You can determine to have your labor, your way. Labor can feel like a swirl of monitors, new faces and urgent decisions. Even when everyone wants the best outcome, it is easy for momentum to take over and for the birthing person’s preferences to get sidelined. Informed consent means you understand what is being proposed, why it is needed, the alternatives, and what could happen if you wait or decline. It also means you can change your mind at any time.
You do not need perfect knowledge to lead your care. You need a few reliable habits that slow the moment down just enough for you to choose. According to the American College of Obstetricians and Gynecologists, informed consent and shared decision-making are the standard of care in obstetrics, and your preferences should guide each step.
Below are five practical, nonconfrontational ways to center your voice before, during and after delivery. Each one includes language you can use and a small step your support team can take to support you.
1. Open every decision with 3 quick questions
Why it helps: Clear questions slow things down and invite plain-language explanations so you can choose, not just comply.
Try it: When your clinician recommends something, ask: What is the goal of this intervention, what are the benefits and risks for me and my baby, and what are my alternatives or what happens if we wait 30 minutes. If timing is tight, say, “Give me the 30-second version.” Informed consent, as explained by MedlinePlus, means your clinician explains benefits and risks, alternatives and what may happen if you wait or decline, then you choose.
Say this: “I want to understand. What is the goal, what are the benefits and risks, and what options do we have, including waiting?”
Partner cue: Your partner can prompt the room with, “We are using our three questions now,” then jot the answers on your birth notes.
2. Establish a consent script for any exam, medication or procedure
Why it helps: Routine care can drift into autopilot. A simple script ensures consent is requested and confirmed every time, even for repeat checks.
Try it: Before labor picks up, tell your team, “Please ask for consent before any vaginal exam, medication, membrane sweep, catheter placement or monitor change. Remind me what you are doing and why.”
Say this: “Before we proceed, please say what you are recommending, why, and what my choices are so I can consent.”
Partner cue: If someone moves in without asking, your partner steps in with, “One moment, please. We need consent explained first.”
3. Create a “decision huddle” and a “pause word”
Why it helps: Huddles give you a predictable way to regroup. A pause word cuts through noise and creates space in non-emergencies.
Try it: Tell your team you will call a 60-second “decision huddle” when a choice feels big or fast. Everyone stops nonurgent steps, faces you, and one person summarizes the options. Choose a neutral pause word like “yellow light” that means wait while we decide.
Say this: “Yellow light. We need a decision huddle. Please summarize options A, B and C, plus what happens if we wait.”
Partner cue: Your partner watches for rushing and calls “yellow light” if your body language says you are not ready.
4. Assign advocacy roles to your support people
Why it helps: Labor is intense. Having others handle logistics frees you to labor and still be heard.
Try it: Give each support person a job before go time. One handles the environment (lights, music, door closed), one tracks your preferences and scripts, and one takes notes. Decide who will ask, “What does the monitor show and how is the baby tolerating this,” and who will say, “Is there a less invasive option?”
Say this: “Partner, your job is to confirm consent was asked. Doula, your job is to offer position changes or nonmedication coping ideas before procedures when safe.”
Partner cue: Keep a small card with questions and the pause word visible on the bedside tray.
5. Narrate care step by step, especially during pushing and after birth
Why it helps: Real-time narration turns you into a collaborator and prevents surprise. It also ensures your consent continues through the third stage and into the immediate postpartum period.
Try it: Ask your team to speak in first person to you, not about you. “I am going to check your cervix now if that is OK,” “Here is why I recommend starting an IV,” “Your baby looks well on the monitor,” “I am going to guide your perineum, would you like warm compresses,” “After baby arrives, we plan delayed cord clamping, does that still feel right.”
Say this: “Please narrate each step and get my yes before touching me or the baby unless there is an emergency. If the plan changes, tell me what changed and why.”
Partner cue: During repairs or newborn procedures, your partner asks, “Can you tell us what you are doing now and what the choices are for pain relief or timing?”
Putting it together: a simple consent plan you can print
- Birth preferences page: One page with your top priorities, your three questions, your pause word and your consent script. Keep it on the tray.
- Daily check-in: At shift change, ask the new team to read the page. Say, “This is how we communicate quickly. Thanks for following it.”
- Postpartum follow-through: After delivery, continue the same approach for newborn care, feeding support, pain control and discharge decisions. Your voice still leads.
Common scenarios and scripts
- Vaginal exams: “I prefer exams only when the information will change the plan. What will this exam tell us, and can we wait?”
- Continuous monitoring: “What are the reasons for continuous versus intermittent monitoring in my case, and can I change positions freely with either choice?”
- Induction or augmentation: “What methods are you recommending, what are the benefits and risks, and what is our plan if my body needs more time?”
- Assisted delivery or cesarean: “Please walk me through the indications, the immediate and longer-term considerations, and what support I will have for recovery. Do we have any safe time to consider our options?”
- Newborn procedures: “Please explain each step before it happens. We want skin-to-skin as soon as possible and we will confirm timing for vitamin K, eye ointment and weighing.”
Labor is a collaboration. When you set clear communication habits early, your team has a simple way to meet you where you are and to explain the plan in language that makes sense. You deserve care that is transparent and humane. Your voice is not extra in the delivery room. It is the standard.