Naked Truth: Bodily Autonomy
Bodily autonomy doesn't end when labor begins!
This might be my next tattoo…ok, maybe not. But this should be inscribed over the doorway of every hospital L&D room, every birth center and every office that cares for birthing bodies.
Can you imagine walking up to a random stranger on the street and rubbing their cute little buddha belly? No? Happens to pregnant bellies all the time. Along with the unwanted touching, you may also encounter unwanted testing, tools, opinions, bad birth stories, scare tactics, fear mongering and push back about your choices for your own body and baby.
Sadly, when pregnant, the power dynamic can be very tilted. We look to the experts to guide us through this pregnancy journey marked with big bellies and big feelings. We need a guide that respects us to make our own choices though. Yes, they have the training and expertise, but you have the fetus and the felt experiences of your body. Along with that, all of us, provider & patient alike, carry our biases, past birth experiences, traumas and life stories into the birthing space.
I want a bullhorn, a flashing, neon sign and a mountain to shout it from the hilltops – you can say no! You can say no to touching, any kind; fundal measurement, ultrasounds, internal exams. You can say no to tests, procedures, inductions, monitors, the nurse that doesn’t match your vibe, Pitocin, your doctor, your midwife, cesareans; basically interventions of any kind.
I don’t recommend you say no blindly or just for the hell of it, because let’s be honest, it can feel powerful to assert yourself. My favorite toddler tagline was, “You’re not the boss of me!”. So while that was true to some extent, I was just trying to assert my power in that situation the best way I could. Informing yourself about the many options of childbirth will help you to make the best decisions about your birth choices. And just so you know, it might be a no, and that’s ok.
Autonomy
autonomy (noun): freedom from external control; independence
Consent
consent (verb): to give permission for something to happen
Just to piggyback on autonomy. People have the right, pregnant & non-pregnant to decide for themselves what happens to their person. We give consent because it is a verb, it is an action, it is permission that we actively give to someone else. If they don’t ask for it, they don’t get it.
Testing, Tools & Touching
- Bodily autonomy means that we have the power to make choices over our bodies, without violence or coercion. In pregnancy & labor that extends to all of the many choices we can make about our bodies & our babies. Many people don’t realize that you may say no to anything that you don’t want. Your healthcare provider might present it as a must because it is routine, but that isn’t usually the case. If you choose a provider that aligns with your birth beliefs, you will naturally have a more positive experience if you are heard, respected and treated as an active member of the healthcare team, which you are, this is your birth!
Your body, your choice, extends to all aspects of reproduction, including gestating & getting babies out. Let’s explore your options – because you do have a voice to speak up for what you want & need, you just have to activate it.
I am not advocating that you refuse any and all of these items below. I am recommending that you understand your options and actively choose what you want for yourself instead of the default idea that all of these are necessary for everyone in pregnancy & birth. You can choose what you say yes to and what you say no to, just know that a no is an option and that you are making it in an informed fashion, free from violence or coercion.
Personal sidenote: I have experienced 4 different pregnancies & 3 unique labors based on how much power I was showing up with. I have experienced:
- doing all the tests without questions
- multiple unwarranted ultrasounds
- birth on my back in a bed
- birth on all 4’s on the ground
- refusing IV’s
- angry L&D nurses
- awesome L&D nurses
- kind and considerate OB’s
- hospital midwives
- independent, homebirth midwives
- ruptured ectopic pregnancy
- 1 salpingectomy (surgical removal of a fallopian tube)
- pregnancies with minimal testing
- pregnancies with no testing
- avoiding the glucose test
- an accidental unassisted precipitous birth
- the U.S. maternity system
- the U.K. maternity system
- immediate cord cutting
- delayed cord cutting
- throwing away placentas
- encapsulating placentas
- prenatal yoga to prep
- lots of walking while pregnant
- big babies
- lots of vaginal exams in labor
- amniotomy
- no vaginal exams in labor
- spontaneous breaking of my bags
- shitty birth support
- birth with a doula
- birth without a doula
- writing a birth plan
- avoiding birth plans
- an amazing partner / baby catcher
- hospital birth
- home birth
- water birth
I can reflect on each birth experience. Sometimes, I was giving away my power and sometimes I was standing in my power. I remember them. They are ingrained in my being. I vividly remember when I felt the most powerful in birth and when I didn’t.
Wombs are powerful. You are powerful. Own your birth – don’t give it away – use your power to decide that is best for you.
TESTING (pregnancy)
- any genetic testing to detect fetal abnormalities
- 1st trimester fetal ultrasounds to check placenta placement, guesstimate the estimated due date and measure your baby
- blood tests that screen for genetic conditions
- any other fetal testing like amniocentesis to gather more information
- glucose tolerance tests to screen for gestational diabetes
- non-stress tests close to term
- ultrasound scans in 2nd & 3rd trimesters to monitor fetal growth, check position of baby, assess the placenta and check amniotic fluid levels
- Group B Strep close to term
TOOLS (in labor)
- IV’s (especially if you aren’t choosing to receive antibiotics, Pitocin or pain meds – at the moment at least – one can always be placed later)
- continuous external fetal monitoring
- ripening agents for induction placed in or around your cervix
- balloon catheters placed in your cervix for mechanical dilation
- internal uterine monitoring with an intrauterine pressure catheter
- amnihooks to break the bags of water
- internal monitoring electrode on the baby’s head to check heart rate
- scissors to cut an episiotomy
- pain medications: IV narcotics, Nitrous Oxide and epidurals
- assisted birth tools: vacuum or forceps
- stitches post birth if it is a 1st degree tear
- cesarean birth
TOUCHING (pregnancy & birth)
- any touch, anywhere at any time
- vaginal exams
- vaginal exams
- vaginal exams
- still vaginal exams because they love to feel a cervix
- fundal pressure during birth
- rough fundal massage after birth
- if your pelvic area requires gentleness and an informed touch, relay that to your provider; most will kindly walk you through any touching that may be happening
- nobody has the right to touch your vagina in or out of labor, anybody that wants to do a vaginal exam to check your cervix needs to ask if it is ok with you first (and not with a gloved up finger with lube on it while they are asking)
Birth Advocacy
Naked Truth Sidenote: Arming yourself with birth information helps craft a birth vision/action plan/wishlist before labor begins. Sharing our wants and needs with our labor team prenatally is crucial.
When we enter the birth space, the power dynamic tilts even further. Labor is a very vulnerable time, and it is common to defer to the experts. Note that fawning & freezing are also part of the stress response and can make it difficult to stand firm in our decisions when stressed.
In birth, we float out of our thinking brain and into our primal birthing brain so it makes it harder to draw on this information. Labor support that advocates for you, even when you can’t, is one of the best labor tools we can have.
Allowing You
Repeat after me…only you can allow yourself. They cannot allow you to do or not do anything. Not if you have agency over yourself.
They cannot allow you to:
- eat or drink in labor
- move into positions that feel the best for your body
- remove the monitors
- forgo an IV
- use the bath or shower
- go pee
- set up the bathroom as your private birth cave
- make all the loud, howling, primal noises you want
- push on all 4’s
- hold your baby ASAP
- do skin to skin & let baby find the nipple
