try to anticipate what's happening next. Yet, they are expected to stay strong through it all—not just for themselves, but for the sake of their unborn child. To say remaining empowered is challenging would be an understatement.
Considering I had a high-risk delivery and the maternal mortality rate in the U.S. is concerning, especially for women of color, I was certainly on edge about pregnancy and the birthing process. Despite the nerves, I did everything I could to remain strong and empowered for both of my pregnancies by meticulously tracking symptoms, quizzing my doctors about my medical charts, and working out when I could to stay calm.
But there are many other things you can do to remain in control. Experts offer tips on remaining balanced and empowered through pregnancy and the early stages of postpartum.
During Your Pregnancy
Create a Birth Plan That Suits You
Identify and assertively communicate your needs and preferences for you and your baby at birth and delivery. Think in terms of what you want and expect, and who needs to know your preferences.
A big part of this has always been deciding how you want visitors to be managed at the hospital and once you get home. Yet as COVID-19 is forcing social distancing and hospitals are changing their policies, forbidding most support-networks from being in the delivery room, pregnant people won't be able to control this aspect much until the pandemic is over. But there are still other things you can control, like trying for a drug-free birth or having music in the delivery room.
Creating your own boundaries and guidelines may help you feel a bit more at ease during and after delivery. "It's not a contract because things change during delivery," says Keisha Wells, LPC, a perinatal mental health specialist based in Columbus, Georgia, and author of From Three Heartbeats to One: A Gentle Companion Offering Hope in Grieving Pregnancy and Infant Loss. "However, it's good to have those requests to further increase advocacy and your maternal health."
Learn Your Rights
Every pregnant person is entitled to certain rights when under a doctor's care. Gain an understanding of those rights and learn the appropriate times to exercise them. "Knowledge is power, and I encourage women to make informed decisions and not just say yes when lacking understanding," says Wells.
Read through the paperwork you are signing at the doctor's office so you can fully understand powers you do have. Pay attention to the policies and procedures of HIPAA—stands for Health Insurance Portability and Accountability Act—which are meant to protect the privacy, security, and integrity of your health information.
Every patient also has the right to a second opinion at any point in pregnancy—and you shouldn't hesitate to get one. "If you ever feel like your questions aren't getting answered, get a second opinion. If you ever feel unsure or uncomfortable for any reason, whether that's medical or even just energy- or vibe-related, get a second opinion," says LaTasha Seliby Perkins, M.D., a family medicine doctor in Washington D.C., who went through a high-risk pregnancy that included gestational diabetes and bed rest.
And know you are able to inquire about procedure costs and can contest recommended ones. Never feel obligated to blindly pay a bill, either—follow up with your physician and insurance company with any questions you might have on what you're being charged for.
Don't Be Afraid to Ask Questions
Always know you have a right to ask questions. Using your voice is essential at every stage of pregnancy and birth, and an important part of empowerment.
"If there is anything you are concerned about, ask questions," says Dr. Perkins. "At every appointment, ask what should be expected between now and your next appointment."
In addition, she suggests inquiring about medications, what are and aren't normal pregnancy symptoms, how you can prepare for delivery, and even who will be in the room if you have to have a C-section.
Get Support From Labor Advocates
There is support available to you during birth and after, and Wells suggests being proactive in identifying who can assist you. Doulas, midwives, mental health services, and social groups can all be beneficial when managing pregnancy—especially in the final weeks and preparing for the postpartum period.
"Based on the mom's needs or preferences during pregnancy and birth, doulas and certified-nurse midwives may be helpful as they serve as birth workers and coaches providing direct, hands-on assistance and comfort, from birthing positions and techniques to education on nutrition and exercise," says Wells. In the midst of the COVID-19 pandemic, pregnant patients can also find these services virtually.
Meanwhile, therapists are helpful in screening for perinatal mood and anxiety disorders and assisting in normalizing experiences in motherhood. Many therapists offer teletherapy, especially during the pandemic, and health insurers that didn't cover these services before COVID-19 are expanding to do so now. Keep in mind there are also therapy apps like Talkspace and Sanvello.
It's a good idea to locate these professionals as soon as you can so that they can be there during your pregnancy journey. You can find various groups and support services by asking your OB team for references or inquiring with your hospital or local gyms if they have a network of professionals or support groups in the area. Postpartum Support International and Therapy for Black Girls both provide a directory of mental health professionals who may be able to assist you in your perinatal journey.
