Advocating for Yourself

Knowing your risks and being heard in maternity care

Your rights & safety After birth 6 modules

1 Why this matters — knowing the picture

4 min read

The UK’s confidential enquiry into maternal deaths (MBRRACE-UK) reported that across 2021–23, maternal deaths ran at 12.44 per 100,000 women giving birth among White women, 16.74 among Asian women and 28.21 among Black women — 1.3 and 2.3 times the White rate. Women in the most deprived areas died at 1.9 times the rate of those in the least deprived.

The report’s own explanation is not biology. It describes "a constellation of biases" in the care women received.

These are still small absolute numbers, and most births are safe. This is not about anything you have done, and it is not a reason to be afraid — it is information, and information is power. Knowing the picture helps you ask the right questions and expect to be taken seriously.

2 Warning signs worth acting on

5 min read

Some symptoms in the weeks after birth need urgent attention: sudden or very heavy bleeding, especially with feeling faint; chest pain or difficulty breathing; pain, swelling or redness in your calf; a high temperature with tenderness in your tummy; and a headache with vision changes or vomiting.

You do not need to be certain something is wrong to seek help — that is what maternity triage, your GP, 111 and, in an emergency, 999 are for.

Trust the feeling that something is off. The point of the previous module is that being taken seriously is sometimes the harder half.

3 Being heard in appointments

4 min read

You know your body better than anyone in the room. A few simple habits make it much more likely you will be heard: describe changes specifically ("this is different from yesterday because…"), and name your worry out loud ("I’m concerned this could be an infection").

Two phrases are especially useful: "What is the plan, and what are we ruling out?" and, if you feel brushed off, "I’d like this written in my notes." Asking for things to be documented is completely reasonable and often changes the response.

Practise saying one of these before your next appointment. It is not being difficult — it is good, collaborative care.

4 Your support team & second opinions

4 min read

You are allowed to bring someone — a partner, friend or family member — to appointments to help you remember, ask questions and advocate for you. Decide together beforehand what you most want to raise.

If you feel your concerns are not being addressed, you can ask to speak to a different clinician or a senior midwife, or request a second opinion. This is your right, not a favour.

Keep a short note of symptoms and dates on your phone. Having the timeline in front of you makes it easier to be clear and to be believed.

5 After a hard experience

5 min read

If your care fell short — you felt dismissed, unsafe, or unheard — that experience is valid, and there are routes to be heard afterwards.

PALS — the Patient Advice and Liaison Service — offers confidential advice and support, and can help resolve concerns about NHS care. You can find your local office through the NHS service search, or by asking your GP surgery or hospital, or calling 111.

None of this is about blame — it is about being taken seriously and helping the next person be safer too. Speaking up matters, and support exists to help you do it.

6 Your right to informed consent & choice

5 min read

Every examination, test or intervention offered to you — a vaginal exam, induction, monitoring, a caesarean — requires your consent, and NHS guidance sets two conditions on it: it must be voluntary, made without pressure, and informed, meaning you were given the information about what the treatment involves including the benefits and risks.

A framework some people find useful in the moment — sometimes called BRAIN — is to ask about the Benefits, the Risks, the Alternatives, what your Instinct says, and what happens if you do Nothing or wait. It is a memory aid rather than official guidance, and you can ask for each part one at a time.

If you have capacity to make the decision, your refusal must be respected — that holds even where the recommendation is well established. And consent is never one-off: you are entitled to withdraw it at any point before a procedure, including once labour has started.