You may wonder if there are things you can refuse during labor. You might have preferences about what you want to do, but you don’t want to feel like a jerk when you ask to do something different from what they normally do. Today I’m going to share some simple things that people often refuse in labor so you can learn how that type of process goes, and can make choices for yourself and communicate them respectfully with your healthcare team. I hope you find this article very helpful for your labor!
But first, how do I know all of this? Hi — I’m Hilary — The Pregnancy Nurse 👩⚕️. I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. 🩺 I have helped thousands of families make choices just like these (often these very ones) during labor. So, I’m an expert in making choices during labor. 🙂
What Can You Refuse During Labor?
Anything. There, I said it. At any point during your stay in the hospital you can refuse something. With that refusal, as with all choices, will come consequences. Some of those may be good or bad. It is important to understand the possible consequences before you make the choice.
One of the most important things you can do is to make an INFORMED DECISION. While a lot of people talk about informed consent, I think an informed decision is the most important part.
An informed consent includes:
- The risks of the choice — possible negative consequences
- The benefits of the choice — things that could be better because of the choice
- Alternatives to the choice — anything else we could do?
These should be given by your provider, and then it would be up to you to make that informed decision.
Pro Tip: Communicating with your healthcare team can be more intimidating than you might think. Which is why The Online Prenatal Class for Couples has an entire video on communicating with your team. It gives real-life examples that you can make work for your situation. Sometimes having words given to you helps!
Ok, so I’m going to give you five common things that people refuse in labor and delivery.
Remember, ANYTHING can be refused. We’ll chat about a few more at the end of this article as well.
Refusing to Wear a Labor Gown
The hospital will provide you with a hospital gown that you can wear during your stay.
Honestly, normal clothes would be REALLY hard to wear during labor (and would get REALLY dirty), which is why we provide a gown.
However, you might prefer to wear something else. A tank top, being naked, your own gown — there are clearly a LOT of options in this arena.
Risks of not wearing a labor gown:
- We may end up delaying care because of needing to get through your clothes (like, if you were wearing underwear or pants and the baby was coming out)
- You might get your own clothes very dirty
- We may have to cut the clothes you have on for you or the baby’s safety.
Benefits of not wearing a labor gown:
- You feel more comfortable in your own clothes
- You have the things that you want
- Possibly less irritation due to scratchy gowns or our laundy detergents
Alternative to Wearing a Gown:
- Wear your own clothes
- Go naked
- Change your mind and switch to a labor gown later
Obviously, I haven’t listed ALL the risks or benefits or alternatives, but that gives you a good idea.
Frankly, we won’t give you informed consent for the gown. But, if it’s something you’re considering not doing, talk with your provider at a prenatal appointment to see what they think.
I have heard a LOT of people on social media saying their hospital wouldn’t let them wear their own clothes in labor. Frankly, I haven’t seen this a lot. A lot of people may feel “pressured” to wear the gown because we have it laid out for them. However, it’s really just their for your convenience as most people (especially during labor) wear the hospital gown.
A lot of people switch to their own clothes after baby is born. Less fluids, I think that’s smart!
Pro Tip: One of the BEST things you can do if you’d like to refuse something that is routine is to talk with your provider about it early on. That gives you more time to more thoroughly think about the risks and the benefits of your choice. It also gives you provider a heads up (which can be important for some of these next ones).
This is a really important one to me, as a nurse. I actually have a whole articles on IV’s vs Saline locks that I think is a great read if you’re considering not having an IV — but this will also condense down that information for you.
Risks of not having an IV
- You could bleed out while they are trying to put one in you
- It could delay an emergency cesarean
- It could delay getting life-saving medications to you
- You can’t have an induction or an epidural without an IV
Benefits of not having an IV
- Feels less “medical”
- More easily able to move-about
- Less likely for infection
- Wait to put in the IV until you are in active labor
- Use a saline lock instead
One of the main problems with childbirth is that someone can be doing completely fine, and normal — and suddenly have a HUGE issue. We aren’t entirely able to guess who will have a problem, and who won’t. Which is why we REALLY like to have IV access.
If an IV is something that you are planning to refuse, please talk with your provider about it as soon as possible. They will really want to talk to you about the risks and the benefits of an IV.
BONUS INFO on saline locks: A saline lock is an IV (so, an IV placement is needed) that is not hooked up to fluids. Often I cover them with a covering so you don’t have to see them or have it snag on something, but is still there and available in case you need something. It is a fantastic alternative that helps appease medical needs, and your need for autonomy. Don’t miss that post on IV fluids during labor.
I also have a video that explains a bit more as well:
Pushing On Your Back
This one is harder since it really depends on each person, if you’re feeling tired, if you have an epidural, etc. I go into the whole thing on my post on why hospitals make you push on your back (which they don’t). But, this will give you an idea (although I’d read that other post if you have more questions)
Risks of not pushing on your back:
- In an emergency situation, providers are trained most frequently to do things while you’re on your back
- You will get tired holding yourself in other positions
- If your legs aren’t steady there would be a risk of falling in an upright position
- The nurse could hurt herself helping you into positions and keeping you safe
Benefits of not pushing on your back:
- Baby may be able to move and shift into a better position with a different maternal position
- You may feel more comfortable another way
- Pushing in several positions may help to find the best one for you
Alternatives to pushing on your back:
- Pushing on your side (great if you have an epidural or are tired)
- Changing positions every few pushes
- Squatting, or standing
I mean, there are a LOT of alternatives. And this doesn’t go JUST for pushing, it can be true during labor as well. In fact, labor movement is so important I created labor movement cards for The Online Prenatal Class for Couples. They’re SO helpful and have both visuals and tips for partners.
