Ep 166. Pregnancy Autonomy: The Nuance of Declining

In this episode, Kelly and Tiffany discuss the complexities of making informed decisions during pregnancy. From personal anecdotes to practical advice, they cover the intricate process of declining health interventions and making autonomous choices.

00:00 Introduction

00:30 The Joys of Podcasting

01:23 Declining in Pregnancy

14:59 Informed Consent and Declination

05:16 Navigating the Skincare Dilemma

07:04 Parental Guidance and Compromise

12:53 Shopping for Safe Skincare Products

14:48 Emotional Rollercoaster of Parenting

15:06 Autonomy in Health Decisions

30:32 Pressure from Society and Self

28:17 Provider Pressure

37:55 Conclusion and Resources

Links to all the extra good stuff:

Things you can decline freebie: HERE
Medical Self-Advocacy Resource: HERE
Low-Tox Summer Options: HERE
Childbirth Education Wait List: HERE
Join our email community: HERE
Submit your answer-on-the-show questions: HERE

Transcript

0:00

Welcome to At Home with Kelly and Tiffany, where naturally minded women gather together as we pursue simplicity and confidence in health alternatives, so we can show up better in our busy lives and feel more at home in our bodies. Join your favorite home birth midwife duo for conversation, candor, and community. You're at home with Kelly and Tiffany. I'm Kelly and I'm Tiffany. I'm happy to be here. It's a good place to be on this Monday morning. Whenever you're listening. I like recording podcasts with you. Sometimes I have that feeling of like, you know, when we are about to record and I'm like having to leave my house. I'm like, oh, I gotta leave my house. But then when I get here, I'm always like, this is so good. We like start talking. I'm like, I'm just talking with my friend about some things that I care about. I think like in a season that we're in right now, which is. Creating a lot of content for a lot of projects that we're working on. That has put the podcast into perspective to make the podcast just looked like fun. Yeah, we get to do we just get to like sit and chat while our kids play and we're like, sorry, we have to go spend time together and have conversations. Yeah. And like I like we've, we've, we've gone so many directions with the podcast over the years, and I agree with you that, right, right now in this space, I am so grateful that we get to do it. Me too. I'm excited to talk about what we're talking about today too, because the idea of declining. Things in your pregnancy or in anywhere in your health, right? It sounds like, oh, you just say no, right. Or you just decline it. And there's so much. More. More potentially to just, just saying no. I should tell my fifth grade self when I took my dear class. Did you have to take that Derek? Of course they did. There's not evidence-based either. No. So that didn't work. Just say no. So here we are. Talking about why there's more nuance than dare. I do love when the, like the t-shirts resurface from thrift stores and stuff. Cause. So I call on it. Oh yeah. I, this is majorly off topic. I remember we had to make skits. I forget. Even what grade you teach fifth grade, maybe, maybe the younger, they have to take that class or maybe you do it a few times. I kind of forget, but we had to make a skit about like the dangers of junk driving or something. We didn't, we were too young to even know really what like being drunk actually meant or whatever. Anyway, we were like making the skit and it's all just. Looking back on it. And this is the feedback we got. It was all just like the positives of these like friends getting drunk together. And he was like, well, you didn't really like, bring the story around of like the nights. We were like, oh, I don't know. I don't even know what you're talking about. Ooh. Yeah. Or like it's just regurgitated. Stuff. Yes. Wait. Johnny know drinking is bad. I made a, I made a poster with a bow. I drew a bottle on it with like the circle and a line through it. And on the bottle, this is how little I, I knew at the time I wrote marijuana. Good job. I don't drink that bottle of. Ana. And I remember my, my parents looking at it and being like, I'm not going to tell her is fine. It was a bottle of marijuana. Don't do that. Just say no. Oh, my gosh. Okay. Do you remember that commercial? We're getting off track here. Do you remember that? this is your brain. This is your brain on drugs. It's like an egg being crafted. Yes. Here's your brain. It's all just perfect and fine. But this is your brain lung drugs. We're going to smash it with a friend pan. It's going to get all scrambled up. I understand the message behind it. Don't do drugs. Yes. But. The, we, we missed a step there and it actually being effective. So I told my kids a couple of years ago, I don't know how it ended up coming up, but you know, in our families, we just talk about. A lot of uncomfortable things. I would let them know people do drugs because it feels good. Yeah. Initially, it seems like a great choice. It feels good. It takes away. Lots of uncomfortable feelings, but it's a slippery slope. Well, I talked to my kids that way about sex. Yeah. Like it. You don't have to shy away from some of the truth of situations. People do this because it feels good. Please don't get pregnant when