Birth Shouldn’t Feel Like a Hostage Situation: A Guide to Birth Trauma and Medical Coercion

by | May 29, 2025 | Postpartum & Motherhood, Pregnancy & Childbirth | 0 comments

Illustration of a pregnant woman in labor sitting on a hospital bed, flanked by two providers—one holding a clipboard labeled “Standard Policy” with a stern expression, and another midwife listening compassionately to the woman. Her partner stands beside her, concerned but supportive.

Birth trauma and medical coercion are more common than most women realize. This article explores what they look like and how to take your power back.

I can’t count how many times a client has sat across from me and said something like,
“I just don’t trust hospitals.”
Or:
“I know this sounds crazy, but I’m terrified of going back.”
Or sometimes, they don’t even say it out loud. They flinch when I mention a hospital transfer plan, or their voices shake when we talk about a past experience. Some are nervous, some are traumatized, and some are just quietly, firmly… done.

And here’s the thing: I believe them. Every single one.

Because while the reasons vary, rude staff, pushy doctors, ignored consent, trauma during a previous birth, the common thread is always the same. They felt powerless in a moment when they needed support. And that stays with a woman. Especially when it happens during something as vulnerable and world-altering as birth.

Now let me be clear. I don’t believe hospitals are full of villains in scrubs.
I’ve worked alongside many hospital nurses and OBs who are smart, compassionate, and absolutely doing their best for the people in their care.
But I also know this: when a system gets too big, the individual gets lost.

Policies replace conversation. Risk charts replace real-life nuance. And suddenly the woman in the hospital bed isn’t a thinking, feeling human being anymore. They’re a protocol to manage, a liability to reduce, or a labor to “progress.”

That’s where things go sideways.

So this article isn’t about bashing hospitals. And it’s not about making you afraid.
It’s about something else entirely: power.
Your power.
The power to understand your rights, spot coercion when it shows up wearing a stethoscope, and know what to do when your gut is screaming that something isn’t right.

But first, a legal note.

Let me get this part out of the way up front:
I am not a lawyer.
Nothing in this article is legal advice.
I am a midwife who knows how to read, research, and ask hard questions. I believe information is power, and you deserve to have both, especially when it comes to your body, your birth, and your care.

Please consult a qualified attorney if you believe your rights have been violated. What I’m offering here is not legal representation. It’s real talk, evidence-based facts, and a map of what the system should be doing. So that if it’s not, you can speak up, push back, and protect yourself.

Let’s get into it.

What Is Medical Coercion?

A midwife in a lab coat stands beside a whiteboard labeled “Medical Coercion?” while explaining the concept.
Understanding coercion in birth starts with asking the right questions—and refusing to accept silence as consent.

Let’s start with the big question: What exactly is medical coercion?

Medical coercion is a major cause of birth trauma, and medical coercion is often overlooked by providers and hospitals alike

At its core, coercion is pressure. It’s when a patient is guided toward a decision using fear, shame, manipulation, or withholding critical information. In the birth world, it happens far more often than most people realize.

It sounds like this:
“If you don’t let us start Pitocin, your baby could die.”
“That’s not allowed at this hospital.”
“We’ll have to call CPS if you refuse.”
“If you don’t consent to a cervical check, we can’t admit you.”
“You’re being difficult. Don’t you care about your baby?”

Sometimes, it’s not even words. It’s a sigh, a raised eyebrow. A provider turning their back. A silence so heavy you feel cornered. It’s the illusion of choice when you’re told what to do.

And here’s the truth many people need to hear: consent under pressure isn’t consent. It’s compliance. And that is not the same thing.

What does this look like in birth?

Medical coercion can happen at any point in pregnancy, labor, or postpartum care. But in the birth room, it often intensifies. Emotions are high, time feels short, and everyone tries to avoid worst-case scenarios. That’s when the pressure ramps up. And unfortunately, so does the risk of harm.

Sometimes coercion goes even further. It becomes obstetric violence.

That might sound like a heavy phrase, but let’s call it what it is.
Obstetric violence is when a woman is touched, treated, or operated on without their consent, physically, emotionally, or psychologically, during pregnancy or childbirth.

For example:
A provider says, “I’m going to check your cervix now,” and immediately performs a vaginal exam without waiting for your permission.
A nurse holds your legs down while you say no to a procedure.
A doctor performs an episiotomy or C-section without informing you or obtaining your agreement.

