Unlike in the movies (3 pushes and a bundle of joy) actual labour experiences vary enormously. There is no “normal” so it can be wise to know what your rights on the labour ward are – especially if you’re concerned a particular situation may arise.
Every woman has the right to a humane level of care and to have her needs and requests listened to and addressed. If you’re giving birth in an NHS hospital, and have an objection you want to raise, your main point of contact will be the head of the midwifery team.
Birthrights is the only charity in the UK protecting the human rights of women in child birth. It provides free, accurate and legal information on this subject.
We spoke to their Chief Executive, Amy Gibbs, and also asked for input from Annabel Athill, a doula, retired midwife and founder of Kensington Midwives, for her own experiences and opinion and to help us answer some frequent questions.
What are your rights on the labour ward? 11 common questions answered
1. Do I have a right to pain relief?
Yes, unless there is a specific medical need to use/not use a particular form of pain relief, you should have options including gas and air or an epidural.
The expert team at your hospital will use their experience to guide you on your pain relief options but they may have to deny a request. For example, if you are too close to delivering the baby/babies to administer an epidural. Despite how much pain you may be in – it could just be too late.
2. Do I have the right to choose my birth partner?
Yes – individual hospital policies vary but you should be able to have at least 2 people in the delivery suite with you.
You want someone with you who will be supportive and help you feel calm – so the midwife team may need to intervene, for example if your birth partner needs more gas and air than you do!
Birthrights provides more information on its website about your rights regarding birth partners.
3. Do I have the right to insist on my birth plan?
A birth plan will guide the hospital staff on what you would ideally like to happen during labour and delivery so it may not be possible to insist on all your wishes.
“Your birth plan does not have any formal legal status but it ought to be respected by healthcare professionals, unless you give consent to a different plan of care.” Says Amy.
“You or your birth partner can ask those caring for you to respect your stated preferences and wishes, and if there are medical reasons for not providing treatment requested, these should be explained to you.
“Healthcare providers have a duty to prevent avoidable suffering, so refusal of pain relief or other forms of support during labour should be considered in the context of your individual circumstances and not solely on the basis of a hospital guideline or policy.
A birth plan may be used as evidence of consent or lack of consent if a woman later challenges the treatment she received.”
“I don’t really say “plan” – I call it a wish list. So you wish for this to happen but you’ve got to be flexible because it might not be safe for it to happen.
“The birth plan is so the midwife feels like she know what you want; natural birth, water birth, epidural. But to insist on your birth plan could be dangerous.
“Obviously, you can not accept advice and not accept treatment but it wouldn’t be very sensible.
“I’ve never met anyone who insisted on their plan. It’s rare to insist on the plan. There are complications – situations where you have to do something different.”
4. Do I have the right to ask for a different midwife?
Yes – just like your birth partner, your midwife should be a supportive, calming presence in the delivery room.
If you feel the relationship is not working well for you, then you or your birth partner can find the head midwife and ask for someone else. You shouldn’t have to give a reason.
5. Do I have the right to refuse a male midwife?
The focus should be on what you are comfortable with, so yes, you can refuse a male midwife.
Let the hospital team know and they should be able to make a swap if another midwife is available.
6. Do I have the right to refuse to have medical students observe my labour?
Any students present in your delivery room should be announced and your permission asked that they stay.
It’s fine for you to say no if you don’t want them there and they should respectfully meet your request.
7. Do I have the right to refuse examinations?
Yes, says Amy.
“Pregnant women have the right to make their own decisions about their bodies in the same way as everyone else. It is against the law to give medical treatment to a pregnant woman unless she agrees to it. This is known legally as giving consent.
“Consent is required for every medical procedure, however minor, and must be sought before any examination or investigation is carried out, or any care or treatment is provided.
“UK law is clear that you can refuse interventions or withdraw your consent at any time, and your decisions must be respected, regardless of whether health professionals agree with them.”
The hospital team should ask for your permission before every examination regardless of whether you’ve had it before.
If you don’t understand why or how the examination will take place you can ask any questions you need to.
There may be a specific medical reason why an examination needs to happen, but you should not feel pressured into anything. Annabel shares her experience:
“As a midwife you’re trained to ask for consent before you do anything. In the birth centre they try to give as few examinations as possible – if they see the labour is progressing. The standard time for an examination is every 4 hours – which is not that often.
“You have the right to say no but it probably wouldn’t be that sensible. [Women in labour] very rarely say no – I’ve never seen it, because the mother wants to know how things are progressing. Mostly it’s: ‘When will we know more!'”
8. What rights do I have if they’re filming at my hospital?
Filming in the hospitals must to adhere to very specific permissions and you should not be filmed in any personal way (e.g. in the delivery room) without having given prior consent.
The requirements are a little more relaxed if, for example, you’re being filmed in the background in a waiting room. The film crew will need to display posters and/or notifications making you aware that filming is taking place and that you can withdraw your permission for them to include you.
9. Does my partner have the right to stay with me after the birth?
Your birthing partner can stay to provide support after your baby is born depending on the hospital policy.
Some hospitals allow birth partners to stay with you if you have to sleep in the ward over night – often on a reclining chair but not in your bed.
Other hospitals don’t allow partners to stay after a particular duration after you’ve given birth.
If you’ve had a particularly distressing birth experience, you can explain this to the hospital team and they should make their best efforts to help you feel calm and secure.
Amy states the following from a legal perspective;
“There is no specific legal right and hospital policies will vary about whether and for how long partners can stay with you.
“There may be good reasons for limiting birth partners on postnatal wards and hospitals have to balance everyone’s rights, including to privacy and to feel safe.
“However, those caring for you should apply the policy flexibly and sensitively to your individual circumstances and you should be given opportunities to explain your particular reasons for wanting your birth partner to stay, which might include having had a c-section, or a difficult or upsetting birth, or because you need help with breastfeeding.
“Hospital staff should take your needs into account and make an exception to the general policy unless there is a good reason not to do so. If there are ways to accommodate your request, such as providing a room off the ward, these should be considered.”
Check in advance with your hospital what is allowed to help manage your expectations.
Annabel has some insightful thoughts on partners in the ward after birth and is quite sympathetic to the husbands as she has 2 grown up sons. However, this could be more of a discussion about ingrained ways of thinking about husbands roles during birth (that’s a whole different article!)
“Pretty much all the hospitals allow partners to stay. It generally helps the midwife to have someone helping her!
“I think sometimes husbands get really tired and can’t cope. Two tired people I think is a very bad idea – I would say anyone else except the husband being there the whole night.
“A fresh, having-slept husband, who is ready for you at home is vital – the first week home is when mothers tend to slip into depression. It’s all a bit of a high in the hospital.”
10. Do I have the right to see my maternity records after the birth?
If you have your baby in an NHS hospital, you can make a request to view your records. The hospital keeps your maternity book after the birth and holds them for 25 years.
You may need to pay a fee of approx. £10 if you want copies of your records made. Birthrights provide further information in their fact sheet about accessing your records.
11. Can I make a complaint?
Often, ensuring that communication is frequent and clear can help calm a situation as it is occurring. For example, an emergency Cesarean suddenly unfolding, can feel quite overwhelming. Having the medical team talk through what is happening, why and when can be reassuring.
If you ever feel that you’ve been unfairly treated or had your rights violated, there are steps you can follow to complain.
Birthrights provide a detailed guide which you can follow. Be sure to take detailed notes of what has occurred and find support from your network, such as through your GP, a trusted maternity professional or the Birthrights organisation themselves.