you're a teenager. That would have a lot of. Difficult consequences for your life. But the reason people are doing it is because it feels good. Yeah. Versus like, I don't know why we're just telling people jugs or bad jugs or adjunct or bad. They have devastating consequences. But. You don't just like it. I don't know, cave to the peer pressure. And then right. There's there's just the piece of context around all of the pieces of this. Absolutely. Yeah. Which is very similar to making decisions in. Your pregnancy and labor. This is your pregnancy. This is your pregnancy on forced interventions. Okay, there we go. It's all scrambled up. But before we jump into that, I have an update on the skincare dilemma. Great that I was having with my girls. A few months ago, and it has all kind of come to a head this week and I thought let's share it on the podcast because I had a couple moms reach out to me and go, thank you so much for. Saying that you're having such a hard time with this piece because we are too, we don't rent to do. And then I was talking to another mom last night and she was like, have you ever thought, just like like don't, don't restrict them at all. And I was like, yeah, I have actually, but that's ah, I dunno. I don't know. There's something about that. That's like, so I can see the value and not putting rules on whatever, but like, as. And not creating a complex. Yes, that's important. Yes. But. Unreal. Yeah. Okay. Okay. So anyways, what we decided to do since then was I had to have a serious talk with my kids and say, we, I know I've been a little bit wishy washy on this so far, I'm making a clear stance on. This is not what we're going to do. Four. You know, The, these types of products that are going to be in my home. And so I just want you girls to know I'm gonna work really hard to help you to find the things that you want that are safe and okay. But from now on, we're not going to do any of this. And my kids are like, so do we have to throw away all of our things that are not okay? And I'm like, no, but just as we move forward with what we're buying, let's be intentional about it. And then one of my children was extremely upset with that. Like like mourning the loss of what this could potentially. I mean for her identity, her future, her. Good. Everything that could possibly go wrong happened in this conversation. And. Like a, like a great parent. We pause the conversation and revisited it the next day and not kids side. Would you be willing to compromise? And I said, tell me what this compromised. It looks like, and we talk to that a little bit and I'm like, I really want to work with you on this because it's so important. And I feel strongly in, you feel strongly and you feel strongly for different reasons, but. So the compromise was you can buy one more terrible thing. Okay. And I felt like I could give it. Yeah, because the overall picture was we're working on this other, we're going this other direction together. And honestly, at the end of the day, that's like, Even if there are using this. Terrible thing for a while longer, the decrease in toxic burden on the body is continuing to decrease. As you know, as those other items are falling off or being emptied, new things are being brought in that kind of thing. And so like, there's, there's a balance there. Yes. And I want to. I don't want to look. Or participate in the situation and like a Dick Tarion way. Right. Like, I want to want to be like, let's, let's this goal that I have. Let's, there's multiple ways to it. Let's figure out how to get there. And as a kid is getting older, too. I'm envisioning which kid this is. Yeah. As they're getting older and navigating a bit more, you know, personal autonomy within the safety. Of the home. That's a good thing to like, be willing to listen to. Yes. Yeah. And to me it didn't, it wasn't just about the skincare and makeup stuff. It was like, this is a chance. To establish a way that we work through lots of conflict that has got to be on the horizon. As that piece plays out, that autonomous I'm growing up. I want my own independence. I don't want my mom telling me what lotion I can use. So. And she was saving up for this one special, really bad thing. That was a big part of it. Dream attached to who she could become if this bad thing. Great. And. So I, there was, and then there was a multi-step process to getting this thing. And we, we got it and it wasn't quite right. And we returned it and we got another one and we paid for shipping that we couldn't get refunded. And like, there are many, many lessons were learned in acquiring this one last bad thing. And then right around the time that we started using that. Consistently. Oh, no. Now there's some dermatological reactions. Okay. Natural consequences. And I, as soon as it started happening, I knew it. And I didn't say a dang thing. I'm proud of you because I'm like, you need to have the few need to experience the fullness of this. Yes, absolutely. Choice. And so it wasn't until this week that she came to me and she was like, I need help. Oh, We need help managing this. And I'm like, yeah. Okay. Let's see, what are we going to do about that? And so I'm hoping that. That experience, not that you ever want, like bad things to happen to your