Communicating with providers can be hard. A lot of us feel like we need to just do what our doctor says, but we may want to make a different choice, or at least get more information from them. How can you say no to your doctor in labor?
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. 🩺 While I do have ALL that experience, when my doctor said she was going to check me from 28 weeks on, I just took my pants off and did it — even though I didn’t want to or even thought it was necessary. I couldn’t say no and I wish I would have….
I’d love to help follow you through your pregnancy and give you some helpful tips:
I also have a whole video on refusing exams:
Ok, so here are 5 tips to saying no to your provider that will help you communicate with ease!
PRO TIP: Remember your provider is just some very highly educated hired help — similar to your flooring contractor or your electrician. Their job is to do what you want and also educate you on what they think would be best. Look at your provider that way — and you’ll be good to go.
Ways To Say No To Your Doctor
Ask for More Time
Ask your provider what will happen if you delay this decision. Most often, nothing will happen (but providers may pressure you to make a choice so your labor can progress).
Now, if you see a flurry of medical help in your room and many nurses are doing lots of things, you may want to make a quick decision. This most often signals that things are more in mother nature’s control than yours.
That being said — most often you have some time to make a choice.
Pro Tip: Ask to use the restroom. Pregnant women always need to pee and while some thick-headed providers may roll their eyes, they’re going to let you (unless, as I said above it’s urgent). You can even ask the nurse to come in and help you and perhaps get some private thoughts from her as well.
Ways to say this:
Ok, that gave me a lot to think about, can I have some more time to consider it.
Is everything OK right now? Would it be OK if we waited to make this choice?
What would happen if we didn’t make this choice right away?
If you find that tips like this are helpful, I have an entire class full of tips that can help you get prepared for you upcoming birth in just a few hours (and do it anytime you want, it’s available 24/7). Grab this class before it’s too late right here.
Be Sure You Know What They’re Doing
I wasn’t sure how to phrase this — but the reality is that sometimes doctors don’t tell you what they’re doing — even sometimes til’ it’s done.
A big example is breaking water. Often they grab the amniotic hook when they do a vaginal exam and will say “Ok, I broke your water” as they’re doing it.
So, when you say it’s OK that they check your cervix, make sure you know what they’re doing down there. I know, I know — this shouldn’t even be a step (and good nurses will hold the amniotic hook until you say it’s OK) — but I just want you to be prepared for how some providers do things.
Ways to say this:
Are you planning to break my water?
What are your thoughts on stripping membranes (that way you talk about it in advance).
Is this just a regular check or something more?
Ask About Alternatives
When a doctor gives “informed consent” they’re required to tell you three things about the procedure:
- Risks — What could go wrong, or what could this cause?
- Benefits — What is the REASON they are recommending this course of action.
- Alternatives — What ELSE could you do (often this is “wait”).
And frankly, they should go over this for most things, including:
- Breaking your water
- Having an induction
- Cesarean sections (this one is required for them to chart)
- Starting any medications
But, often they don’t do it — or they do it in a hurried way that only lists a few benefits and doesn’t really dive into why they are recommending it.
Also, I find that most often they weigh heavily on the benefits of the procedure, may give a couple of risks and rarely talk about the alternatives? Why? Well… I think it’s human nature. They’re busy people and they feel that they are the most educated one in the room. I am probably over-simplifying that.
But, imagine you’re talking to a friend about a flooring guy you really liked, right? You might say something like “He was super prompt in the mornings, and his finished product is great.” You are really likely to say “Well, he was there right on time, and he did a great job, but the risk would be that he’s not as great for you — and I do have a list of other providers I didn’t use.” Right? It just doesn’t always come naturally — so they tend to do it in a way that is more natural for them.
Is this right? No, but I hope you can see a bit where a good provider is coming from.
The other reason? Most people don’t want informed consent. They literally want their doctor to just tell them what to do. I have seen countless providers give informed consent in the office to patients and the patient comes to the hospital and when we ask them why they’re being induced they say “I don’t know, my doctor told me to come here” — I have actually seen this with my own eyes where they schedule the induction in front of me and then the patient comes back with literally no idea what the provider said.
And frankly, I’m sure I’ve been that person. Often all they hear is “you’re going to have your baby” and the rest of the information is a blur.
Ok, so let’s talk about some ways you can say this:
Ok, that sounds like a good choice — is there anything else we could do?
Are there any different tactics we could try?
Is there anything else you might recommend?
Whatever you’re doing make sure you let them know a few things:
- That you appreciate their time. Remember this isn’t just the time in the room with you. Doctors spend a LOT of time in med school and even more currently doing research for the best methods of treatment via reading studies. Be mindful of this. While I like to compare it to your flooring guy — think of your doctor as someone who grew the tree, cut them down, cut the strips of flooring and then came to you. Be respectful of that. 🙂
- Make sure they understand that you’ve heard what they said. Something along the lines of:
Ok, I hear that you think it will speed up my labor, but I think I’d really like to wait. I sure do appreciate you coming here though, it made me feel so much better to see you.
In the hospital we often call this closed loop communication. While in a code someone might say please give epi .9 ML Hilary — and I’d give it and then say out loud “.9 ML epi given”. Meaning I’ve closed the loop.
When you let providers hear that you have heard the risks and the benefits it helps them feel better about your choice too. As I said above, a lot of the time people just hear one thing and the rest is a blur. When you close the loop they know you know and don’t need to educate any more.
BTW, it can be really comforting to already know a lot of your options, which is why people take a prenatal class like this one.
Just Do It?
You may have you heart set on xyz, but the provider is coming in and giving you new information. While you’re in their care they are always getting new information — things like:
- Vital signs — a fever or high blood pressure
- Baby’s vitals — is the heart rate going down with contractions
For instance, maybe you don’t want any vaginal exams, but they are seeing the baby’s heart rate go down deeply with each contraction and they’d like to make sure the cord hasn’t come out (this is called a cord prolapse). The only real way to do that is with a vaginal exam.
Once you have the new information you may change your mind.
Frankly, that’s the beauty of all of this, right? That you’re getting new information and you can change your mind when you feel like the risks outweigh the benefits (or vice versa).
Now, while these are my best tips for communicating with providers, I have a brand new video coming to The Online Prenatal Class for Couples all about communicating with doctors that will be put in there in the next few weeks. In it, I give real life examples of using language that helps you get the information you need, while also being respectful of your providers and also making your own choice.
I hope you’ll join me in that class, so you can be more prepared for your upcoming birth!
If you’re not quite ready for the whole thing, check out my free birth prep pack. It’s going to get you started on your road to childbirth prep!
- 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.