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Things You Can Refuse During Labor

If you’re worried about having to accept medications and interventions during labor that you don’t want, this blog post is for you. We’ll go over all the things you can absolutely refuse during labor and why you can feel totally justified in doing so.

pregnant woman in hospital bed with wires and machines around her

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It makes me sad that I’m even writing this blog post today. The fact that we women even have to consider asking the question “what can I refuse during labor” suggests that there’s something very wrong with our healthcare system.

So while I will lay out all the things you absolutely can refuse during labor, let’s be clear right up front: this is YOUR birth, this is YOUR body, this is YOUR baby.

I don’t care how much schooling someone has had or how many births they’ve seen or what authority they claim. No one can force you to accept anything, especially during such a special, sacred time.

Hospitals do have policies. Doctors and nurses do follow strict routines. But they do NOT have the power to say you HAVE to do anything. 

So keep that in mind. You have rights. And you can and need to stand up for those.

With that said, let’s get to it. Here are all the things you can refuse during labor.

What Can You Refuse During Labor?

The list of things you can choose to reject during labor—even if repeatedly offered or recommended—is long. I’ll cover each thing briefly but for more detail, click through the links I’ll add in each section.

Cervical Checks

Both during pregnancy and during labor, you can absolutely reject cervical checks (also called vaginal exams). Cervical checks can provide some information, but that info only gives you a snapshot of where you’re at in any given moment.

How dilated you are or any other measurement found through a cervical check cannot tell you how fast you’re going to progress in the next hours or minutes. 

So whether cervical checks make you uncomfortable, you’re worried about infection, or anything else, you can refuse cervical checks.

READ MORE >> Understanding Cervical Checks During Labor: You Get to Choose

Induction

We’ve all been taught that the average pregnancy is 40 weeks. In reality, that number is somewhat arbitrary. Every woman is different and due dates aren’t often super accurate. So if you are offered an induction (or pressured to accept one…) because you are approaching or past your due date, know that induction is rarely necessary, if ever.

Induction can minimize some risks but it increases others. The main risk is the possibility of accidental prematurity—meaning your baby being born before they are ready because of induction.

Induction can take the form of an IV with Pitocin, pills or gels in your vagina, a membrane sweep, a foley balloon, or other methods. 

Whatever the method, you never have to accept it.

READ MORE >> Understanding Induction: Pros and Cons of Inducing Labor

Artificial Rupturing of Membranes (Breaking Your Water)

Sometimes a care provider will intentionally put a small tear in your amniotic sac in hopes that it will trigger (or speed up) labor.

Most researchers agree that this breaking of the amniotic sac does not consistently improve labor length or outcomes—and actually increases risk to the baby in some cases. So, obviously, this is something you can safely refuse.

Hospital Admittance If Water Breaks

While we’re on the topic of breaking waters, I want to make sure to explain something about the timing. Sometimes a woman’s amniotic sac will rupture spontaneously before labor begins.

Most of the time, labor will begin shortly and there is no risk in letting things proceed how they will, even if it takes a day or more.

Despite that fact, it’s common for doctors to put a time limit on labor once a woman’s water breaks. In most hospitals, doctors will want labor to begin (and probably finish, too) within 24 hours of the water breaking.

But time limits and stress never helped any woman give birth effectively.

If you go to the hospital after your water breaking, you’ll probably get hooked up to an IV with antibiotics, receive cervical checks, and maybe even be given Pitocin to induce labor.

You can refuse any and all of those things (which will talk about more later).

IVs

A lot of women wonder if they can choose not to have an IV during labor. This is a good example of the sticky situation women are in when they give birth in hospitals.

Technically, yes, you can refuse an IV. That said, it will probably be a bit of a fight. IVs are routine and provide the quickest way to give you antibiotics, liquids for hydration, and doses of Pitocin.

If you get an epidural or a c-section you will almost certainly get an IV so that you can receive pain medication and avoid dehydration and other complications.

So, in short, you can refuse an IV. But of all the things you may have to fight for, this might not be the highest priority.

Pitocin

Pitocin is a synthetic form of oxytocin, a hormone our bodies naturally produce. It is given during labor either as a form of induction or to augment (speed up and strengthen) labor.

Pitocin does strengthen contractions, but it also causes them to be closer together and longer. And those three things combined make contractions much more painful. Because of that, Pitocin is one element in what I call the “fetal distress cycle.”

When a woman experiences those painful Pitocin contractions, she’s much more likely to want an epidural. If she gets an epidural it will likely help with the pain, but it’s also likely to make contractions less effective. That begins the cycle.

More Pitocin is given to strengthen contractions but also makes them more painful, so the epidural is upped too. 

And the whole time, the baby is feeling it all. The extra strong contractions will likely cause a decrease in blood and oxygen flow to the baby which will be picked up by the fetal monitors. If the distress continues for long, the doctor will probably recommend a c-section.

