PNW Doulas

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Decision Making in Labor {Free Download}

"Tell your families to speak up! If we don't know what they want, we can't help them get the birth experience they're hoping for."


Those words from a L&D nurse are important for you to hear. The nursing staff wants you to speak up. They want you to ask questions, to clarify, to PARTICIPATE in your care. You're not annoying them or being of "those" patients by taking an active role in your pregnancy and delivery.

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It can be hard to focus during labor (or even during the often-rushed prenatal visits). We have a favorite way to slow down and refocus everyone in the room. This is a list of respectful questions that allow your support team to understand that you are seeking all the information you need to make an educated decision in the situation. You can download a PDF of the BRAIN list here.

What does this actually look like in the delivery room? A little something like this:


OB: "We're having a hard time keeping baby on the monitor. We would like to use an internal fetal monitor to get a better idea of what is going on."

Parent: "Can you explain the process to the monitor?"

OB: "This is a monitor that goes on the baby's scalp. It is placed during a procedure that is similar to a cervical exam. The monitor then stays on until the baby is born."


Parent: "What is the benefit to doing this?"


OB: "We have some questions on how baby is handling the contractions. This monitor allows us to get a constant read on how the baby is doing. Sometimes the external monitors slip away or pick up your heart rate instead."

Parent: "Are there any risks to doing this?"


OB: "Your membranes have not yet ruptured. To do this type of monitoring, we will need to break your water. That can increase the intensity of your contractions. It can also raise the risk of infection to the baby."


Parent: "Is this something we can wait to do? Is there another option to get a better idea of how baby is doing?"


OB: "This isn't an emergency. We would just feel more comfortable with a constant tracing of baby's heart rate... and we're not getting that currently."


Parent: "Can we have a few minutes to discuss it?"


OB: "Absolutely. Just call us back in when you're ready. Let me know if you have any further questions."


There are emergencies in labor. Sometimes there's not space for a full conversation- but there's always space to ask: "Is this an emergency or is there time for us to ask questions?"

Birth is not something that happens TO YOU.

Your labor and delivery is an event in which you are an active participant. Your questions and clarifications are an important part of that participation.