Pregnancy can be full of joy, but it’s also understandable if the maternal health crisis has left you feeling vulnerable. There are vast disparities in care depending on your race and where you live, and the maternal mortality rate is tragically high, especially among Black, American Indian and Alaska Native moms. Many other populations, especially members of the military community and immigrant families, face additional concerns about giving birth too.

Moms aren’t responsible for solving this crisis, but empowering yourself with knowledge can help ensure a safe delivery and healthy start for you and your baby. And perhaps the most important thing to know is exactly what your rights are.

Birth outcomes improve when maternity care providers promote agency and autonomy, but it’s hard to know how and when to advocate for yourself. What to Expect’s Pregnancy Bill of Rights aims to help you do just that as you move through pregnancy, birth and beyond.

1. I have the right to ask as many questions as I want

During pregnancy, you can ask for more information from a doctor, midwife, nurse or doula at any point.

"I just really want people to know that they have power and choice over what happens in their bodies, full stop," says Nicole Calloway Rankins, M.D., a board-certified practicing OB/GYN and the creator and host of the All About Pregnancy & Birth podcast.

Instead of focusing on the vulnerability of pregnancy and postpartum periods, try taking the alternative perspective that advocating for yourself now is a skill that will have lifelong benefits, Dr. Rankins notes.

Asking your OB/GYN the right questions, especially if you're a Black mom-to-be, can shape your entire experience.

What to say: I'm not sure if that decision works for me. Can you explain that further? Are there other care options available? If so, can you inform me of any pros and cons?

2. I have the right to culturally competent care

In a perfect world, all health care would be accessible, affordable and affirming, but unfortunately, that isn't always true. Good providers will listen, respect you as a human capable of making the best decisions, and know how to admit when they've made a mistake.

"Listen to your gut instinct," Dr. Rankins says. "Listen to that voice telling you how you're feeling in that moment, [especially] if you're in front of someone and something makes you feel tense or doesn't feel right."

Moms can't always have their maternal care dream team, Dr. Rankins admits. If you live in maternity care deserts, you may have fewer options, but you shouldn't receive less respect. You should feel comfortable around your care team. Be prepared to communicate what respectful care looks like for you and your circumstance. If you need additional help, tap a support person!

What to say: I feel better respected when I [am referred to with these pronouns, have a loved one present, get to take notes, have time to ask questions, receive materials in another language … ]

3. I have the right to be respected

Autonomy in reproductive care is respecting and supporting a patient's right to decide what care works for them, says Anna Balagtas, founder of Pocket Doula in Toronto.

You can establish an expectation of autonomy-based care during consultations and prenatal visits by asking questions and being clear about the active role you want to play. Ask your provider to help you understand the pros and cons that accompany the choices available.

What to say: I know you suggested that I do X, but it would work better for my family and me if I could try Y. Let’s discuss this decision.

4. I have the right to feel all of my emotions without guilt

Mental health during pregnancy and postpartum is a mixed bag. You deserve space to process the complicated and often conflicting feelings that come with this process guilt-free. You should feel supported as you ride the emotional waves instead of worried about how others may perceive or misinterpret your feelings, Balagtas says.

"People just need to feel free to feel how they need to feel, especially when it's a big thing like birth," Balagtas says. "Your emotions will be up and down, and you just need to move through and not be questioned."

Still, there will be times when big feelings reveal more serious struggles. Get support from a trained mental health professional who respects you in the case of severe, overwhelming or suicidal thoughts. The National Suicide Prevention Lifeline is available at 988 or 1-800-273-8255. The National Maternal Mental Health Hotline is 1-833-9-HELP4MOMS (1-833-943-5746). Service members and their dependents can find free support at Military OneSource.

What to say: I'm feeling [insert emotion] and need time to take care of myself and process my feelings. Can you watch the baby (or give me some space) for a while?

