Nov. 19, 2025

Mini Episode: Know Your Rights In Labor

Send us a text When contractions hit and the baby feels low, the last thing any parent needs is a clipboard. We walk through the legal protections that guarantee timely care under EMTALA and translate them into practical steps you can use the moment you arrive at the hospital in labor. From spotting red flags of imminent birth to understanding exactly what “medical screening exam” and “stabilizing care” should look like, we break complex policy into clear, actionable moves that keep you and y...

Send us a text

When contractions hit and the baby feels low, the last thing any parent needs is a clipboard. We walk through the legal protections that guarantee timely care under EMTALA and translate them into practical steps you can use the moment you arrive at the hospital in labor. From spotting red flags of imminent birth to understanding exactly what “medical screening exam” and “stabilizing care” should look like, we break complex policy into clear, actionable moves that keep you and your baby safe.

You’ll hear a grounded, real-world analysis of a widely shared ER incident and why it mattered—not for outrage, but as a lesson in what to demand. We share concise scripts your partner can read verbatim to activate the right team fast: how to ask for the labor and delivery charge nurse, how to request an OB rapid response, and what to say if anyone prioritizes paperwork over care. We also cover what to prepare now: a phone note titled “Hospital: My Rights In Labor,” a simple printed card to hand over if you can’t speak, and smart questions to ask your provider about emergency workflows and who moves you to labor and delivery.

We speak directly to Black mothers and families about the documented risks of delayed care and minimized pain, offering tools to be heard the first time. The goal isn’t fear—it’s confidence. With a few phrases, a plan, and a clear understanding of your rights, you can turn confusion into momentum and make the hospital work for you when minutes matter.

If this helped, subscribe, share with a parent-to-be, and leave a review with the one phrase you’re saving to your phone. Your story could help someone get the care they’re owed.

Coaching offer

Kelly Hof: Labor Nurse + Birth Coach
Basically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!

Support the show

Connect with Kelly at kellyhof.com

Join the Bump & Beyond Online Community!
https://www.facebook.com/groups/bumpnbeyond

Grab The Book of Hormones on Amazon!

Medical Disclaimer:
This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman’s medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

00:57 - Why EMTALA Matters In Labor

02:00 - What The Law Requires From Hospitals

02:48 - Red Flags Of Imminent Birth

04:33 - Screening Exam And Stabilizing Care Explained

05:57 - Exact Phrases To Demand Care

07:32 - Prepare Scripts And Plan Ahead

08:50 - Addressing Bias And Being Believed

09:44 - Empowerment, Resources, And Final Message

WEBVTT

00:00:29.140 --> 00:00:32.500
Hi! Today I want to talk to you about something really important.

00:00:32.899 --> 00:00:37.060
How to protect yourself when you show up to the hospital in labor.

00:00:39.780 --> 00:00:50.260
You may have seen the viral video of a mom in Texas in obvious active labor, stuck in a wheelchair in the ER, screaming that her baby was coming while staff focused on paperwork.

00:00:50.420 --> 00:00:56.500
It's heartbreaking, it's dangerous, and it's also a violation of a federal law called mtala.

00:00:57.060 --> 00:00:59.859
But this video isn't just about what went wrong there.

00:01:00.019 --> 00:01:02.340
It's about helping moms know their rights.

00:01:02.579 --> 00:01:20.180
I'm going to talk about what mtala actually guarantees when you walk into the hospital in labor, the red flags to watch for, exact phrases you and your partner can use if something feels wrong, and how you can prepare now, while you're pregnant, so you feel confident walking into any hospital.

00:01:20.340 --> 00:01:26.020
My goal is that you walk away from this video feeling informed, grounded, and equipped, not scared.

00:01:26.259 --> 00:01:29.140
Let's start with what MTA even is.

00:01:29.460 --> 00:01:34.180
MTALA stands for the Emergency Medical Treatment and Labor Act.

00:01:34.340 --> 00:01:42.579
It's a federal law that applies to almost every hospital in the U.S., basically any hospital that has an emergency department and takes Medicare.

00:01:42.819 --> 00:01:57.459
In simple terms, if you come into the hospital with a possible emergency, including being in labor, the hospital must give you a medical screening exam, provide stabilizing treatment, and it cannot delay care based on insurance, payment, or paperwork.

00:01:57.700 --> 00:02:03.620
For pregnant and laboring moms, that means you must be seen quickly, not left in the waiting room for long periods.

00:02:03.780 --> 00:02:14.420
If you're in active labor, especially if the baby might come soon, you must be evaluated right away, moved to a safe place for delivery, and cared for in a way that protects you and your baby.

00:02:14.659 --> 00:02:19.939
Paperwork, registration, and insurance come after you're medically safe, not before.

00:02:20.099 --> 00:02:28.180
I'm not going to spend a ton of time on the details of the Texas video, but I want to highlight it as an example so you can recognize red flags.

00:02:28.420 --> 00:02:32.500
In the video, we see a mom saying the baby is in her butt.

00:02:32.740 --> 00:02:37.460
That is classic language that we hear when the baby's head is very low and birth is close.

00:02:37.699 --> 00:02:41.939
She's in a wheelchair strapped to a blood pressure cuff, not on a bed.