These aren’t just bad manners.
They are violations. Of your body. Of your rights. Of your humanity.

And yes, they’re common. Too common.

I’ve had clients come to me years after their births, saying they still can’t shake the feeling that something was taken from them in the hospital. They didn’t have the words for it at the time. They just knew something felt wrong.

Now they know. It was coercion. Sometimes, it was assault.

So let’s stop pretending this doesn’t happen. Let’s stop calling it “just how it goes in the hospital.” Let’s name it so that we can do something about it.

Next, we’ll talk about what should happen because you have rights. Informed consent is not optional.

Informed Consent: Your Legal and Ethical Right

Illustration of a wooden gavel striking a surface, with the words “Informed Consent” carved boldly into the head of the gavel.
This isn’t a suggestion. It’s the law. Informed consent isn’t optional—it’s your legal right and ethical bottom line.

Informed consent is not a favor. It is not something you earn by being agreeable. It is your right, protected by federal law and upheld by every major medical ethics organization in the country.

At its most basic level, informed consent means this: no one is allowed to touch your body, perform a procedure, or make a medical decision for you unless you say yes after being fully informed of all your options.

Let me say that again, because it matters:
You have the right to hear the risks, benefits, and alternatives, including doing nothing, before anyone does anything to you.

And yes, that includes during labor.

What the law says

Hospitals that receive federal funding through Medicare or Medicaid are required to follow the Medicare Conditions of Participation. These rules, enforced by the Centers for Medicare and Medicaid Services (CMS), state that every patient has the right to make informed decisions about their care, including the right to accept or refuse any treatment.

This is not a grey area. It is a legal requirement.

The Department of Health and Human Services (HHS) also supports this standard, stating that patients must be informed of their health status and be involved in decisions about their care. That applies to adults, adolescents in some cases, and especially pregnant women.

Professional organizations like ACOG (the American College of Obstetricians and Gynecologists) and the AMA (American Medical Association) back this up with strong ethical guidelines. They emphasize that proper consent requires more than a signature. It requires a conversation.

What informed consent looks like

Real informed consent includes:

  • An explanation of the treatment or procedure being offered
  • A discussion of the risks and potential side effects
  • A clear presentation of any alternatives, including doing nothing
  • An opportunity to ask questions
  • Time to think about your decision
  • The freedom to say yes or no without pressure

It also includes the right to change your mind.

And no, “standard protocol” is not a valid reason to skip this process. Just because something is routine for the hospital does not mean it’s routine for you.

Pregnancy does not suspend your rights

This one is worth emphasizing. Too often, pregnant women are treated like they’ve forfeited their bodily autonomy the moment they walk through Labor and Delivery.

Let me be clear. Being pregnant does not reduce your legal rights.
Being in labor does not cancel your right to say no.
Concern for the baby does not override your right to informed consent.

Can providers explain risks? Absolutely.
Can they recommend treatments? Of course.
But they cannot legally force, trick, or pressure you into anything.

Informed consent is not optional. And it does not disappear because a fetal monitor is picking up contractions.

What Hospitals and Providers Are Required to Do

Illustration of a pregnant woman and her partner in a hospital bed as a doctor gestures while speaking over them, ignoring their expressions of concern
If your provider talks at you instead of with you, it’s not informed consent—it’s medical theater.

So, we’ve talked about your legal and ethical right to informed consent. But what does that mean in practice? What are hospitals and providers supposed to do to protect that right?

Turns out, quite a bit. Whether they do it well or at all is another matter.

Let’s walk through the actual requirements.

Patient’s Bill of Rights

Most hospitals in the United States post a version of the Patient’s Bill of Rights. This is usually a written document handed to you on admission or available on the hospital website. It outlines, in plain language, your rights as a patient. Things like:

  • The right to receive information about your diagnosis and treatment
  • The right to participate in decisions about your care
  • The right to accept or refuse any treatment
  • The right to be informed about the consequences of refusing treatment
  • The right to know the name and role of your providers
  • The right to have your pain managed
  • The right to file a complaint or grievance if you believe your rights were violated

Ask for this document if you haven’t seen it at your local hospital. Read it. Keep a copy. It’s the hospital’s list of promises to you. And if something happens that doesn’t line up with that list, you’ve got written grounds to speak up.