Fetal Monitoring

In the hospital, it’s routine for a woman to have two stretchy bands wrapped around her belly: one to monitor the contractions and one to monitor the baby. These bands are usually left on throughout all of labor. 

While there is not inherent harm in wearing them, they can be uncomfortable. And they can cause problems in a roundabout sort of way.

We humans tend to see problems even when there may be none. That tendency is only amplified in doctors who are trained in recognizing and treating disease and distress.

If the monitoring systems show indicators of possible distress, doctors may jump to conclusions and intervene (with medication or a c-section) even when it actually wasn’t needed.

Plus, many women report that while wearing fetal monitors, nurses who come to check on them pay more attention to the reports from the machine than Mom herself.

The crazy thing is, the research shows that there is next to no benefit to using continuous fetal monitoring (which is what those stretchy bands do). In fact, continuous monitoring increases the likelihood of c-section and instrumental delivery.

It is better for mom and baby if care providers monitor intermittently with a doppler or other device.

You can confidently refuse continuous fetal monitoring knowing the evidence backs you up.

An Epidural

About 70% of women use an epidural during labor. But that doesn’t mean you have to. Aside from the fact that there are other ways to cope with contractions, epidurals don’t come without risk.

Epidurals…

  • can lead to longer labors
  • increase your chances of experiencing instrumental delivery or a c-section
  • may cause low blood pressure, fever, and heavy motor blockade (a temporary feeling of paralysis)
  • make breastfeeding initiation harder

Some women love their experience with an epidural and have no complications. You don’t need to be terrified of getting one and experiencing side effects. But do know what can happen. 

If for any reason you don’t want an epidural—even if your only reason is you want to be fully aware of what’s going on in your body—you can refuse one.

Catheters (and the Cascade)

Sometimes, a woman in labor will have a catheter inserted into her bladder. Most commonly, this will be necessitated by an epidural.

Women who have an epidural may not be able to get up and go to the bathroom on their own so they need a way to empty their bladder. That’s what the catheter achieves.

And this brings up an important point: sometimes you can’t pick and choose which things you want to accept and which you want to reject. Things like epidurals and catheters will come together. (If you get an epidural you’ll also be under continuous monitoring to make sure your baby is alright.)

In fact, this occurrence of one thing necessitating another during labor has a name: the cascade of interventions.

READ MORE >> The Cascade of Interventions [Explained]

Opioids

Did you know that women are sometimes given opioids during labor? These painkillers usually come under the brand names of Fentanyl, Demerol, Stadol, Nubain, and Morphine.

In fact, epidurals are usually made up of an anesthetic AND one of these opioids.

Opioids may dull the pain. But women I know said that, in their experience, opioids didn’t do much other than slightly lessen some discomfort.

And with such a small benefit, the risks stand out that much more.

Opioids pose a danger to your baby’s breathing and heart rate, have unpleasant side effects for mom (such as itching and nausea), and make it harder to initiate breastfeeding.

Not only CAN you refuse opioids during labor, but I recommend you DO.

READ MORE >> Medications During Labor: Is It Worth the Risk?

Food and Drink Restrictions

The normal policy for eating and drinking during labor in most hospitals is “NPO,” which stands for “nil per os” and means “nothing by mouth.” But this is one of those routine things that has no evidence to back it up.

Giving birth is one of the most physically taxing experiences a human can go through, so it really doesn’t make sense to restrict eating or drinking. Trust me, you’re going to need your energy. 

Most women will get tired during labor. But the faster exhaustion sets in, the more likely it is that mom will need or want interventions like an epidural or instrumental delivery.

Hospital policy will likely say you need an IV and can only eat ice chips. You can ask your hospital beforehand what their policy is so you can choose your birth place knowing what you’ll get.

Though I’ve never experienced it, I would guess that you’ll get some pretty intense pushback if you bring food to eat during labor. But they can’t starve you! Again, this is your body, your birth, and your rights.

If you want to eat and drink during labor, do it.

READ MORE >> Snacks for Labor: Why and What You Should Eat During Labor

A Certain Person In Your Room

If there is a nurse you don’t like or even a family member stressing you out, you can ask them to leave. In fact, you can insist that they be barred from your room for the remainder of your time there. 

I’ve heard lots of stories of awesome husbands refusing to let an unkind or unhelpful nurse back into the room at their wife’s request.

Lying in Bed

For many women, lying in bed is the most uncomfortable way to spend labor. You can choose to be in any position you want during labor and for the moment of birth.

That said, if you are connected to machines and an IV stand, moving around will be harder. Make sure your decisions of what to accept early in labor don’t restrict your ability to be in the positions you want later in labor. 