kids, or you never want them to like, have to suffer because of their consequences, but in a. Controlled safe. Right. I'm right here kind of way, like walking out this thing. Yeah. You know, which, you know, for many, many children there would never, they. There would never be a visible. Anything to their choices. Yes. That's another reason why I feel like my kids in particular need to be extra careful about this stuff, because we are just more something. Our skin is absolutely insane. Yeah. So so that's where we are. We are like, we are like trying to heal and recover from. This big thing. This is a great, this is a great follow-up and I feel like there's so many pieces of like how, I mean, even as adults, right? Idolizing certain things. And then realizing, oh, that's not. Obviously like where my fulfillment is going to come from, or like, that's not going to fill this one hole that I have, that I, that I want. And so that's a good lesson to be walking through of like, I don't know, there's certain things, certain kids, I mean, every kid, it may not be skincare, but it may be something else that like turns into an idol of some kind. And you're like, and I guess that can go the other way, if you're so hung up on. I don't know. What exact ingredients that you can not have, whatever. Yes exactly. But this is like such a good, safe way to walk through. Some of it wouldn't want, you know, skincare issues. That's like a bummer, especially that age. It just doesn't feel good. But That's a good natural consequence and helpful to like walk through that. Yeah, totally. Okay. And so one of the funny little, like pieces of this is. That I told my kids. I'm not taking you to Sephora and Ulta anymore, just to walk around and look at all the things you can't have. It just don't see the value in that coughing the whole way. Yeah. And the last time I went in there, I was like, no, we just can't do this. It's. Look at for me I'm I have to be there with you. Breathing that air. And so I told them there's nothing here that you can have anyways, besides like hair clips. So. There's just no point in us walking around, looking at it and testing it and stuff. However, as I was researching skin barrier repair and. Certain ingredients that you do want in some of these products, when you're trying to work on that. I found. Great company that has really good EWG ratings. And everyone says, don't buy this on Amazon because there's too many, there's too much inconsistency. It's one of those products that they're like, this isn't the real thing. So like, don't buy it on here. Because when I go to look, where can you buy news? Ulta is one of the realtors. Or. Real. Retailers. They're realtors also. One of those places has beauty counter. Yes. Ulta. Okay. Those are maybe two things. So I was like, oh gosh, of course, of course I need to like go to my kids now and say, I am sorry. Actually, there are things that you can have. I actually need to go there right now and pick this stuff up for you. Oh, that's interesting. But, yeah. So I learned that I've learned that that for myself, We went on a journey in our home. My child learned a lot about lots of those things, and we'll see where this takes us, but it didn't inspire me to. Get our low talks, summer list, spiffed up and updated. And I did add these products to that list. So even though if you guys will look I think it's called, I think it's called cocoa kind. Is the brand. If you look on our low tox summer list, which I'll link in the show notes, you'll see in those reviews, people say, don't get it on the Amazon, but anyways, you can see the actual product there and go find it at your local old. And again, they had great, great readings on these really cute. Skincare thing was that that's, that seems to be a part of it is just having. Aesthetically pleasing product. Products. But these products will actually help to. Fortify your skin barrier. I love it. Woo. I love it very much. We've we've been on an emotional rollercoaster so far in this episode. Oh, we didn't even get to the, the stuff about declining, which is sure to be emotional. Yep. Okay. So you guys hear us on this podcast. You follow us on Instagram and we're just constantly trying to shop from the rooftops. Like you can decline, you can decline, you can decline. There's there's nothing you can to decline. But it is easier said than done. And so I thought we would spend an episode just kind of getting into the nuances of that and talk about informed consent informed declination and help women navigate it a little bit more practically. In everyday life. Yeah. It's, it's one thing to say. No. In your mind, or like when I go in. I know that these things are going to be offered and I'm going to say no, or you're in the appointment and things are offered potentially in a way that makes you feel like maybe I shouldn't say yes, but I actually don't know yet. Right. Or being able to kind of sort through those pieces. And like the actual conversation of declining something. Right. And so I feel like taking a step back and understanding. Some of the kind of nuances of. Making decisions. Of voicing your own opinion is really, really important. I feel like as, as you're walking through any of these things, being able to take a moment to be