Documentation requirements

Hospitals must also document your consent (or refusal) in your medical record. This isn’t just for major procedures like surgery. It includes things like:

  • Vaginal exams
  • Inductions
  • Pain medication
  • C-sections
  • Episiotomies
  • Use of forceps or vacuum
  • Even basic treatments like IV fluids or continuous monitoring

In theory, this documentation helps protect everyone. But in practice? It can also shield providers if the chart says “patient consented” when no real conversation happened.

That’s why it matters to speak up if something feels wrong, and to ask that your objections be documented clearly. You can say, “Please note in my chart that I declined this procedure and asked for alternatives.”

It might not make you popular. But it puts the truth in writing.

What if it’s “just hospital policy”?

Ah, the infamous phrase. “That’s just our policy.”

It’s incredible how often that line gets used to shut down a conversation. But here’s the thing about policies: hospitals can’t make rules that override your federal rights.

Let’s say a hospital has a policy that all patients in labor must receive continuous electronic fetal monitoring. You ask for intermittent monitoring because you want freedom of movement. They say no, it’s “just policy.”

Legally, you still have the right to decline. Policy doesn’t trump consent.

Hospitals can recommend what they believe is safest. They can tell you what the standard is in their setting. But they cannot force anything on you without your permission. Not even if it’s “how they always do it.”

What about Texas?

Since I practice in Texas, let’s talk state specifics.

Texas recognizes informed consent as a legal requirement for all medical procedures, and the Texas Medical Disclosure Panel (TMDP) outlines specific risks that must be disclosed for certain procedures, including many in obstetric care.

Texas hospitals are also required to provide a written grievance procedure and respond in a timely manner to complaints. If you feel your rights were violated, you have the legal right to file a formal complaint, and they have the legal duty to respond.

In short, the laws exist, and the protections are in place. But whether they’re followed often depends on whether someone is watching.

What to Do in the Moment: How to Push Back Against Coercion

Illustration of a pregnant woman sobbing into her partner’s chest while a hospital nurse stands nearby with an annoyed expression.
If you’re in tears and the nurse is in a huff, that’s not care—it’s coercion with a clipboard.

Let’s talk about that moment, the one where something feels off.

You’re in labor. Or you’re sitting in a gown with an IV in your arm. Someone walks in and says, “We’re going to…” without asking if that’s okay. Or they start listing risks so fast that it sounds like a threat, or they look at your partner instead of you.

Your gut twists. You feel cornered. And your brain goes foggy.

It’s hard to think clearly when your body is in fight-or-flight mode. That’s why it helps to have a few simple tools ready before you’re in that moment.

Questions to Slow Things Down

If something doesn’t feel right, try asking:

  • Can you explain all the alternatives, including doing nothing?
  • Is this happening right now, or is it something you’re worried might happen?
  • What would happen if we waited?
  • Can you give me a moment to think about this?

These questions can break the momentum of pressure and bring the conversation back to where it belongs, with you.

Statements to Reclaim Your Voice

Sometimes the fastest way to reset the room is to speak clearly and calmly. Try:

  • I understand what you’re recommending. I am choosing ___, and I take full responsibility for my decision.
  • Please document in my chart that I am declining this and asking for alternatives.
  • I hear your concern. I’ve considered the risks and benefits, and I am not consenting to that at this time.

Notice how none of those statements are confrontational. You’re not yelling. You’re not being dramatic. You’re being clear, direct, and legally unambiguous.

Bring an Advocate If You Can

Having someone in the room who knows your wishes can make a huge difference. This could be your partner, doula, a trusted friend, or even a knowledgeable family member.

Better yet, assign someone the role of “documentation support.” This person can:

  • Take notes on who said what and when
  • Ask follow-up questions if you’re focused on coping
  • Calmly say, “Can we clarify what’s happening before anything moves forward?”

Some hospitals also have patient advocates or ombudsman services. You have the right to request one at any time.

And here’s something else worth knowing. At my homebirth practice, if a client ever needs to transfer to the hospital, we go with her. Every time. That may not make us the most popular faces at the nurse’s station, but our priority is the woman we’ve spent months getting to know. By the time she’s in labor, we’ve often had dozens of hours of conversation, built deep trust, and learned her values. We understand hospital jargon. We speak the lingo. And we make sure her voice doesn’t get lost in translation.

