Articles

Key takeaways

• Trust your instincts about your body and your baby.
• You have the right to make decisions about your care.
• Know key symptoms that need immediate attention.
• Communicate clearly and bring support if needed.

Why your intuition matters in pregnancy

During pregnancy, birth, or after your baby is born, you may need to speak up for yourself. It is common to feel that healthcare professionals are in charge. You might feel you must follow their advice.

However, in the UK, you have the legal right to make decisions about your body. You can accept or decline care. Listening to pregnant people and their families leads to safer maternity care.

Communicating your needs and preferences can positively affect your pregnancy and birth. You can use the B-R-A-I-N decision-making tool when choices feel difficult.

• Benefits – what is the reason or benefits for what is being suggested?
• Risks – what are the potential risks or consequences with this option?
• Alternatives – are there any alternatives to consider?
• Instincts – what does your gut tell you about the suggestion?
• Nothing – what happens if you do nothing for a while?

Signs and symptoms you shouldn't ignore

Always trust your instincts and share any worries with your health professional. If you are Black or Black Mixed-Heritage, studies have shown that it is even more important to tell your midwife or doctor if you are worried.

Do not worry if you have talked about it before. Do not be concerned about wasting anyone's time. This is your pregnancy, and it is important to trust your own instincts if something feels wrong. If you feel that you are not being heard it might be helpful to get a second opinion.

Some symptoms need checking out when you are pregnant. Call your midwife, doctor, or NHS 111 if you experience any of the following:

• Bleeding from your vagina.
• Brown or pink discharge.
• A severe headache that will not go away.
• Severe itching, especially at night – this can be a sign of a liver disorder (obstetric cholestasis, or intrahepatic cholestasis of pregnancy).
• Vision problems – blurring, light sensitivity, seeing spots, or flashing lights.
• Pain just below the ribs.
• Extreme swelling of the feet, ankles, hands, and face.
• Persistent stomach pains.
• A high temperature (above 37.5 degrees C) with no other flu or cold symptoms.

Do not hold back from reporting a concern. If you have any concerns, get in touch with your midwife or labour ward.

How to communicate your concerns effectively

Making notes beforehand can help you remember your questions. You can also make your own notes of appointments with your healthcare team. If you want to record appointments, let the healthcare team know you are doing so.

You are all part of a team trying to achieve the best care for you and your baby. Here are some useful phrases for communicating clearly:

• "This is what I/my partner would like. How can we work together to achieve that?"
• "I'm worried I'm not explaining myself clearly. Could I try saying it another way?"
• "I feel like I need more time to think about this. Can we pause for a moment?"
• "Am I in immediate danger? Is my baby in immediate danger?" – this helps clarify the actual risk and urgency.
• You can also always say "Wait," or "Stop".

Advocating for yourself means seeking information or stating your needs.

What to do when you don't feel heard

If you feel that you are not being heard, get a second opinion. You can calmly restate your concern. You can say, "I'm worried I'm not explaining myself clearly. Could I try saying it another way?" Ask about alternatives to suggested care. You can ask to speak to a more senior health professional.

If you are not happy with your community midwife, contact the community midwifery manager. You can reach them through the hospital switchboard or the Head of Midwifery.

At the hospital, you can ask to speak to the midwife in charge of the ward. You can also speak to the ward matron, consultant midwife, or the professional midwifery advocate.

It is important to have a good relationship with your midwife so that you can trust them with your care. You should feel able to talk to them about any concerns. You can always ask if you can change midwives if something does not feel right.

Seeking support and making complaints

If you find it hard to understand your care or speak up, a birth partner or doula may help. They can help ask questions, explore options, and offer support. They can also ask to speak to a more senior health professional.

There are also independent advocates available who can help during pregnancy or after birth.

An advocate can help you understand your care. They can help you talk about how you feel. They can also help you make or challenge decisions.

You have the right to give feedback about the NHS service you receive.

You have three options for raising concerns:

• Raising a concern – This can be done informally with a senior member of the maternity team. You can also contact the Patient Advice and Liaison Service (PALS) or your local integrated care board (ICB).
• Making a complaint – All NHS trusts and other healthcare providers have a complaint policy. Ask PALS for a copy and details on how to complain.
• Contacting the Ombudsman – If you are not happy with the reply to a formal complaint, contact the Parliamentary Health Service Ombudsman (PHSO) or the Public Services Ombudsman (PSO). This is an independent service for unresolved NHS complaints in the UK.