intentional, to even ask yourself, Like say something is offered to you, right? Or, you know, something will be, or you're looking and you're just being very proactive on what's going on in this trimester for you. What is normal to be you know, recommended, which has been a cool part of what we're doing in our childbirth education class of this, like kind of being aware of what will kind of be coming up this trimester to be able to give some context to that, but even asking yourself, like, is this something that I want, right. Is this lab something I want to do? Is that information from the ultrasound, something I want is. Is that vaginal exam. Is that something that I do want, like, what are, what is your motive for declining something? Is it because you saw somebody on Instagram say don't drink that glute Cola drink, but what if you actually want to write. And so what if that feels like the right decision, but you're trying to navigate saying no, because you feel like you should, or the other way around, right there. Six, so many little, little pieces there, but I feel like that is a. Important aspect of figuring out what it is you actually want. And being able to move forward. From there. Yeah. And I think like it, we can fall into a ditch on one side of the road. That's, I'm going to just do everything that I'm told and we could fall into a ditch on the other side of the road. That is I'm, I'm overwhelmed. I think everyone's out to get me. I'm just going to decline everything and then I'll avoid all of that potential conflict. And so you have to ask yourself like, Are you actually declining? Are you really saying like, I do not want this. I think that a little bit of birth vision work can kind of help in this area too, like women who are willing to sit and do the work of like, what does this ideal experience look like for me? Does that include, is that going to, am I going to need to decline a bunch of things in order to make that happen? Maybe? Yeah. But potentially you would be more willing to go to the links in which you need to for yourself once, you know, this is what this experience is going to look and feel and be remembered by. Yeah, absolutely. And so you've heard us mention this before. There's sort of this acronym that you can walk through in your own head as you are disc kind of you know being offered things. What are the benefits, right? This brain idea. What are the benefits? What the are being risks. What is that? A alternatives or do you have other options? I, your instincts, what is your gut telling you? And like, what if you just do nothing? What if you just kind of like keep going the road that you're going down and don't do a single thing. And so that's like a really important piece of making a truly informed choice and feeling confident that when you walk in to say, no, you're like my no is going to be my no, and I know why. And that is really powerful. I feel like because then you actually have solid grounding to stand on. Absolutely. I would say one of the biggest challenges in declining things for women is just actually the confrontation. The actual saying no part. I think it's really easy for us to fall into people. Pleasing habits. It's really easy for us to just avoid confrontation and just be peacekeepers, but there are lots of ways to say no. And I usually recommend women who are struggling with it. Like me to practice how they're going to decline and just say out loud to yourself, like in the mirror that morning. You are smart. Beautiful. But exactly what you're going to say. And there's lots of ways to say no, you can say no. Thank you. I'm not going to do that right now. I heard your recommendation, but I am still declining. I appreciate the information, but we're still undecided. I won't be doing that. I think saying I won't be doing that. It's so much more effective than saying no thank you. Or like, oh no. Cause then you gonna say like, oh, I have actually taken in all the information. I did a little bit of my research already and I've come to the conclusion that I won't be doing that. You can also say I do not consent. That's really strong, strong words, but in a birth environment where somebody is coming at the umbilical cord with scissors, you might have to say, you don't have my consent to cut the cord. And he, and they hear that. And the room hears that. And especially the idea of consent in general is. W having a moment. It is like in EV as it should, right. Is having like a lot of people are aware of what that really means. And the, and the gravity of it. So saying that. Usually holds quite a bit of weight, especially for people in the medical. Community. But yes, I completely agree. I was the people pleasing person. I mean, I'm like recovering, I suppose. But for sure, in my first pregnancy, I remember feeling very uncomfortable being like, oh, I read this thing, but actually the way that you're describing it maybe I do that in like just kind of questioning and not wanting to kind of push the envelope. So it's a, it's a real thing of in your head wanting to say no, but then the reality of actually getting those words out when your heart is racing or you're feeling really uncomfortable. Or now you're questioning everything because potentially you're feeling. I don't