Helping Clients Build Personal Advocacy Skills: Step Two
by Michal Klau-Stevens, LCCE
You Need to Know What You Want in Order to Get It
If you don’t know what it is you need, you won’t be able to ask for it. When a person has clarity on their values, needs, and wants, they are much better able to advocate for themselves. They can express themselves clearly to the people who are in position to meets their needs. One way we can help our clients get their needs met is by leading them through an assessment of their values, needs, and desires, so they can gain the inner knowledge they’ll need to communicate effectively with their caregivers.
In my previous post in this series focusing on teaching personal healthcare advocacy skills to clients, we discussed the importance of acquiring a foundation of knowledge about the maternity care system in order to be able to make informed healthcare decisions. The second step in teaching personal healthcare advocacy skills involves teaching your clients how to take a personal inventory of their values, needs, and desires. Individuals are experts on themselves. When your clients tune in to these aspects of themselves and gain clarity on how to verbalize them, they are able to bring important information to the table as they work with their healthcare providers. In our roles as childbirth educators, doulas, and birth workers, we can offer our clients tools to do this type of personal inventory.
The personal inventory begins with exploring core values. Core values are closely held beliefs about what is right and what is wrong. They dictate actions, behaviors, and expectations for oneself and for relationships. When clients explore their beliefs about health, illness or impairment, vulnerability, personal agency, and the caregiver/patient relationship, they uncover the drivers of both their own behaviors and their working philosophy towards pregnancy, birth, and parenting. Clients who identify their core values and use them as a guide for finding caregivers with similar values and beliefs will be more likely to experience care that is in alignment with their personal philosophy, and that is more likely to be satisfying.
The next part of the inventory involves exploring the client’s needs. A thorough inventory will include a review of all physical, emotional, spiritual, and practical needs. It should address medical needs, physical supports, psychological concerns (especially if there is a previous history of abuse or trauma), religious practices including special dietary needs or rituals around the time of birth, practical concerns relating to care and healing once home, care of other children or pets, work concerns, financial needs, insurance coverage, and other family concerns. The more comprehensive this part of the inventory, the better prepared your clients will be in arranging for these needs to be met.
The last part of the inventory addresses your client’s desires. What does their ideal birth look like? What does it mean to them to be fully supported, physically and emotionally throughout pregnancy, birth, and beyond? Often our clients can more easily identify what they don’t want, but there is great power in visualizing clearly what it is they do want. Sometimes desires are so strong they cross over to become needs. This is fine. It’s these personal touches that give our clients the opportunity to make their vision of birth and parenting more closely match their reality, create life-long memories, and give them feelings of confidence and competence that are vital to a positive experience. For example, I client of mine wanted candlelight and drumming at her hospital birth. We used battery-powered tea lights, and her husband brought his 3-foot djembe drum along. He tapped out a beat that helped her quickly get into the rhythm of her labor after the rush of getting to the hospital. The dancing and drumming was a highlight of their birth experience.
This inventory should be comprehensive and cover the time span of pregnancy, birth, breastfeeding, and the first few months of parenting. Couples should work on this inventory together, with husbands or partners contributing about their values, needs, and desires too. Rather than seeing this as a one-shot deal, the inventory should be a working document that changes as your clients grow and learn. It should inspire expectant parents to have open conversations with their loved ones, and to develop plans to ensure the care they are signed up for with their obstetrician or midwife and place of birth is in alignment with their expectations.
This type of inventory can easily be incorporated into your childbirth education classes or prenatal appointments. Your clients might need to guidance or coaching to complete their self-assessment, or they may be fine filling it out on their own. The purpose though, is to get them to think about what is important to them, and what they anticipate they will need as they face the physical and mental challenges of childbirth, and they make this life transition into parenting. By incorporating this assessment into your repertoire you will be giving your clients a powerful tool to help them advocate for individualized care.
What other values, needs, and desires will you add to the self-assessment you create for your clients?
The International Childbirth Education Association (ICEA) is a professional organization that supports educators and health care professionals who believe in freedom to make decisions based on knowledge of alternatives in family-centered maternity and newborn care.