Medical Mistreatment of Pregnant People

You have the right to give birth with the support and in the environment that you choose. This can look different for everyone. For some people, giving birth in a hospital with an Ob/Gyn might feel best, but others prefer a birth center or at home with the support of a midwife. Exercising your right to the provider or environment of your choosing may come with its own challenges, but you have the right to change providers if you are not feeling supported.

To learn more about your options for pregnancy and birth, you can visit Childbirth Connection.

A birth plan lets your provider know in writing what kind of care you want to receive during labor and delivery. You do not need one, but some people find it a helpful tool to talk to their providers, understand all their options, and communicate their wishes to their provider, nurses, and staff in the labor and delivery unit. Your health care provider should follow your birth plan as closely as possible, but a birth plan is not a legal document that they must follow.

Your birth plan should include whatever YOU want. Everyone’s birthing experience is unique. It should include what you believe is right for you and important to you. You can also include what you do not want, such as an epidural, or that you would like to avoid a C-section if medically possible. When you create or talk about the birth plan with your health care provider, let them know what is important to you and ask what they can or cannot provide.

Some providers dislike when their patients create a birth plan or will ignore birth plans. If you don’t feel supported by your health care provider, you can think about changing providers to see who you might be more comfortable with. You can read about changing your provider below under If my health care provider won’t agree to explore a VBAC with me or support my preferences, what can I do?

If you have any questions about your options during labor and delivery, ask your health care provider for more information. And remember, you can always change your birth plan. It’s entirely up to you, so include as many or as few details as you’d like. There is no right way to create a birth plan. For a sample birth plan and outline you can use, see the one created by the American College of Obstetricians and Gynecologists (ACOG).

You should speak to your provider about your wishes because having a vaginal birth after a cesarean (VBAC) birth depends on many factors. Not all providers or hospitals will support a pregnant person having a vaginal birth after a prior cesarean delivery so start the conversation with your provider as early as possible. You can also call the office when you are searching for a health care provider to ask how they support VBACs before you schedule an appointment. You want to make sure that your provider has your medical history, so try to get any medical records from past pregnancies and births so that you and your health care provider can discuss your circumstances and options with your records in front of you. To learn more about VBACs, you can visit these resources:

• International Cesarean Awareness Network (ICAN)
• Evidence Based Birth Podcast
• American College of Obstetricians and Gynecologists

You can tell your provider that a VBAC is really important to you and you’d like to explore the option. You always have the right to change your provider, but if it is later in your pregnancy or if your pregnancy is considered high-risk, it will be harder to find a new provider.

You can make calls to different providers and offices and ask if they will see a new patient. And if there are other providers at your current office, you can ask to see them instead. Sometimes they will agree, but not always. It depends on your specific circumstances and how far along you are in your pregnancy. There may also be people in your community who have had a successful VBAC, and you can talk to them about their experience with their provider.

Anyone! Many people get support from family members, friends, or a significant other, but you can also have the support of a doula. A doula is a trained professional who can provide physical, emotional, and/or informational support before, during, and/or after birth. Doulas can help people have a healthy pregnancy, birth experience, and postpartum period. There are many ways a doula can be certified or trained. What’s important is that your doula has the values, skills, and experience that are important to you. Specifically, a doula can:

• answer questions you may have about prenatal care and postpartum care
• provide education and information around labor and delivery
• lessen the risk of legal intervention
• be present with you wherever you choose to give birth
• provide pain management techniques and support
• advocate for you during the birthing process; if this is important to you, be sure to ask the doula in advance if this is something they do

You can find a doula by searching online for doulas near you. Some health care providers may also know of local doulas or doula groups that they can recommend. Or people in your community can recommend a doula that supported them during their birth. For more information on how to find a doula, see below.

The cost for a doula varies. Some doulas offer payment plans or sliding scale services, and some offer their services for free in order to complete their certification requirements. Some insurance companies will also reimburse parents if they submit a claim. In a few states, Medicaid covers doula services. But in most cases, having a doula is an out-of-pocket expense. Contact your health insurance directly to ask whether doula services are covered. If you find a doula you like, but your insurance does not cover the cost, you should ask the doula about financial options and payment plans.

The postpartum period can be a challenging time and having support can be really important for a successful recovery. Your health care team should talk to you about the healing process, including guidance on how to take care of your body and reasons to call your provider or seek emergency care.

If you plan to breast- or chestfeed, you can ask for more information and request a visit from the hospital or birth center’s lactation consultant. Not every facility has a lactation consultant on staff though, so you should discuss this with your health care provider before your delivery date.

You can also ask for postpartum care supplies, such as pads, mesh underwear, peri bottles, dermoplast, ice packs, newborn diapers, formula, and wipes. Some providers also offer visiting services where someone from your health care team will come to your home to check on you.

If you do not feel supported by your health care team after you give birth, you have the right to ask them for the help that you need. But we know not everyone can or wants to do this. And sometimes, involving health care providers can create risk. You can also reach out for support in your community, such as a postpartum doula, a new parenting group, and/or a breast-or chestfeeding group. You can learn more below under Resources to locate doulas.

National 

• Ancient Song Doula Services – National birth justice organization working to eliminate maternal and infant mortality and morbidity among low-income Black and Latinx people. Provide resources and access to holistic doula care and services regardless of their ability to pay.

• Black Doula Locator – The Black Doula Locator is a resource pregnant or postpartum mamas to locate Black Doulas from around the country

• DONA International – A directory of DONA certified doulas throughout the country.

• National Black Doulas Association – A directory of Black doulas throughout the country.

• Doula Match – Nationwide Doula Look Up

• Queer Doula Network – A directory of queer full spectrum providers for queer individuals seeking support during reproductive journeys.

Local

• Atlanta Doula Collective – A team of doulas providing affordable labor support options for Black families throughout the Metro-Atlanta area.

• Birth Matters NYC – Doulas and resources in New York and New Jersey areas

• Black Doula Project – Doula services for black families in D.C. and Baltimore City

• Baltimore Doula Project – Community doula program that offers full-spectrum (birth, postpartum, and abortion) doula services for families in Baltimore City and County on a sliding scale
• Triangle Doulas of Color – Doula services and resources in North Carolina

• Sésé, Birthing Freedom – Bronx-based cooperative providing doula services, movement classes and educational workshops for people before, during and after childbirth

• American College of Obstetricians and Gynecologists Sample Birth Plan – Sample birth plan

• International Cesarean Awareness Network (ICAN). Offers information and support regarding the prevention of unnecessary cesareans and recovery from cesareans, including recovery from birth trauma.

• Prevention and Treatment of Traumatic Birth. PATTCh is a collective of birth and mental health experts dedicated to the prevention and treatment of traumatic childbirth.