During my first few weeks postpartum, I was fortunate enough to find a local mommy group at a gym, as well as a breastfeeding support group and a supportive lactation consultant, which felt like a personal lifeline. Considering life postpartum can be isolating, it felt good to have a group available to listen. They were especially helpful in rooting me on as I struggled with breastfeeding due to my son's tongue-tie. Again, you can always find this support virtually too.
Know Your OB's Team
It's possible your favorite OB may not be available when you go into labor. That's why it's a good idea to get to know the other members of the team to avoid a blind delivery. Read their bios online and schedule appointments with other doctors so you become familiar with everyone.
"As you get closer to the delivery, see if you can schedule appointments with each team member who will be on call around the time you are expected to give birth," says Dr. Perkins. "If you really like your primary doctor, keep your appointments with them and have the other doctors come in and say hello during the appointment."
Consider Taking a Birthing Class
Things like labor and lactation classes can be beneficial in boosting your confidence during pregnancy and trusting your body. During these classes you can learn things like relaxation techniques, pain relief options, and comfortable positions. You can also discuss any fears you have about delivery with the instructor.
Call your hospital to see if they offer birthing classes, and keep in mind, many offer virtual courses, especially during the COVID-19 pandemic. For example, Mount Sinai offers a nine-month interactive program covering childbirth, breastfeeding, and newborn care, while the Atlantic Health System offers a web-based program leading expectant parents through pregnancy, labor, medical procedures, and comfort techniques. Those who want to learn all about breastfeeding can check out a new virtual course by Milky Mama, a company offering lactation supplements and breastfeeding support, founded by Krystal Nicole Duhaney, a registered nurse and international board-certified lactation consultant. There are other online platforms that offer free resources to boot, including Kopa Birth and Lamaze International.
Even things like prenatal yoga can be helpful as it can assist with anxiety and endurance of muscles during pregnancy. You can also do these classes from the comfort of your own home through companies that offer online classes and even YouTube.
Focus on What Your Body Can Still Do
Dealing with limitations during pregnancy can be difficult. As a fitness enthusiast, I struggled with my inability to work out the way I preferred. Consistently being told "no"—from what I could eat, how I could travel, and how I could exercise—was extremely disheartening and made me feel powerless as I recognized the lack of control over my body after I gave birth.
Though frustrating, I found the easiest way to combat this was to focus on everything I could still do. Sure, I wasn't able to take pole dance classes anymore, but I was able to keep up with other hobbies, such as Zumba, yoga, and walks through the park, with my doctor's approval. Recognizing everything you are capable of can work wonders in reclaiming your power throughout the birthing journey.
Learn About Your Body
Becoming in tune with your body and knowledge of potential postpartum complications is essential to feeling empowered and advocating for your care. I spent hours seeking out information about potential issues prior to giving birth. Doing so enables you to better identify if something is wrong and act when necessary.
Wells urges mothers to learn about side effects and complications as well as perinatal mood and anxiety disorders. Some symptoms experts suggest you pay close attention to are high blood pressure, swelling, and headaches, all of which can be a sign of preeclampsia.
Though it was scary at times, it felt good arming myself with knowledge had it become necessary to fight for specific care and attention if something didn't feel right. Most importantly, I was reaffirming that my well-being remained in my hands.
Read Positive Birth Stories
On that note, spending so much time learning about the "what ifs" of pregnancy and preparing for the worst can be a bit of a downer. It's important to remind yourself of the positives that come from birth so you won't find yourself feeling discouraged. Despite all the concerns of complications, a smooth and uneventful birth is still possible. Uplift yourself by acknowledging those negative experiences from others, but recognize that it doesn't have to be yours, suggests Wells. There are a bunch of positive birth stories to read on Parents.com—settle in and read some here, here, and here.
During the Postpartum Period
Take a Shower
One of the most common things new moms complain about post-birth is the inability to take a shower between caring for a baby and exhaustion. However, a shower can give you a power boost. Taking a shower may seem like a no-brainer, but let's just say that when you look and smell good, you feel good, and that brings you that much closer to feeling empowered. Sure it's just basic hygiene, yet it's one of the simplest things you can do that can make you feel like you.
Celebrate Small Victories Postpartum
You may have struggled with getting Baby to latch right away or even with walking as quickly as you would have liked following that C-section. But don't forget to acknowledge the wins, no matter how big or small. Even simple things like changing a diaper flawlessly or getting Baby to sleep are worth celebrating and can help get you to the bigger achievements you anticipate. Highlighting those small victories can help you feel like a powerful force of nature. "We tend to want to accelerate everything postpartum," says Wells. "Give yourself grace; you're moving forward. Be proud of yourself and the work you've done."
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