Not all midwives do this, and not every transfer allows for it. But in our practice, it happens less than five percent of the time, and when it does, our clients consistently say that having us there made all the difference.

If you don’t have that kind of continuity of care with your provider, that’s okay. Just make sure someone in that room knows you, trusts you, and can help hold space for your choices.

Look for Red Flags

Some things providers say are worth paying extra attention to. These are often signs that your consent is being pushed, not earned.

  • “We’ll just do this real quick, okay?” (That’s not consent.)
  • “It’s our policy.” (Ask to see it.)
  • “Do you want a dead baby?” (This is fear-based manipulation. Full stop.)
  • “We’re going to go ahead and…” (Stop them and say, “I haven’t consented yet.”)

A good provider won’t shut down when you ask for clarity. They’ll welcome it.

A Powerful Phrase to Keep in Your Back Pocket

If all else fails, and you feel the situation slipping away from you, you can say this:

“I understand what you’re saying and why. I choose ___, and I take full responsibility for that choice. I release you from liability. Thank you for understanding and for caring.”

This one sentence puts the ball firmly in your court. You’ve acknowledged the recommendation. You’ve declined respectfully. You’ve clarified that this is your decision, and you’re not blaming anyone. It often disarms tension instantly.

And if someone still tries to move forward without your permission?

You say it clearly: “I do not consent.”

Then ask them to document your refusal in your medical record.

If It’s Too Late – How to Report a Violation

Postpartum woman sits at a kitchen table with a laptop open, visibly emotional but focused, filing a complaint after a traumatic birth experience.
You don’t owe silence to a system that harmed you. File the complaint. Name what happened. Power doesn’t return unless you claim it.

Sometimes the moment passes before you can act. You’re home days later, lying in bed, and the what-just-happened feelings won’t go away. You’re second-guessing yourself. You’re replaying the scene over and over in your head. And it hits you, you didn’t imagine it. That wasn’t okay.

So what now?

If you believe your rights were violated, there are steps you can take. You can speak up. You can file a complaint. And depending on what happened, you may be able to pursue formal action. Will it fix what happened? Maybe not. But it can help you reclaim your power, prevent future harm, and sometimes create real accountability.

Step One: Start with the Hospital

Every hospital that accepts federal funding is legally required to have a patient grievance process. This means they must provide a way for you to file a formal complaint, and they are obligated to respond.

To file:

  • Visit the hospital’s website and look for “Patient Rights” or “File a Complaint”
  • Call the hospital’s patient advocacy office or quality department
  • Ask for a written copy of their grievance policy and form

Be specific in your complaint. Include names, dates, what happened, what you said, what was done without your consent, and how it affected you. Keep a copy of everything you submit.

This step is important not because it will necessarily result in justice, but because it creates a paper trail. It also forces the hospital to open a file and respond.

Step Two: Report to State Agencies

You can escalate if the hospital’s response is inappropriate or if the issue is serious enough that you want to pursue it further.

Here in Texas, your next steps might include:

  • Texas Health and Human Services (HHS): accepts complaints against hospitals, birth centers, and licensed facilities
  • Texas Department of State Health Services (DSHS): investigates public health violations and medical facility complaints
  • Texas Medical Board: file a complaint if a physician acted unethically, coercively, or without consent
  • Texas Board of Nursing: file a complaint against a nurse for unethical or harmful behavior

You can usually file complaints online through these agencies’ official portals. Most allow anonymous reports, though it’s better to include your name if you want a response.

Step Three: Federal Reporting

If your rights were violated through discrimination, coercion, or lack of informed consent, especially if the facility receives federal funding, you can file a federal complaint with the Office for Civil Rights (under the Department of Health and Human Services).

This may apply if:

  • You were denied care because of race, language, disability, or religion
  • You were coerced or forced into procedures
  • You were treated differently because of your pregnancy choices

You can file a complaint online at hhs.gov/ocr.

Step Four: Consider Legal Action

If the harm you experienced involved physical violation, trauma, medical negligence, or long-term damage, legal action may be an option. This could include:

  • Battery (touching you without consent)
  • Negligence (failure to meet the standard of care)
  • Malpractice (harm caused by provider error or disregard)

I’ll say it again, I am not a lawyer. But if something happened that continues to haunt you, or if you suffered lasting harm, talk to someone. Some offer free consultations or work on contingency. You deserve to know what your options are.