know, belittled or as if you don't. As if you don't know as much about that specific thing. You can trust your trust, your instinct on that too. And if you are in that space, You don't actually have to make a decision in the moment or if you're uncomfortable. With the firmness of that decision, depending on what it is right. To just kind of give yourself. A bit more time too, and just keep pushing it off. If you have to that, you're still deciding that you're unsure that you need to do more research, those types of things so that If you're still working on that piece, that gives you a little bit more. I don't know. Time to time to work on it. Yeah. There's very little that needs to be decided in the moment that it's presented to you. And so if you're unsure about that timeline, then you can say, when do I need to make this decision by? Yeah. Oh, Never. I never like there's no. Ah, you would prefer that I make it right now, but if I never make a decision, then nothing will happen. Okay, thank you for letting me know. This is working out wonderfully for me. But there's so much pressure that can be felt externally. So you can be really confident in your decision. You can look at the information, you can be like, oh yeah, I don't want to do that. But then there are so many little nagging pieces of pressure that can come in on you. And some of that can be pressure from yourself. Just wanting your pregnancy to look a certain way or to just, you wanted to feel really confident with your decision, but really, maybe you're not quite sure yet. And so you're kind of pushing yourself to make a decision or to try to get your pregnancy or birth, to look a certain way. And I think, should we just say the name knowledge that we're putting often? The pressure is us putting it on the situation ourselves. Yeah. Wanting to get it perfectly right. Or wanting it to look a certain way. I mean, I have a friend who was walking through the idea of getting antibiotics for her kid recently, who was like, I'm not going to tell anybody because I feel like a lot of shame for doing this. And I feel like it's the right decision, but I just don't want to tell anybody because I feel like I'm going to be judged for it. And I was like, dude, that is that's heavy stuff that we carry as moms. And even if you haven't had your baby birth, your baby yet. Like these are parenting decisions. And I feel like you know, especially places, you know, on Instagram, social media and things, you can kind of put somebody high on a pedestal and be like, well, if I made. Every decision that she made, then I can look, I have this kind of. Life or put this idea out into the world. And maybe you're not necessarily thinking that, but there. Is something kind of subconsciously sitting there too. Idealism. Idealism is just, oh, that'll just kill. That'll just kill autonomy. Up and down and sideways. Yeah, for sure. So you can have pressure from yourself, but you can also potentially have pressure from your partner, people in your family, especially for some reason, moms seem to be in that space. Often like moms, moms, or partners. Moms. The grandmother. Yeah. Who has had the experience of motherhood? Who wants to input? Their experience onto yours. And there's there's a lot of nuance there, but potentially not being on the same page as your partner or as your mom or mother-in-law or sister or whatever. You know, choosing something different than they potentially would, or just getting a lot of pushback, a lot of talk about, oh, the risk of that, or, oh, the safety or don't, you know, like for. For the baby's sake, make this decision. Right. And that can feel very uncomfortable. It can feel really like you're on, unsought like not solid ground, right. Especially when it's with your partner and being able to really sit down and chat about. Most likely the things that you are researching, that he has not. A lot of that incongruity comes from, I'm not saying they're ignorant, but just they do not have the same desire. And. You know, most likely that like time and effort is usually not put into doing the research that you are doing for your decisions in your pregnancy. It's pretty common for that to be the case that men. Need a little bit more discussion on that. Absolutely. And we get asked all the time, like, well, how do I get my partner to, you know, fill in the blank? And I think that the wisest way to go about not being on the same page about things is to just have continual conversation about it. If your partner is anything like my husband. He is like, why? I just am not equipped to have this conversation right now because you clearly have thought about this longer, done more research. Well, and, but something about this, I don't feel comfortable. I'm not there yet. So then I'm like, yes, honey. I know. We'll get you there. That's why I did all the research for. There's very little that he, that he's like, I'm questioning where you're at on this. But the things that are is like, well, it's not, it's not respectful or appropriate for me to move forward yet until we have come to a decision together. And sometimes that just requires a lot of talking and compromise and unfortunately in pregnancy and birth, there's so many decisions that have to be. Made and ideally you guys