The main one on this one is, frankly, that your provider might not like it. I’ve had MANY providers roll their eyes when I have a patient pushing in a different position. So, talk with your provider ahead of time about your wishes (can I say that enough?).
Again, this one REALLY depends on your circumstances — which is why I have a whole post on refusing cervical exams that I think you’ll find helpful.
Risks of not having a vaginal exam
- You wouldn’t know if you’re dilating (or if baby is coming)
- You wouldn’t know if your cervix is out of the way so you can start to push
- You wouldn’t know if your labor is progressing
- You wouldn’t know if the hospital is the best place for you to stay (or if something else could be wrong and the pains aren’t contractions)
Benefits of not
- Less pain with the exams
- Less risk of infection with the exams
- Less trauma if that is an issue for you
- Delay exams for as long as possible
- Get an epidural to feel the exams less
This one is such a hot button topic on social media I actually did a whole podcast on refusing cervical exams:
A Note from The Pregnancy Nurse: I really don’t want to minimize any of these things you want to refuse in labor. I know that you may have specific fears centered around these things, but I have to take it from a scientific point to give you the best advice for you and your circumstances. Be sure to discuss with your provider your wishes and any reasoning behind them. It helps us understand each other better as humans.
The catheter is a tube inserted into your bladder to let your urine drain. I have a whole post (and a video on how they work) in this post on foley catheters that might be helpful.
Pro Tip: All tubes in the hospital are called catheters, in case you hear them talking about a catheter, there are a lot of them (even though most people think of a urinary catheter).
Risks of not having a catheter
- If you are unable to pee, your bladder could fill up which could cause issues with baby’s descent.
- During a cesarean section, a full bladder could more easily be nicked by a scalpel
- You can bleed more if your bladder is full and you don’t (or are unable) to pee (it makes it so your uterus can’t clamp back down)
- They may be unwilling to have a caesarean section or an epidural if you do not have a catheter
- Risk of walking to the restroom if you are in preterm labor or on magnesium sulfate
Benefits of not
- Less chance of infection
- No trauma to your urinary tract from the tube
- Not having to have a catheter (I am aware there is a lot of “ick” factor to this one)
- They may be able to put a tube in every hour rather than having one in your bladder constantly
- Get up on your own to the restroom
- Delay the catheter a bit
The catheter is used in many ways, so this really over-simplifies it, but hopefully it gives you some ideas.
Other Things You Can Refuse in Labor:
Again, as I said before, you can refuse LOTS of things (you can also refuse things AFTER labor in the postpartum unit):
- Making the choice to eat
- Not laying in the bed, but moving about the room
- Not having fetal monitoring on constantly
- Not having vital signs taken as frequently
- The epidural or pain medication
Those are all a bit more complicated, so again I STRONGLY suggest talking to your provider about them at your next appointment if it’s something you’re considering refusing.
And just because they are OK with it now, if you get into labor and are in a more high risk category (let’s say you have high blood pressure, or are being induced) it could change the risks and the benefits quite a lot (and you’d need to re-discuss it at that time).
Making an informed decision is YOUR responsibility. It is the provider’s responsibility to give you the risks, benefits and alternatives so that you can do what’s right for you.
Ways to ask for informed consent without feeing weird:
It can feel weird to ask for more information (but it shouldn’t). Here are a few phrases you can use to get more information in a casual way (and yes, I talk more about stuff like this in the provider communication bonus video in here)
- Is there anything else we could do instead? (this helps get the alternatives)
- What types of complications could come from that? (this helps understand the risks)
- What will that help? (this gets the benefits, although I find providers are BIG on providing benefits, less so on the other two)
Most often you do have time to make a choice. You can ask the providers to step out of the room, so you can discuss it with your partner. Most often if it is an emergency it will be really apparent with many staff in the room. You can always ask “is this an emergency?”
Why Don’t Providers Always Give Informed Consent in Labor & Delivery?
Frankly, for the majority of things, most patients don’t want it.
Think about it this way — if we truly gave informed consent for EVERYTHING it would be SO much talking on things like (this is especially at admission):
- Applying fetal monitors
- Getting a blood pressure
- Getting a temperature
- Checking your oxygen status
- Starting your IV
- Doing a vaginal exam
- Asking you personal questions for the admissions process
- Specifics to starting your induction
Most people REALLY don’t want it for EACH of those. So, if there are ones you want to know more about just speak up and ask. Nurses LOVE to talk and educate you. You’ll likely find out lots of information that can help you make future choices, the more questions you ask.
Remember, some people do NOT want to talk about things, and some people want to talk a LOT about things. And we have no way of knowing who is who unless they speak up for themselves.
Once we know, we can do better.
And once you know more about the labor and delivery process, YOU can do better. Which is why I recommend EVERY couple take a prenatal class. There’s no need to make big decisions like this on your own, get you partner involved too (not just a cheerleader, an actual team member). The Online Prenatal Class for Couples…
- Can be done in just a few hours
- Starts at just $35 (save another 10% with coupon code PREGNURSE)
- Is entirely done by an experienced and fun nurse who will keep you both engaged!
I love what Sarah M had to say:
“Hilary was great about explaining terms and not assuming everyone is familiar with medical/OB vocabulary. Her very approachable, down to earth personality made the course feel personal and easy to watch.”Sarah M. ~ Former student
And, if you’re not quite sure you’re ready for that full thing, check out my free prenatal class. It’s your first step toward becoming your own birth boss.
- About the Author
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A nurse since 1997, she has worked in various fields including pediatrics, geriatrics & hospice.
She has 20 years of labor and delivery experience in the San Jose, CA and Phoenix, AZ areas.