Consent or Coercion?
Is It Consent or Coercion? Knowing the Difference in Pregnancy and Birth
Pregnancy is meant to be a time of feeling held and supported — but too often, it feels like a series of instructions rather than a shared journey.
You might hear things like:
“You’ll need to be induced at 39 weeks.”
“That’s hospital policy.”
“You’re not allowed to...”
But here’s the truth:
Consent isn’t really consent if you didn’t feel able to say no.
And sometimes, what’s framed as “guidance” is actually pressure.
So how can you tell the difference between consent and coercion?
Let’s talk about it.
💬 What Is Consent?
Consent in maternity care means that you:
✅ Receive clear, balanced information (including risks and alternatives)
✅ Have time to ask questions and think things through
✅ Feel free to say yes, no, or “not right now” — without fear or guilt
✅ Are supported in your choices, even if they’re different to what’s suggested
🚩 What Is Coercion?
Coercion is when you feel pushed, manipulated, or worn down into agreeing to something. It might sound like:
“You’re putting your baby at risk if you wait.”
“This is just what we do for people like you.”
“We’ll book you in.” (before you’ve even consented)
Or even more subtly: a raised eyebrow, a sigh, a comment made in front of your partner
It can feel hard to spot — especially when you’re exhausted, emotional, or just trying to do the right thing.
✨ My Story: Even as a Midwife, I Felt the Pressure
When I was pregnant with my youngest, I was over 40 and classed as overweight. Because of that alone, I was repeatedly told:
“You’ll need to be induced at 39 weeks.”
But I’d already made an informed decision to decline unless there was a medical reason. I knew my baby was well. I’d had a straightforward birth before. I was confident in my plan.
When my waters broke and labour didn’t start right away, I still wasn’t worried. I was getting signs of labour each night and felt sure it would kick off soon. But when we popped into hospital for monitoring over a bank holiday weekend (because the community midwife couldn’t visit), we were met by four health professionals all strongly recommending induction.
And then — they separated me from my husband.
They told him:
“You do know she’s putting your baby at risk?”
Thankfully, my husband knew I was a midwife of 15 years by then. He trusted me. He calmly said:
“If Nickie says we’re going home, that’s what we’re doing.”
I never loved him more than I did that day.
And just like I believed it would — labour started naturally. Finley was born at exactly 39 weeks, almost seven full days after my waters broke. No complications. No drama.
Just the way I knew it could happen — if given space.
Looking back, I’m certain it would’ve happened sooner without all that pressure.
🧠 Why It’s So Hard to Say No
Even if you’re confident, declining recommended care — especially in a hospital setting — can feel incredibly difficult. Without support, you might feel:
Overwhelmed by authority
Scared of making the “wrong” choice
Worried about being labelled “difficult”
Emotionally worn down by repeated conversations
And it’s no wonder. The system isn’t always set up to support genuine choice. There are roles in the NHS specifically there to help — consultant midwives, specialist teams, safeguarding professionals — but even these can unintentionally add pressure when you go “off script.”
Sometimes, you’re not doing the wrong thing — you’re just doing something they haven’t seen before. And that can make professionals uncomfortable.
💡 What Can Help?
If you’re finding it hard to stand your ground, here are a few things that can help:
Outside support: Speaking with an independent midwife, birth rights advocate, or specialist organisation can help you work through the actual evidence and gain confidence.
The BRAIN tool: Ask about Benefits, Risks, Alternatives, what your Intuition says, and what happens if you do Nothing.
Birth partners: Having someone by your side who knows your plan (and will stick up for it!) can make all the difference.
Documentation: Write your choices into your birth plan and refer to them during appointments.
Kindness to yourself: This is emotionally exhausting. You're doing your best.
🤍 You Deserve Respectful Care
Whether you say yes, no, or “let me think about it” — you deserve to be heard, supported, and informed.
Real consent is about partnership, not pressure.
It’s about support, not persuasion.
And it’s your right, not a privilege.
In fact, it’s more than just good practice — respecting your choices is part of the NMC Code of Conduct, which all UK midwives and nurses are legally bound to follow.
🧾 The Code requires midwives to:
“Prioritise people”
“Treat them as individuals and uphold their rights”
“Make sure that people’s physical, social and psychological needs are assessed and responded to”
If you don’t feel your care reflects that — if you’re not being listened to, or feel coerced — you are within your rights to speak up. That could be as simple as saying, “I don’t feel heard,” or as formal as submitting a complaint or involving the hospital’s Patient Advice and Liaison Service (PALS).
You shouldn’t have to fight for respectful care — but if you do, know that you have every right to advocate for yourself.
If something doesn’t feel right, trust that instinct.
If you’re not sure what your options really are, ask.
And if you’re facing resistance — it may be because your strength and clarity make others uncomfortable.
Hold steady. You’ve got this.
And if you need someone walking beside you, Mobile Midwives is here to help.
This was me and my baby moments after birth, at home, in water as planned.
