There is something I have witnessed more than once lately that I think we need to talk about: informed consent during childbirth.

As a trauma-informed birth doula in St. Louis, I am very aware of how vulnerable labor and birth can feel. You may be in pain. You may be exhausted. You may feel scared or overwhelmed. There may be several people in the room, monitors beeping, questions being asked, and decisions happening quickly.

But through all of that, one thing remains incredibly important:

It is still your body.

Being admitted to a hospital to have a baby does not mean you have given blanket permission for anyone to touch your body or perform every suggested intervention without a conversation.

What Is Informed Consent During Childbirth?

Informed consent is more than someone saying, “I'm going to check you now.”

Whenever circumstances allow, you should have the opportunity to understand what is being recommended, why it is being recommended, the potential benefits and risks, what alternatives may be available, and what could happen if you choose to wait or decline.

Then you get to participate in the decision.

Consent should be a conversation—not simply something that happens to you.

This applies throughout pregnancy, labor, birth, and postpartum care.

Consent During Labor Includes Routine Care, Too

When people hear the words “informed consent,” they may immediately think about major medical procedures.

But some of the situations that concern me most as a doula involve things that have become routine in birth settings.

It might be someone reaching under a gown to perform a cervical check without clearly asking first.

It might be an intervention beginning while it is being explained rather than giving Mom an opportunity to process the information and respond.

And sometimes it happens after the baby is born.

I've seen a well-meaning member of a care team reach over and grab a mother's breast to help position it for baby's first latch without first asking whether she was comfortable being touched.

The intention may be completely supportive.

But good intentions don't eliminate the importance of consent.

Imagine the difference between simply touching someone's breast and saying:

“Would it be okay if I used my hand to help you position your breast for baby's latch?”

It takes only a few seconds, but that question gives control back to the person whose body is being touched.

For someone who has experienced trauma, that distinction can be especially significant.

But you do not need to have a history of trauma for your boundaries to deserve respect.

Can You Say No During Labor and Delivery?

One thing I want expecting parents to understand before birth is that they can ask questions about their care.

You can say:

“Can you explain why you are recommending this?”

“What are the benefits and risks?”

“What alternatives do we have?”

“Is this something that needs to happen right now?”

“What could happen if we wait?”

“Can my partner and I have a few minutes to discuss this?”

“Please ask me before touching me.”

“I don't want a cervical check right now.”

“I'd like to wait.”

And yes, you can say:

“No.”

Asking questions does not mean you are being difficult.

Wanting more information doesn't mean you don't trust your doctor, midwife, or nurse.

And wanting to understand an intervention doesn't mean you are against medical care.

It means you want to be an active participant in decisions involving your body and your birth.

Consent Is Ongoing During Birth

Another important piece of informed consent is understanding that consent is ongoing.

Saying yes to something once does not necessarily mean you are agreeing to it every time.

You might be comfortable with one cervical exam and decide later that you don't want another at that moment.

You might originally plan an unmedicated birth and later request an epidural.

You might initially decline an intervention and then decide differently after receiving more information or circumstances change.

Birth plans change.

Medical circumstances change.

And you are allowed to change your mind, too.

What About an Emergency During Childbirth?

Birth can sometimes change very quickly. There are situations when seconds matter and the amount of time available for a lengthy discussion may be limited.

That doesn't make communication unimportant.

Whenever circumstances allow, even a brief explanation of what is happening and why the medical team is recommending immediate action can help someone understand what is happening to their body rather than feeling as though control has suddenly been taken away.

This is one reason I believe conversations about birth interventions are so valuable during pregnancy and prenatal doula visits.

You don't want the first time you've ever heard about an intervention to be while you're frightened, exhausted, or experiencing an emergency.

Knowledge before labor can make unexpected situations easier to understand and process.

Why Trauma-Informed Birth Support Matters

As a trauma-informed St. Louis doula, consent is something I care deeply about.

Trauma-informed care recognizes that we don't always know someone's history.

Something that seems routine to one person can feel frightening, invasive, or triggering to another.

Small changes in communication can make an enormous difference:

“May I touch you?”

“Is it okay if I move your gown?”

“Would you like help positioning your breast?”

“Are you comfortable with a cervical exam?”

“Would you like me to explain what I'm doing?”

Those few words acknowledge something incredibly important:

There is a person attached to the body receiving the care.

How a Doula Can Help You Advocate During Labor

My role as a doula is not to make medical decisions for you.

It isn't to speak over your doctors or nurses.

And it isn't to tell you which medical interventions you should accept or decline.

My job is to help you find and use your own voice.

Sometimes that means reminding you that you can ask another question.

Sometimes it means helping slow the conversation down so you can process what you just heard.

Sometimes I might quietly ask:

“Do you understand what they're recommending?”

“Do you have any questions?”

“Would you like a minute to talk about it?”

And sometimes it means reminding you of something we discussed during our prenatal visits so that you can communicate your wishes to your medical team.

I work alongside medical professionals, and I deeply value skilled nurses, physicians, midwives, lactation professionals, and other members of the birth team.

This isn't about creating an us-versus-them mentality.

It's about making birth care better by keeping the person giving birth at the center of their care.

You Still Have a Voice in Your Birth

You can want an epidural and still want informed consent.

You can plan an unmedicated birth and change your mind.

You can choose an induction.

You can ask questions about an induction.

You can consent to an intervention.

You can ask whether an intervention can wait.

You can say yes.

You can say no.

You can say, “I need more information.”

You can say, “Give us a minute.”

You can change your mind.

Consent is ongoing.

One of the most important things I want families to know before walking into their birth space is this:

You are not simply a patient lying in a hospital bed while birth happens around you.

You are a person with a voice, preferences, boundaries, and the right to participate in decisions involving your body.

Trauma-Informed Doula Support in St. Louis

As a St. Louis birth doula and birth photographer, I support families throughout pregnancy, labor, birth, and postpartum with an emphasis on education, emotional support, autonomy, and trauma-informed care.

My goal isn't to create a particular kind of birth.

It's to help you feel supported through your birth—whether that includes an unmedicated delivery, epidural, induction, planned or unexpected C-section, or circumstances you never anticipated.

Because however your baby enters the world, your voice should still be part of your birth story.

If you're expecting a baby in the St. Louis or surrounding Missouri area and are looking for compassionate, trauma-informed doula support, I'd love to talk with you about how doula care can support you and your partner throughout pregnancy, birth, and postpartum.

Terri Anne To the Moon and Back Photography and Doula Services
Serving St. Louis and surrounding communities with birth doula support, birth photography, maternity photography, Fresh 48 sessions, and newborn photography.

This article is intended for educational purposes and is not medical or legal advice. Talk with your healthcare provider about the risks, benefits, alternatives, and urgency of recommendations specific to your pregnancy and birth.