Understanding Consent & Autonomy in the Birth Space

Informed consent means you have the legal and ethical right to understand all aspects of a treatment, medication, or procedure before anything is done to or for you. You also have the legal right to refuse any medical treatment, even if others view it as necessary or lifesaving.

Consent is more than just saying "yes" or "no". It's a conversation and collaboration between you and your care provider. It means you:

• Receive clear, full information about what's being suggested
• Are given time to ask questions
• Are respected in your right to accept, decline, or pause decisions
• Remain the ultimate decision-maker in your care

You have the right to change your OB, midwife, hospital, or birth center at any point in your pregnancy, even in the third trimester or close to your due date, if you do not feel supported, heard, or respected.

Your comfort, trust, and sense of safety matter deeply in the lead-up to birth. This right includes transferring care for:

• Personal reasons (such as feeling dismissed, pressured, or not emotionally supported)
• Cultural or spiritual mismatches (if you feel your traditions or preferences are not being honored)
• Medical reasons (such as your pregnancy moving from low-risk to high-risk, or needing access to specialized care)

It is never too late to advocate for the care you need. You deserve a provider and a birth environment that aligns with your values, respects your autonomy, and honors your unique needs. Even if switching means starting fresh, it’s often worth it to feel safe, seen, and empowered for the journey ahead.

Yes! you still have rights during labor. While changing your entire birth setting once labor begins is logistically more complex, you can still advocate for meaningful changes to your care experience, such as:

• Requesting a different nurse, midwife, or OB if the one assigned to you makes you feel unsafe, dismissed, or not listened to.
• Refusing any procedure, medication, or intervention that you do not consent to. Consent must be informed, voluntary, and ongoing—even during active labor.
• Asking for a second opinion or time to think before making decisions.
• Switching hospitals in very early labor if you feel your values and safety will be better supported elsewhere (this depends on timing, distance, and the medical situation).

You deserve to be treated with compassion, dignity, and genuine respect throughout your pregnancy, labor, birth, and postpartum experience. This means:

• Being listened to and believed. Your concerns, preferences, and intuition matter, and should never be dismissed.
• Receiving information clearly and without judgment. You have the right to understand your options, ask questions, and take the time you need to make decisions.
• Being free from mistreatment or coercion. No one should pressure, shame, or intimidate you into accepting any intervention or care that you don’t fully consent to.

Respect in the birth space includes honoring your body, your story, your voice, your cultural values, and your lived experience. If at any point you feel disrespected or unsafe, you have the right to speak up, request a different provider, or ask your support person to advocate on your behalf.

Labor and birth are not meant to be experienced alone. You have the right to be accompanied by someone who brings you comfort, strength, and emotional support—whether that’s a partner, doula, friend, or family member.

• In most hospital settings, at least one support person is allowed to be with you at all times. Many hospitals also allow a second support person, such as a doula.
• During public health emergencies (such as COVID-19), policies may change, so it’s a good idea to check ahead with your birth location about current visitor guidelines.
• You get to decide who is part of your birth team. This includes the right to ask someone to leave if their presence is not helping you feel safe or supported.

When a decision arises—big or small—the BRAIN acronym can guide you:

• Benefits: What are the benefits of this procedure?
• Risks: What are the risks (short- and long-term)?
• Alternatives: Are there other options?
• Intuition: What is your inner voice telling you?
• No / Not now / Nothing

Print it. Memorize it. Bring it. Use it.

It’s often hard to speak up in medical settings, especially during labor. Practicing ahead of time with your partner, doula, or a trusted friend helps build confidence and clarity. Try using phrases like:

• “Thank you. I need a few minutes to think.”
• “Are there any alternatives?”
• “This doesn’t feel right for me.”
• “I’d like to try something else before moving to that.”
• “What happens if we wait?”

Use realistic birth scenarios to explore conversations and strengthen your voice before the moment arrives.