Often times, pregnant women have a specific vision for how they want their pregnancy and delivery experiences to go. Yet once you go into the doctor’s office or hospital, it can feel as though you are subject to the actions and decisions of a medical system that doesn’t necessarily prioritize your desires first and foremost.
However, as a patient - and human being - you have every right to make your own choices about what happens with your baby and your body. The most important thing during your pregnancy is taking care of yourself and meeting your needs, and you should be able to make the choices that you think are best for you. So in honour of International Women’s Day and its accompanying focus on women’s rights, we’re outlining everything pregnant women and new mothers need to know about their rights in maternity care and pregnancy.
Why Is it Important to Know Your Rights?
When we think of human rights, we tend to think of various subgroups of people based on categories such as race, gender, sexuality, nationality, and religion. This is because basic human rights are, unfortunately, often denied to people on the basis of these identities. However, one group’s rights that are not discussed often enough is that of pregnant women. Yet the reality is that expecting mothers are a vulnerable population and the issue of a woman’s right to dignity, autonomy, and equality is as relevant as ever when it comes to how she is treated during her pregnancy and childbirth.
Tragically, expecting mothers are vulnerable to degradation and dehumanisation in the form of inadequate maternity care, invasions of privacy and disrespect of dignity, insufficient pain relief or pain relief (or other procedures) given without consent, unnecessary or unexplained medical interventions, and a lack of respect for their choices about the circumstances of their delivery. All of these constitute a violation of human rights.
It is also important to consider intersectionality in this context, as marginalized and vulnerable groups such as pregnant women of colour are more likely to have their rights infringed upon. For example, during the Coronavirus pandemic, pregnant Native American women have been disproportionately singled out for COVID-19 testing, being forcibly separated from their newborns while awaiting results, something no new mother should be made to go through.
Notably, one of the most important steps in protecting one’s rights is knowing and understanding what they are and what one can do if and when they are close to or have been violated. By knowing your rights, you can not only avoid preventable complications or birth trauma and improve the health of you and your baby, but you can also assure that you will have the pregnancy and delivery experience that you want, something you are wholly entitled to.
Basic Rights for Mums and Mums-To-Be
So, that being said, what exactly are the rights you have as a mother and mother-to-be?
The Right to Choose a Maternity Care Provider
Under Article 2 of the European Convention, the state is required to provide access to basic life-saving health services, including maternity care. Not only does every woman have the right to maternity care, but you also have the right to choose who will be providing it for you. According to Bonita Katz, president of the International Childbirth Education Association (ICEA), "Every person has the option of choosing their caregiver and changing their caregiver at any point in time.”
The Right to the Best Available Care
In addition to having the right to receive maternity health care from the provider that you choose, you also have a right to the best available science-based care. As the Health Policy Project’s Charter listing the universal rights of childbearing women says, “Every woman has the right to healthcare and to the highest attainable level of health.”
The Right to Make Your Own Choices
If you’ve ever felt unsure of whether or not you are allowed to make choices such as having a homebirth or breastfeeding immediately after giving birth, the answer is a resounding yes. You have every right to manage your own pregnancy and birth as you wish. Article 8 of the European Convention guarantees the right to private life, including the right to physical autonomy and integrity.
This means that nobody can perform any medical procedure on you without your consent and that you are entitled to sufficient, objective, and unbiased information to help you make informed choices. If you wish, you are even allowed to decline any medical care at all. The bottom line is that the European Court of Human Rights has declared women have the right to make choices about the circumstances in which they give birth. Home birth, water birth, hospital birth - whatever you prefer, you have the right to enact it.
The Right to Have a Support Partner During Pregnancy and Birth
No woman should have to be alone during the trying experience of childbirth if she doesn’t want to and, in fact, one of your rights is that you can have a partner present for your delivery - even during COVID-19. After all, being alone during delivery increases a mum’s stress, which has a negative effect on labour and the postpartum experience. No woman can be forced to be subject to this stress against her will.
The Right to Equal Care
As we mentioned above, human rights are a complex issue, with certain marginalized groups having their rights questioned and violated at a higher rate than others. That being the case, a tremendously important human right is that of the right to equal care, meaning, as the Charter puts it, “Every woman has the right to equality, freedom from discrimination, and equitable care” during pregnancy and childbirth. Under no circumstances can a woman be treated differently or discriminated against on the basis of her race, nationality, immigrant status, sexuality, religion, age, disability, incarceration status, or genetic information.
Not only does a pregnant woman have rights in the medical system, but she also does in the workplace, both during pregnancy and post-partum. Pregnant women can not be discriminated against in the workplace and, on the contrary, they have the right to have their health and safety protected by their employer. This means that, in the European Union, pregnant women cannot be fired on the basis of their pregnancy, cannot be made to work night shifts, may take time off work for prenatal classes, are entitled to maternity leave for an uninterrupted period of at least 14 weeks before and/or after delivery, and are entitled to return to the same job after their maternity leave.