5. I have the right to challenge and report mistreatment

Health care should be a collaborative process based on information, support and respect. If your care team isn't respecting you, it's okay to escalate the situation.

"If someone is not listening to you and they're not respecting you, then you have to take it up a notch," says Dr. Rankins, noting patients may not be in a physical position to advocate for themselves. A loved one or support person can advocate for you if your concerns go unrecognized.

The reporting process depends on the hospital. Talk to the charge nurse if you have issues with nursing staff, ask to see a patient advocate or speak to hospital decision-makers.

"There are always hospital administrators who are on call 24/7," Dr. Rankins says.

What to say: I've asked you to do X, and it seems you're not hearing me or respecting my concerns. Is there someone else I can speak to or work with to get the care I need?

6. I have the right to think through my options before deciding

True emergencies happen, but they're rarer than frequently used terms like "emergency C-sections" would suggest, Dr. Rankins says. This means that there's often an opportunity to take 15 minutes or so to process the options.

"You can say, 'I need a minute to talk to my partner,' or, 'I need a minute — can you step out of the room so I can think about things?'" she says. Don't be afraid to ask for space — give yourself a chance to consider the choices at hand.

What to say: Thank you for giving me this information. I have concerns about X. I'm going to take a moment to discuss this with my support team and get back to you.

7. I have the right to choose and change my maternity care team

"Advocacy starts from the first prenatal appointment," says Kimberly Seals Allers, who created the app Irth to help Black and Brown people have more safe and empowered pregnancy and parenting journeys.

"From the very first appointment, you should ask the doctor key questions," she says. "If you get the sense that you are not being respected or heard or your vision for your birth does not align, then flex your consumer's muscle and choose another provider if you can."

Discuss your birth preferences with your care team long before delivery day, Dr. Rankins says. "Ideally, you don't want to have to fire your doctor in the middle of labor, but I have seen people say, 'I don't want you to come into my room anymore. I want a different doctor.'"

What to say: I have concerns about your [C-section rate, lactation support resources, room-in policy]. I envisioned [alternative outcome]. Can we discuss this to make sure we're a good fit?

8. I have the right to a positive birth experience

Find peace and joy during pregnancy in community with other moms. Seals Allers created Irth so patients could see how other people rated their experience with providers or hospitals. This helps them build confidence and supports them as they explore their options. It also challenges negative pregnancy stories.

"We only share joyful Black birthing stories as a direct counter to the doom-and-gloom narrative too common in mainstream coverage of Black maternal health," Seals Allers says about Irth and the Birthright podcast she hosts.

What to say: I'm not interested in hearing any more negative birth stories. But I am willing to discuss X with you.

Your provider should educate you about the risks, benefits and alternatives of a given procedure so you can give informed consent.

Professional organizations like the American College of Obstetricians and Gynecologists have standards for shared decision-making, but 1 in 4 pregnant women feel ignored or dismissed by health care providers, a 2022 What to Expect survey found.

"These guidelines are about centering the patient, making sure they are aware of all options, respecting their wishes, but consistently this is not happening," Seals Allers says.

You deserve to get the knowledge you need to make a decision.

What to say: Can you tell me more about that? What are the pros and cons? What are my other options?

10. I have a right to change my mind at any time

Flexibility is essential at every stage of the parenting journey. New circumstances can change your perspective, and new medical information can shift your plans. You have the right to change your mind about what feels the most supportive for you, Balagtas says, especially as your doctor provides you with appropriate insight into your health care.

"I tell my clients, 'We're not going to build a birth plan; we need to build your birth preferences list,' because it gives you permission to change your preferences," she says. Knowing all your options — and their advantages and disadvantages — can help you decide if you need to change tacks.

What to say: I know we discussed this, but with the information you provided, I've actually decided I would prefer that. What do we need to shift to make this possible?

It's normal to feel overwhelmed during pregnancy, but with this Bill of Rights in hand, know that you're entitled to respectful, thoughtful and informative prenatal and postpartum care.