The Power of a Pause
When you think about preparing for birth, you probably picture creating a birth plan, choosing a provider, packing your hospital bag, and practicing comfort techniques. But one of the most powerful tools you can carry into the birth room isn’t physical at all. It’s the ability to pause.
In modern hospital births, especially in the U.S., decisions are often presented quickly, with phrases like:
“Let’s go ahead and break your water.”
“We’re going to start Pitocin now.”
“It’s time to get this baby out.”
The speed of these statements can make it feel like you don’t have a choice, like the next step is already in motion. But unless you're in a true medical emergency, you almost always have time to stop, breathe, and make a decision with clarity and autonomy.
In this post, we’ll explore:
Why fast-paced decision-making is common in hospital births
How pausing can protect your autonomy and reduce unnecessary interventions
What the evidence says about time in labor
Real-life scripts and techniques you can use to pause
How to prepare your birth team to protect your space
⏳ Why Is Everything So Rushed?
Birth is not a medical emergency for the vast majority of healthy pregnancies. Yet hospital systems often operate with efficiency and liability protection as their top priorities, not physiological birth.
Providers, especially in large hospital settings, are under pressure to:
Keep births within a certain time frame
Minimize overnight labor management
Avoid legal consequences
Follow protocols that may not be individualized to your care
This environment can create a sense of false urgency, where interventions are offered (or pushed) simply to keep things moving, not because you or your baby are in danger.
📊 What the Evidence Says About Time and Labor
Let’s look at some key evidence:
1. Labor Takes Time, and That’s Okay
In 2014, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) issued a joint consensus called “Safe Prevention of the Primary Cesarean Delivery.”
They emphasized that:
“Active labor should not be diagnosed until 6 cm of dilation.”
“Slow but progressive labor should not be an indication for cesarean.”
“Extended time in second stage (pushing) is acceptable in the absence of fetal distress.”
This means: length alone is not a reason to rush. Interventions should not be automatic just because labor isn’t progressing according to an outdated timeline.
2. Informed Consent Includes the Right to Refuse or Delay
ACOG’s Committee Opinion No. 439 clearly states:
“Pregnant women have the right to refuse recommended treatment... even if the physician believes that refusal endangers the life or well-being of the fetus.”
You are not required to agree to any intervention, and you are entitled to accurate, unbiased information, time to decide, and respect for your decision.
🛑 Why a Pause is Powerful
The pause is where you reclaim your role as the decision-maker.
When you pause:
You give yourself a moment to breathe and calm your nervous system
You create space to ask questions and receive full explanations
You avoid reacting from fear or pressure
You prevent consent from being rushed or coerced
You activate your support team to help you evaluate your options
And here’s the best part: it only takes a few seconds.
Even if you’re in active labor, even if a provider is standing in front of you waiting, you are allowed to take a moment.
💬 Real-Life Scripts to Use
Here are simple phrases to help you hit the pause button:
“Can we have a minute to talk about this privately?”
“Is this an emergency, or do we have time to think about it?”
“I’d like more information before making a decision.”
“I’m not ready to decide right now.”
“What are the risks if we wait a little longer?”
“I hear your recommendation, but I need time to consider my options.”
“I don’t consent at this time.”
You do not have to make a decision just because someone in scrubs is waiting. If your provider pushes back, that’s a red flag.
🧠 Use the B.R.A.I.N. Tool
To guide your decision during a pause, you can use the BRAIN acronym, a classic tool used by doulas and childbirth educators:
B – Benefits: What are the benefits of this procedure or decision?
R – Risks: What are the potential risks or downsides?
A – Alternatives: Are there other options available, including doing nothing?
I – Intuition: What is your gut telling you?
N – Nothing: What happens if we wait or do nothing for now?
This method slows down the process and puts you back in control.
👫 Prepare Your Birth Team to Protect the Pause
Sometimes, in the intensity of labor, you may not feel able to speak up yourself. That’s why it’s so important to brief your support team ahead of time. This includes:
Your partner or spouse
Your doula
Your nurse (as you get settled in)
Your provider (during prenatal visits)
Let them know:
You intend to ask questions before agreeing to anything
You want to be informed of all options
You expect time to make decisions unless there’s a real emergency
You want someone to speak up for you if you seem unsure or overwhelmed
🚨 What About Real Emergencies?
Sometimes there is a genuine need to act quickly, such as in the case of severe fetal distress, uterine rupture, or a cord prolapse. In those moments, your provider should clearly explain what’s happening and what needs to be done.
Even then, you still deserve:
An explanation
Respect
Emotional support
Involvement in the process as much as possible
But here’s the truth: most situations in birth are not true emergencies. And many that are framed that way are based more on protocol than danger.
🧘♀️ Practicing the Pause in Pregnancy
Pausing is a skill. Like breathing through a contraction or pushing effectively, it gets easier with practice.
Here’s how you can build that muscle now:
When your provider suggests a test or screening, pause and ask about it.
Practice saying “I’ll need time to think about that” during prenatal visits.
Use BRAIN when making pregnancy decisions (like about induction or membrane sweeps).
Role-play with your partner or doula: what would you say if you felt rushed?
The more you practice now, the more natural it will feel when you need it most.
👣 Final Thoughts
In birth, there will be moments when things feel fast. You may feel like your power is slipping away as decisions swirl around you. But you don’t have to rush. You can always pause.
You can ask questions. You can think. You can say no. You can change your mind.
The pause is not a delay, it’s a declaration:
“This is my body, my baby, my birth. I will move forward when I’m ready.”