What to Include in a Complaint

No matter where you report, here’s what helps:

  • Date, time, and location of the event
  • Names of providers or staff involved
  • What was said and done (use quotes if possible)
  • What you requested or declined
  • How your rights were ignored
  • How the experience affected you physically or emotionally

Stick to the facts. Be honest. Be clear. And remember, you are not being dramatic. You are not overreacting. You are documenting something that shouldn’t have happened.

Why It Happens – Bureaucracy, Burnout, and Blind Spots

Hospital providers focus on charts and monitors while a laboring woman fades into the background, overlooked and ignored.
When protocols matter more than people, real humans get erased. She’s not a checklist—she’s the whole damn point.

By now, we’ve covered a lot: what coercion looks like, how to push back, and what to do if your rights have already been violated.

So let’s ask the next honest question.

Why is this happening in the first place?

Because I don’t believe that most doctors, nurses, or staff wake up thinking, “Today I’ll ignore someone’s consent.”
I don’t believe that bad people usually cause birth trauma.

But I do believe that it happens in bad systems. And those systems don’t need villains to create harm. They only need pressure, policy, and people too overwhelmed to see what’s happening before them.

Bureaucracy: when the chart matters more than the person

Hospital systems are designed to manage risk. That’s not necessarily a bad thing. However, it becomes a problem when the risk to the institution becomes more important than the patient’s reality.

That’s when care becomes checkbox-driven.
That’s when “we have to document this” replaces “do you understand your options?”
That’s when “it’s our policy” becomes a conversation-stopper instead of a safety net.

Birth gets reduced to a flowchart, and anything that doesn’t fit is labeled dangerous, even when it isn’t.

Burnout: when compassion runs on fumes

Healthcare workers are exhausted. Especially right now. Especially in labor and delivery.

Hospital nurses are often short-staffed, stretched thin, and under constant pressure to stay ahead of emergencies. Doctors are managing multiple patients, battling liability fears, and juggling administrative chaos between deliveries.

Burnout doesn’t always look like rage or withdrawal. Sometimes it looks like detachment. Eye contact that disappears. Conversations that get shorter. A slow slide from patient-centered care to “just get through the shift.”

And I say this as someone who’s been there.

I worked for years as a hospital RN in several different departments, including labor and delivery. I saw this burnout and institutionalization with my own eyes. And I’m sad to say, I was guilty of it, too. Not because I didn’t care, but because that’s how the system is built. You move fast. You follow orders. You get through the checklist. There isn’t time to ask “Is this what she wants?” when the schedule’s stacked and the protocol is loud.

In the end, that’s what pushed me to go back to school and become a midwife. I couldn’t stand being forced to treat people in ways I wouldn’t want to be treated myself. I needed to offer care that centered the woman, not the system. I needed a different model.

And I know I’m not the only one who’s walked away for that reason.

Blind spots: when fear and training silence instincts

Here’s the hardest part to say out loud:
Even good providers can unintentionally cause harm.

Sometimes they’re following protocols they don’t even agree with. Sometimes they were trained in environments that normalized coercion. Sometimes they truly believe they’re doing what’s best for you, and don’t realize they’ve stopped asking what you think is best.

I’ve seen it happen. I’ve worked with providers who cared deeply about their patients but still defaulted to fear-based language or dismissed a woman’s concerns because it didn’t match what the monitor said.

They weren’t evil. But they were wrong.

And unless someone calls it out, the cycle repeats.

This is why informed, respectful care is radical

Not because it’s complicated. But because it asks the system to do something it doesn’t naturally do, slow down, listen, and trust the woman giving birth.

It asks a burned-out provider to take a breath.
It asks a massive bureaucracy to make space for one voice.
It asks all of us to remember that safety doesn’t come from policy alone. It comes from relationships. From trust. From consent that means something.

Final Thoughts – You Are Not Powerless

Family of five walks down a beach at sunset, parents holding hands and smiling, the mother carrying a newborn in her arms.
You may have felt powerless then. But that was never the truth. You can still rise, speak, and reclaim what’s yours.