EU law also forbids discrimination against breastfeeding mothers and employers are obligated to ensure their well-being. This means that working conditions that could harm a breastfeeding mother must be adjusted and employers are required to provide suitable facilities for breastfeeding mothers to rest in as well as adequate rest time and meal breaks.
Learn more: A guide for breastfeeding mums returning to work
How COVID-19 May Change Regulations
Of course, many things inside (as well as outside) the medical system have changed as a result of the COVID-19 pandemic, and it is important to know how your birth rights are impacted, if at all. First and foremost, according to the World Health Organization, "All women have the right to a positive childbirth experience whether or not they have a confirmed COVID-19 infection."
Despite the fact that fewer people can be allowed to enter hospital rooms because of Coronavirus, most facilities still permit one support person to be with a mother during childbirth, and some permit a doula in addition. However, a support person with any symptoms of COVID-19 or a positive test for COVID-19 within 10 days is not allowed to physically attend labour and birth. That being said, they (and others) can be a part of a mother’s labour and delivery via video. Mums are still permitted to be with their baby after delivery for skin-to-skin contact and can breastfeed even if they have or had COVID-19, which data shows can not be transmitted through breast milk.
How to Advocate for Yourself and Protect Your Rights
We hope it’s clear by this point of the article that you are unequivocally entitled to several inalienable rights as a pregnant woman, including respectful maternity care and making your own choices regarding your body and pregnancy. In an ideal world, this would not need to be said because these rights would be understood and respected by all. Yet the reality is that women do have their maternity care rights violated. So what can you do to ensure that you will receive all of the dignity, autonomy, and humanity that you are entitled to? Here are some steps you can take.
Know Your Rights
As we mentioned above, the first step to protecting your rights is knowing your rights. After all, knowledge is power, and you can’t safeguard your rights if you don’t know what they are. The more you can learn about women’s rights, maternity care, and pregnancy, the more informed you will be, which will help you to advocate for yourself.
In the interest of becoming as informed as possible, we encourage you to attend prenatal classes and mother’s groups, take childbirth courses, share your experiences with other mums and learn from their experiences, and do research about topics such as pregnancy, delivery, breastfeeding, skin-to-skin, and so on. Online antenatal education courses can be a great resource to help you learn about and prepare for the pregnancy journey, the experience of giving birth, and your first few weeks with your baby. Knowing what to expect will help if you’re anxious about being pregnant, as so much of the time, anxious pregnancy symptoms are related to a lack of information.
Learn more: Pregnancy and COVID-19: Dealing with stress and anxiety
Plan Your Birth
Another step that will serve you significantly in maintaining and protecting your rights during pregnancy is having a plan for how you want your pregnancy and birth experiences to go. Researching the available options and creating a birth plan that reflects your chosen birth experience will give you and those around you an understanding of what you want and how to treat you and what kind of care to provide you with. After you put together your birth plan, you can contact hospitals and doulas in order to confirm that they will be able to carry out your wishes. If you find that there is any pushback, you can insist. And if the healthcare provider is unable to offer what you are seeking, you’ll have time to find a different one who will be able to do so.
Communicate Your Needs
Part of why a birth plan is so important is that other people will not be able to meet your needs if you do not communicate them. While it should go without saying that you should be treated with respect and dignity and that you should not be made to undergo any procedures that you do not want to or to be separated from your baby after you give birth, it is possible you will find yourself in a situation in which these things are put into question or your desires are otherwise not being met. To avoid this as much as possible, communicating your needs with hospitals, partners, and family ahead of time is highly recommended. And if you are unhappy with anything that you experience, making your feelings clear and requesting a change in treatment is not only okay, it’s your right.
Use Your B.R.A.I.N.
If you’re anxious while pregnant about the possibility of making a “wrong” decision during labour, there is a tool that can help you make informed choices about your healthcare during conception, pregnancy, birth, postpartum, and parenting. It’s called BRAIN and it stands for Benefits, Risks, Alternatives, Intuition, and Nothing. These are all factors that you can consider when being asked to make a decision regarding your pregnancy.
Ask yourself: What are the benefits of making this decision? In contrast, what are the risks associated with this decision? Are there any alternatives to this decision? If so, what are they? Ever important, even if you do prefer to take a science-based approach: what does my intuition say? And what if I do nothing? What will happen if I wait it out? This tool is a way to get in touch with your own desires for your pregnancy so you can know what to ask for and take advantage of your right to make your own choices.
Your Body, Your Baby, Your Choice
The most important thing for you to take away from this article is that, on Women’s Day and every day, as a pregnant woman, as a mother, as a woman, and as a human being, you have the right to decide what happens with your body and your baby. Nobody can take that away from you. There isn’t a person out there who is more qualified to make choices about your body and your life than you are. No one can abuse you, disrespect you, discriminate against you, treat you without your consent, or come between you and the medical care you deserve and desire. Knowing this will help empower you to advocate for yourself and have the best possible maternity and childcare experience. After all, it’s your right.