make those together because again, it's parenting. Yeah, for sure. So you parenting together versus like the input of the sister, the mother-in-law, that kind of stuff. You will forever. If that, if that's coming up now, you'll probably forever be dealing with some of those pieces. Sorry, as you parent and potentially make different decisions. I feel like, especially with moms, what it SI, you know, grandmothers of the baby. It tends to come down to, well, I made this decision for you and I felt like I made the right one and you making a different decision makes me feel like you're doing this at me. Like I did something wrong. I don't think most of them actually potentially realize that, but it's almost like you're making the decision at them. Which you most likely are not, I don't know. But I feel like that's a really important piece to kind of pull out and to just remember that it's you and your partner who are parenting your baby, not anybody else. Yeah. And like that particular circumstance that you just brought it up. That is that's grandma's work. She needs to go work on that and sort that out. That's not your job. That's not your work. So, yeah, that's a hard one to, that's a hard one to untangle sometimes. You could have a lot of provider pressure. And this is what we hear most women complaining about because they are the person who feels like they're holding an authority over your care and over your process. And so the way that providers have learned to apply pressure to get. Patients to consent, we call it. We call it in, for being informed to. Consent. Yeah. So not informed consent, but being informed in a way that gets you to consent. And usually just comes down to what they are the most comfortable with. And they are absolutely allowed to have their preferences and have their recommendations. And they're allowed to say Mo you know, I dealt with a situation last month and it was a disaster. So that's why I'm telling all my clients, they should probably just do this other thing. That is all valid and fine. But at the end of the day, you are the decision maker and your provider's preference or what they are comfortable with does not. Trump. You are comfortable with or what your preference is. And so that can be an especially tricky one to untangle. Yeah, for sure. And we've, we've mentioned this in other episodes too. You may actually be the holder of more current research. Then what your provider is actually utilizing and, you know, in their kind of everyday practice, because it takes so long for some of these protocols and policies to shift. And so you can also feel confident as you walk in with your information that that. You know, it's not necessarily this power. It shouldn't be this power division piece. But if you are feeling like every single thing you are having to decline and feel so much pressure and leave your appointments crying, or you're like exhausted before you even get there, because you're anticipating how that's going to go. Let that be a red flag for you that you may not be in the right place for you also. And so just planting that seed of like, if this is the biggest piece and it feels overwhelming and exhausting. There is another way or there are other options. Yeah. Like changing providers. Primarily that. You may also feel like a lot of pressure from society or your community. There's other people's voices. Sometimes they are louder than your own or louder than, than the other pieces that you're considering. And maybe we don't even like, know these people in real life that we. Imagine or a part of the society voice, but they just end up being so loud and pregnancy is just a natural place to be turning more and more internal and inward. And so if you find yourself wanting less and less of other people's opinions and other people's information, and you've running your stuff off of, you know, basing it off of that that would be a really normal, physiological reaction to just being like, I'm just gonna, I'm going to tune in a little bit more into. Meet and what I need and what I want and how I'm processing this and tune out and make. Lower those other voices. Yeah. That's just, that's just good for life in general. And for, as you enter into. You know, again, you're making parenting decisions now, but as you continue to make them when the baby is here and the baby is growing and all this other pieces that it can, it's a good. Kind of rhythm to get into now and to get comfortable with, because that will, it'll keep popping up in different, weird ways. Surprising ways for yourself probably. And so getting comfortable tuning out or turning down some of that will be important. And as you're making some of these decisions on declining things, And you're feeling confident about, okay, this is the choice I want to make. You may also be feeling like, well, I know I want to make this decision, but also if I say no to this, there are just sort of like some natural consequences to that. Right. And because you are informed because you are making these decisions thoughtfully, most likely you are aware that there's no matter what, there's always just going to be some kind of. Natural consequence to the decisions that you are making. So one of the things that we see often. That we chat about