We’ve covered a lot.

We talked about what medical coercion looks like, especially in the birth room.
We named the difference between consent and compliance.
We broke down your legal rights, what hospitals are required to do, and how to advocate for yourself in the moment.
We looked at what to do if something already happened, and where to report it.
And we pulled back the curtain on why even good people working in healthcare sometimes cause harm, burnout, bureaucracy, and blind spots are real.

If you’re feeling overwhelmed, that’s okay. You don’t have to remember every single rule or quote federal law like an attorney. You just need to know this:

You are allowed to ask questions.
You are allowed to say no.
You are allowed to expect respectful, evidence-based care, even when you’re scared, even when you’re vulnerable, even in a hospital gown.

That’s not extra. That’s basic.

And while we’ve spent a lot of time here focusing on hospitals, and on childbirth specifically, I want to be very clear: this isn’t just a hospital problem. Coercion can and does happen in birth centers. I’ve even seen it happen in homebirth settings. Any time a provider pushes past your boundaries, skips informed consent, or uses fear to control your decisions, it’s a problem. The setting doesn’t make you safe. The relationship, the respect, and the process of real consent do.

These same principles apply to any healthcare activity. Not just birth. Not just women. Not just one kind of provider. Anytime someone touches your body, prescribes a treatment, or recommends a procedure, you have the right to full information and real choice.

And just to be crystal clear one more time:
I’m not a lawyer. Nothing in this article is legal advice. I’m a midwife, a researcher, and someone who has seen what happens when people don’t know their rights. My goal is to inform, support, and point you toward resources so that you can make your own decisions, and get legal help if you need it.

Because you deserve better than confusion and coercion. You deserve care that honors your voice.

If you experienced birth trauma and medical coercion, know this: you are not powerless.

Let’s keep raising the bar.

I’ve included a large list of resources below to help you learn more, take action if needed, and share this information with others.

—Stay Strong!  Jaelin—

Sources & Resources

Here’s a comprehensive list of resources referenced throughout this article, including legal foundations, complaint portals, advocacy groups, and additional reading. Use these to research your rights, take action, or help someone else do the same.

Legal Foundations for Informed Consent and Patient Rights

Where to File a Complaint

Hospital and Facility-Level Grievances

  • Ask your hospital for their internal grievance process or check their website under “Patient Rights” or “File a Complaint”

Texas-Specific Complaint Portals

  • You may be able to report unethical behavior to their certifying organization (e.g., DONA International, CAPPA, etc.)
  • If the doula was working under a hospital’s doula program, you can report concerns to the hospital through its patient grievance process.

Federal Reporting

Legal Support and Advocacy Organizations

Additional Reading and Education

About the Author:

Dr. Jaelin Stickels, DNP, CNM, APRN

Dr. Jaelin Stickels, DPN, CNM, APRN, is a deeply passionate and highly skilled Certified Nurse Midwife, Women’s Health Nurse Practitioner, and the owner of Holistic Heritage Homebirth in Houston, Texas. With over a decade of midwife experience, Jaelin has had the privilege of helping several hundred (over 700 as of 2024…) women welcome their babies into the world. In addition to her advanced practice licensure training, she has additional advanced training in twin and breech births, making her one of only a few with these skills in her area.  Jaelin approaches every birth with expertise, compassion, and a deep respect for the birthing process.

Jaelin’s journey into midwifery began with a profound love for supporting women through the incredible experience of pregnancy, labor, and postpartum. Since 2010, she has been dedicated to walking alongside families during these transformative moments, offering guidance, support, and care tailored to each individual’s unique needs. She is a big believer in informed consent and ensures clients are given the best evidence-based information to make the best decisions for themselves and their families.

Married to her high school sweetheart Ted (aka Chef Ted) since 1984, Jaelin is the proud mother of three grown children and the delighted grandmother of one amazing granddaughter. When she’s not assisting in births, Jaelin finds joy in going to the movies with her husband, quilting, and cherishing time with her family. Known by the other midwives in her practice (Holistic Heritage Homebirth) affectionately as the “Birth Hog,” she brings an unmatched dedication and enthusiasm to her work—no one loves birth quite like she does.

Read Jaelin’s Bio

Find out more about Jaelin’s Homebirth Practice (Holistic Heritage Homebirth) in Houston, TX

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