Speaking up


“Can you come and see me, pleeeease?”  Alison was sobbing down the phone. When I had seen her as an antenatal client she was strong, capable and pro-active about being prepared for becoming a mum. Now, she was vulnerable, teary and awash with post birth hormones. Being in hospital with ‘helpful’ people prodding her body was an experience we had discussed, but until you actually have somebody grabbing your breast and shoving your baby’s head into it, it can be difficult to realise how hard it can be to speak up and how easily this realisation can further undermine your confidence.  We are all conditioned that professionals are the ‘experts’ so even though it is your baby and your body when you are a ‘beginner’, being assertive, especially when people are trying to help you, becomes a whole new ball-game.

From the time you discover you are pregnant, you can find yourself the target of ‘helpful’ advice and you may at times have to assert yourself with family, friends and health professionals to get support for your choices around birth and parenting. But it is the intrusion on your bodily space that can be hardest to handle with dignity.

Friends and family can be comparatively easy to distract politely or with a bit of humour. If they insist on asking your baby’s name for instance and you don’t want to disclose this, you can respond with “we (use your partners name) want it to be a surprise.”  Or you can throw them off track by telling them the most ridiculous names you can think of. If their advice is more intrusive or about a more personal issue, you can say, “we don’t feel comfortable talking about this. Can we change the subject, please? And then bring up another topic.  Practising your assertiveness skills on family and friends during pregnancy can give you a head start for when you are actually in labour or have a new baby and you need to express your needs politely but firmly with strangers, including professionals.

Being assertive doesn’t mean being aggressive or telling people where to ‘shove it’ (not on my breast, please!). It is about asking for what you want and explaining how you feel without hostility: try saying, ‘I would like…’ ‘it would help if…’ or ‘I would prefer…’

After a visit with Alison and some reassurance, she was able to tell the nurses, “I would rather try attaching my baby by myself. Can you please just watch and see if he is attached properly.”   Kirsty, another mum who was distraught because a paediatrician had advised her to give her baby formula due to low weight gain was able to tell him, “I would like to see a lactation consultant before I resort to formula. Please can I have two weeks to see if we can change things around?” Of course, when he saw how determined the mum was to continue breastfeeding and that she was willing to have her baby monitored, he granted her perfectly reasonable request.

When you are dealing with professionals, although they deserve respect, you don’t have to accept everything they say as final and you have every right to ask questions.  Your birth plan can be a handy tool for discussion. It can also help to write down any questions that occur to you between check-ups, so that you remember to raise them at your next appointment. Enter all discussions at the same level as your health carer: for instance, if you need to ask questions, wait until you are at least sitting up and you are at eye level with your doctor. After all, it isn’t easy to ask questions when you are lying naked from the waste down with your legs spread and somebody you have just met is peering into your vagina! And, if you are feeling intimidated by a health professional, imagine them naked or in their underwear (or wearing a white sequinned Elvis suit if the thought of them in the buff brings on an attack of nausea).

Being assertive:

  • Write a list of questions before medical appointments.
  • Enter discussions at the same level as your caregivers – wait until you are sitting up before asking questions.
  • Role play with your partner or a friend – ask, “What is the procedure and what are the alternatives?” “This is important to me”
  • Sometimes it may be worth giving in on things that aren’t really important to gain something that really matters to you.