How to Advocate for Yourself in the Maternity Setting

After a traumatic or difficult birth, walking back into a maternity setting and trying to speak up is one of the hardest things you can be asked to do. Not because you lack confidence, or preparation, or the right words, but because the last time you tried, it may not have worked. Your body remembers that. Your nervous system remembers that. In this episode, Katie explores what advocacy actually means in the maternity setting, and why it can feel so impossibly hard when you have a difficult previous experience behind you. She covers the trauma responses that shut down your voice when you most need it, what you are legally and ethically entitled to throughout your care, and practical tools you can have in place before fear kicks in, so you don't have to rely on your brain being fully on board in the moment. There is something in this episode for wherever you are in your pregnancy, from early antenatal appointments through to the postnatal ward and home.

IN THIS EPISODE

• Why speaking up after a traumatic birth takes courage, and why it makes complete sense that it feels hard
• The pressure to be compliant, and the fear that asking questions will affect your care
• Freeze and fawn: the trauma responses that can silence you in appointments and during labour
• Your rights in the maternity setting, what you are actually entitled to at every stage
• The BRAIN framework: a simple tool for making decisions when fear makes clear thinking difficult
• Prompt cards: how to communicate when words aren't available
• How to use the pause, and why asking for a moment is always valid
• How to prepare your birth partner to be your voice when you need them to be
• Specific support for neurodivergent people navigating the maternity system
• Advocacy across the full journey: antenatal, labour, postnatal ward, and home

THE BRAIN FRAMEWORK
The BRAIN framework gives you a structure for making decisions in the maternity setting, particularly in moments when fear or overwhelm makes it hard to think clearly. Instead of having to come up with questions from scratch, you have a simple set of prompts ready to use.
Write these out and keep them with your birth plan, or save them to your phone so they are there when you need them. Share them with your birth partner too.
B - Benefits
What are the benefits of what is being suggested? What does it achieve, and for whom?
R - Risks
What are the risks? How likely are they, and how significant are they to me specifically?
A - Alternatives
What are the alternatives? Is there another way to achieve the same outcome?
I - Intuition
What does my gut say? My instinct matters and is worth considering alongside clinical advice.
N - Nothing
What happens if we wait? Is doing nothing right now an option? In many situations, there is more time available than it can feel like there is.

YOUR ADVOCACY PREPARATION THIS WEEK
Two things, neither taking more than fifteen minutes:

1. Write your advocacy preparation

• The most important things your maternity team need to know about your history and what you need
• Your BRAIN questions - written out so they feel familiar before you need them
• The signal you have agreed with your birth partner for when you need them to step in

2. Make your prompt cards

On your phone or on actual card

• Three or four sentences for the situations where you are most likely to go blank
• Examples: "Please give me a moment before we continue." / "Can you explain what you are recommending and why?" / "I am not able to speak right now. Please wait." / "I have a trauma-informed birth plan, please can you read it."
• Keep them somewhere you can actually reach them, and make sure your birth partner knows they are there

Resources Mentioned:
Free Trauma-Informed Birth Plan Workbook | Birthcare with Katie

Other Resources
30-Day Calm & Confident Birth Challenge (free)
https://birthcare.co.uk/30-day-mindset-challenge

Better Birth Anxiety Workbook — The Birthcare Collection
https://birthcare.co.uk/products-list

Birth Without Fear: Essentials for a Better Birth
https://birthcare.co.uk/birth-without-fear

CONNECT WITH KATIE:
Instagram: @birthcarewithkatie
Website: https://birthcare.co.uk/