in our practice. Would be about GBS testing. Right. So say you're like, okay, I've heard all about GVS testing. I've researched it. I'm just going to go ahead and decline it because I just don't. Find that information helpful for me at all. And so in declining it, you actually, in like the medical world would then be presumed to be positive. They'll look at you as if you have it, because they don't know if you do or not. So then you're like, okay, well even if I'm presumed positive, okay, they're going to offer me antibiotics then, but I want to decline the antibiotics. But if I do that potentially, they might want to keep my baby in the hospital for longer just to kind of monitor them, make sure they're not having infection. Right. So all of a sudden you're seeing like, oh man, my declining, this one thing may have some consequences, but it feels still really important for me to decline. But also I need to be aware of what might be ahead of me if I do. And so. So it's definitely a balancing act of you know, understanding what you want, but also balancing that with what, you know, may, you know, kind of come next. And it's important to know what some of those things may actually be. That's part of that informed consent piece. And certainly it is much better if you are able to determine some of those things and recognize what feels important to you before even hiring your provider or deciding on a birth location in general, because some of those pieces will absolutely be impacted by those very foundational decisions. And like, just knowing. To which questions to ask and how to say, is there anything in your practice? It's non-negotiable okay. And so if I do decline that, what. What would that look like for me? Because I think women are sometimes feeling really empowered to say no to something. And then all of a sudden they're met with an immediate like, well, then I'm going to call CPS, or then you're kicked out of my practice. Or then you have these crazy consequences of, you know, medical holds and AMA and et cetera. And so that's a huge part of navigating declining things is understanding what that decision might lead to. And I want women to know that they have rights that are not usually. Paramount in that discussion. So when there are threats being made. That go into like legal boundaries and stuff. Usually the, the provider who's making those threats or just is just trying to put more pressure on you to get you to consent to the thing that they want. And they don't recognize that like you do actually have rights to take in all the information and make the best decision. So that might be a part of that conversation with that provider is. Do you have a list of patient rights? Does this hospital have a list of patient, right? I'd like to read them so that I can be. Sure about what my abilities are in. Being able to decline some of these things and also asking for a patient advocate, especially in larger facilities, there is usually someone on staff or someone on call that if if a patient says I'm not getting. I'm not getting the type of care that I'm asking for here. I need somebody to go between me and the. Provider from an administrative perspective and say like, what do I, what do I actually have to do here? And how, how can I navigate this without the pressure, without the coercion, without those pieces. And we've shared it here before, but there is a resource called medical advocacy inside of the. Shop online, beautiful one midwifery.com Melissa, in the show notes too, but it basically gives you all of the tools for informed consent. It gives you lots of scripts for declining things so that you can really like look and see which one makes the most sense for your particular situation. But it also talks about patient rights. It also talks about different ways in order to navigate. Actually breaking through some of that coercion and that pressure. Yeah. And that's so helpful. I mean, certainly in pregnancy and it's unfortunate that we even have to like, have this part of the conversation. Right. But that's so helpful even beyond that. Right. Because a lot of the health systems are set up very similarly. And so to be able to have a resource in your back pocket that can help you. Navigate all the different types of care and options and things like that. Honestly. I'm just recalling a time where I had to be in the hospital for a bit, for with my son, my son was in the hospital and I had to be the, I was with him for awhile. And navigating those pieces. I was like, I am so thankful that I have this wheelhouse of information that I can pull from, because I know what I can say. I know what my rights are. I know, like kind of the questions to ask and the. That I can say, no, thank you to this person. And like, can I have a new, you know, whoever nurse or whatever to be able to feel more confident in that. So it goes so far beyond. Just pregnancy to, oh, absolutely. I had a good time talking with Instagram about this on line this week, just saying like, okay, you guys let me know the things, what are the actual pieces that make it difficult to navigate this? And one, one lady said that it was hard for her to find quality evidence to share with her provider in order to bolster her choice. And I absolutely understand.