There is a specific silence that can happen in medical rooms. It’s not that you don’t have words. It’s that the environment feels louder than your instincts. Monitors beep. White coats move quickly. Recommendations come confidently. And suddenly, you are expected to decide… fast.
For Black mothers especially, this moment carries weight. Research continues to show that our pain is minimized, our concerns are dismissed, and our outcomes are disproportionately affected. Advocacy is not optional for us. It is protective.
Using your VOICE is not about being combative. It is about being clear. Grounded. Present in your own care. Here is what VOICE stands for, and how to use it.
V : Validate Yourself First
Before you seek validation from a provider, validate yourself. What are you feeling? What feels off? What feels aligned?
Self-doubt is often the first barrier to advocacy. Many women are conditioned to believe that medical professionals automatically know best. While providers bring expertise, you bring lived experience in your body.
Both matter. You are not dramatic for asking questions. You are not difficult for expressing concern. You are not ignorant for wanting explanation. Trust your internal cues before outsourcing your power.
O: Obtain Clarity
If something is recommended, pause and ask:
What exactly is the concern?
Is this urgent or precautionary?
What are my alternatives?
What are the risks of waiting?
What are the risks of proceeding?
Clarity shifts the dynamic.
When you ask informed questions, you move from passive recipient to active participant. Medical language can feel intimidating. Ask for it to be simplified. Ask for it to be repeated. Ask for time to process. You are allowed to understand what is happening to your body.
I: Identify Manipulation
Not every urgent tone signals an emergency.
There is a difference between evidence-based urgency and fear-based pressure. Statements like “We don’t want a bad outcome” or “This is what we usually do” are not complete explanations.
Ask directly:
“Is my baby in distress right now?”
“Is this an emergency?”
Gaslighting can sound subtle. It can sound like dismissal. It can sound like reassurance that avoids specifics. If you feel confused instead of informed, pause. Confusion is often a cue to slow down.
C: Challenge Dismissiveness
If your concerns are minimized, respond calmly but firmly.
“I hear you. I’m still concerned.”
“I need more information before I agree.”
“That doesn’t sit well with me.”
Advocacy does not require anger. It requires steadiness. You can be respectful and assertive at the same time. Tone does not determine legitimacy. Your question stands on its own.
E: Empower Your Decision
Once you’ve gathered information, make the decision that aligns with you. Not the one that pleases the room. Not the one that avoids being labeled “difficult.” The one that feels informed.
Informed consent means you agree because you understand, not because you were rushed. Informed refusal is also a right… I just want you to know that.
When the decision is yours, you retain power, regardless of outcome.
Why This Matters
Black maternal mortality rates in the United States remain disproportionately high. Advocacy is not about ego. It is about safety.
Using your VOICE creates space for:
Being heard
Questioning authority
Resisting gaslighting
Standing in your truth
You deserve care that is collaborative, not coercive. You deserve explanations, not intimidation. You deserve to feel like a participant in your birth, not a bystander.
Your voice does not have to be loud to be powerful. It just has to be used.
Preparing Your VOICE Before Birth
Before birth ever begins, there is a quieter preparation that has to happen first. Not packing the hospital bag. Not washing the baby clothes. Not finishing the nursery.
It’s preparing your voice. Because in the moment, when contractions are strong, when emotions are high, when professionals are moving quickly, you will not rise to the occasion. You will fall to your level of preparation.
Advocacy is not about becoming someone else in the delivery room. It’s about becoming more solid in who you already are. So instead of waiting until you feel pressured to figure out what to say, let’s practice now.
Let’s get honest about your patterns. Let’s get clear about your fears. Let’s strengthen the muscle before it’s tested. Take your time with these prompts.
There is no right answer.
There is only awareness… and awareness is where power begins.
Journal Prompts: Strengthening Your VOICE
When have I felt dismissed in a medical setting before?
How did I respond?
What does my body feel like when something doesn’t sit right with me?
Do I tend to shrink, over-explain, become silent, or become defensive under pressure?
What phrases feel natural for me to say when I need clarity?
What am I most afraid of when it comes to speaking up during birth?
What would it look like for me to leave my birth feeling proud of how I used my voice, regardless of the outcome?
Practice Exercise
Write three advocacy statements that feel authentic to you. Keep them short. Keep them steady.
Examples:
“I need more information before I decide.”
“Is this an emergency right now?”
“I’m not comfortable with that plan.”
Now read them out loud… Say them again. Confidence grows in rehearsal. Your voice is not something you find in the moment. It is something you strengthen before the moment arrives. And when the room shifts, because sometimes it will, you will not have to search for it.
It will already be there.
Have you ever left an appointment thinking, I should’ve said something?
You’re not alone.
If you’re comfortable, share what you wish you had said. Let’s rewrite those moments together.
And if you have a partner, send this to them.
Advocacy is easier when someone in the room knows your voice and is ready to echo it. And if you’re preparing for birth, comment “VOICE” and I’ll share a few additional advocacy phrases you can practice this week.\
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