An Episiotomy

An episiotomy is a cut in the vaginal opening. For decades, doctors believed an episiotomy made labor faster, protected a woman’s pelvic floor, and prevented severe tearing.

None of those things is true. In fact, it’s quite the opposite.

Episiotomies usually lead to more severe tearing, make recovery harder, and do nothing to speed up labor. Though episiotomies are less common now, I still have friends who got an episiotomy despite not wanting one.

Please refuse an episiotomy. Tell your doctor before labor begins that you do not want one. You’ll be glad you did.

C-section

Too many women have experienced a c-section. The average c-section rate in America is almost 33%. That’s one third of all birthing women. 

C-sections can be lifesaving, but most today are unnecessary.

In many cases, you can choose to continue laboring with no extreme risk to you or your baby. Ask questions and get all the information you can about what will happen if you do accept a c-section and what will happen if you don’t. 

And remember: accepting a c-section with your first child drastically increases your chances of having c-sections with the rest of your children. So refuse a c-section if you feel you can.

READ MORE >> C-sections: Why and How to Avoid Having One

Newborn Procedures and Tests

This thing isn’t actually during labor but it’s immediately after and it’s important so I’m including it. Your brand new, minutes-old baby is likely going to experience a lot of things if you give birth in the hospital and you don’t know what you can refuse.

This long list of procedures and tests includes…

  • Cord clamping
  • Skin-to-skin and bonding time
  • Initiating breastfeeding
  • Bathing
  • Measuring
  • Antibiotic eye ointment
  • Hepatitis B shot
  • Vitamin K shot
  • Newborn blood test
  • And more.

You have choices in all of these areas. You and your baby will have a better experience if you get informed beforehand so you know what you do and don’t want to happen to your baby.

READ MORE >> What Happens To Baby After Birth?

Tips to Make Refusing Things Easier

The last thing you’re going to want to spend your energy on during labor is learning about your options and advocating for yourself. So I want to give you some tips on what you can do now to make it easier to get what you want—and not get what you don’t—during labor.

Get Educated NOW

First and foremost, spend the time and effort now to get educated on your options. This is why this blog—Give Birth Give Life—exists! I want you to be truly informed so that you can make intentional choices for you and your baby and have a beautiful birth experience.

If you start learning as soon as you know you’re pregnant, the long list of things you need to know about and decide isn’t so overwhelming.

RELATED >> Your Third Trimester Checklist: What to Learn, Do, and Decide

Educate Your Husband

But don’t do all this learning on your own! Bring your husband or partner with you on your journey of understanding your body and what to expect during labor so that he can support you in the ways you need. 

Dads can be a vital part of a positive birth experience, whether it be through advocating for Mom or helping her stay calm and relaxed. 

Hire a Doula

If your husband isn’t able or willing to be there with you or if you want additional support, hire a doula! Doulas are trained in supporting women during labor to help the experience be as comfortable and go as smoothly as possible.

They can help with coping and relaxation and can be invaluable in helping you understand hospital lingo and advocating for you.

READ MORE >> What is a Doula and How Can They Make Your Birth Better?

Learn Natural Coping Techniques

Even if you think you’ll get an epidural (and especially if you don’t want one) I recommend you learn some natural coping techniques. The list of possible methods is long, but if you have a few practiced and ready you’ll likely have a much better experience.

And if you know how to handle the pain with non-medical techniques, it will be easier to refuse medications you didn’t want.

You might even impress a few nurses along the way!

READ MORE >> How to Cope With Contractions: Natural Pain Relief During Labor

Give Birth Somewhere Besides the Hospital

Honestly, the best advice I can give you if you’re worried about having to refuse lots of things during labor is to consider giving birth outside of the hospital. While it may seem crazy at first, you may find that giving birth at home or in a birth center can provide the experience you’re hoping for, far better than a hospital can.

It’s only in the hospital that you’ll have to worry about epidurals, opioids, IVs, and continuous monitoring (to name just a few). So if you want to avoid them altogether, choose a different birth location!

READ MORE >> Hospital vs Birth Center: What’s the Difference, Really?
READ MORE >> Hospital Birth vs Home Birth: The Truth About Your Options

Conclusion: You’re the Boss

Now you know all the things you can refuse during labor. Be sure to go back and read more about each one so you’re positive about what you want.

And don’t forget about the tips: get educated (with your husband!), hire a doula, learn coping techniques, and consider alternate birth locations.

Most of all, remember that YOU are the boss of your birth. This is your body and your baby, so you make the rules. Don’t let anyone tell you otherwise.

Until next time,

Allison

READ MORE:

How Not to Be Scared of Giving Birth

The Cascade of Interventions: Myth or Reality?

67 Quotes About Birth That You Need to Hear If You’re Pregnant

9 Exercises to Prevent Tearing During Birth

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