00:02:42.180 --> 00:02:44.819
I also noticed the wheelchair does not have brakes on.

00:02:44.979 --> 00:02:46.900
That's not a safe situation.

00:02:47.060 --> 00:02:51.699
And she is in clear, severe pain and cannot sit upright or stay still.

00:02:51.939 --> 00:02:55.060
The staff are focused on paperwork and not on the patient.

00:02:55.219 --> 00:03:01.379
From a clinical perspective, this is all unsafe because a wheelchair is not a safe place to deliver.

00:03:01.539 --> 00:03:05.539
There's risk of fall, baby injury, and inadequate support.

00:03:05.780 --> 00:03:09.139
She's giving clear signs that she needs to push.

00:03:09.539 --> 00:03:15.300
Mtala requires immediate evaluation and stabilizing care in a situation like this.

00:03:15.379 --> 00:03:20.500
So we're going to use this as a case study to say, okay, if I ever felt like that, what could I do?

00:03:20.659 --> 00:03:21.939
What can my partner say?

00:03:22.020 --> 00:03:24.020
And what are my options in the moment?

00:03:24.259 --> 00:03:29.620
First, let's talk about some red flags that tell you, this is not okay, I need help now.

00:03:30.099 --> 00:03:34.099
You're in so much pain you can't walk or talk through contractions.

00:03:34.580 --> 00:03:39.860
You feel strong rectal pressure, like you need to poop, or the baby's head is in your butt.

00:03:40.099 --> 00:03:43.460
You can't sit without feeling like you're sitting on the baby.

00:03:43.699 --> 00:03:47.699
You're involuntarily pushing or grunting with contractions.

00:03:47.939 --> 00:03:51.379
Your water has broken and contractions are intense and close.

00:03:51.620 --> 00:03:52.979
Or you're bleeding heavily.

00:03:53.139 --> 00:03:56.900
If any of this is happening, you are not just uncomfortable.

00:03:57.060 --> 00:04:00.020
You may be in active labor or even close to delivery.

00:04:00.099 --> 00:04:05.620
And Mtala says you need a medical screening exam and stabilizing care right away.

00:04:05.860 --> 00:04:10.180
Before we go any further, I want to explain two terms that are really important.

00:04:10.340 --> 00:04:14.419
They are medical screening exam and stabilizing care.

00:04:14.659 --> 00:04:17.620
These are the exact things this mom did not receive.

00:04:17.860 --> 00:04:20.100
Here's what they mean in plain language.

00:04:20.340 --> 00:04:23.139
A medical screening exam is the first step.

00:04:23.300 --> 00:04:31.699
It's the hospital's legal obligation to check you immediately to see whether you are having an emergency, including whether you're in active labor.

00:04:32.019 --> 00:04:39.539
This exam cannot be delayed for paperwork, registration, insurance, triage bottlenecks, or have a seat and wait.

00:04:39.779 --> 00:04:47.779
If you walk in and say, I'm in labor, or your body is clearly telling them that you are, that screening exam needs to happen right away.

00:04:48.019 --> 00:04:53.300
Stabilizing care is what happens after we realize you are in fact in an emergency.

00:04:53.620 --> 00:05:13.860
For labor, stabilizing care means, not necessarily in this order, moving you to a safe location, usually labor and delivery, getting you onto a bed, checking for crowning, making sure you or your baby aren't in danger, usually checking for fetal heart tones, calling the right team immediately, and preparing to deliver if birth is imminent.

00:05:14.180 --> 00:05:21.379
The whole purpose of stabilizing care is to prevent you or your baby from getting worse while figuring out the next steps.

00:05:21.620 --> 00:05:27.620
In this video, she didn't get the screening exam, she didn't get stabilizing care, and she didn't get moved to a safe place.

00:05:27.779 --> 00:05:29.779
All of those are MTOL violations.

00:05:29.939 --> 00:05:31.540
Now let's get really practical.

00:05:31.699 --> 00:05:35.300
I want you to have actual sentences you can write down to bring with you.

00:05:35.540 --> 00:05:38.339
If you are the one in labor, you may not be able to say much.

00:05:38.420 --> 00:05:42.259
So this is especially important for partners, doulas, or support people.

00:05:42.420 --> 00:05:44.259
Here are phrases you can use.

00:05:44.579 --> 00:05:48.579
To get an immediate assessment, she's in active labor.

00:05:48.740 --> 00:05:52.180
We need an Imtala medical screening exam now.

00:05:52.420 --> 00:05:55.779
Under Imtala, she needs to be evaluated immediately.

00:05:56.019 --> 00:05:58.660
She is not stable to sit in the waiting room.

00:05:58.980 --> 00:06:04.259
If they are focused on paperwork or registration, you can say, paperwork can wait.

00:06:04.420 --> 00:06:05.779
She needs to be seen now.

00:06:05.939 --> 00:06:08.019
Please call the labor and delivery team.

00:06:08.339 --> 00:06:13.379
Or we will sign anything you need after she has been medically assessed and stabilized.

00:06:13.779 --> 00:06:19.779
If the baby feels very low or like she's pushing, you can say, She is saying the baby is coming.

00:06:19.939 --> 00:06:22.019
This is an obstetric emergency.

00:06:22.339 --> 00:06:25.379
Or she's having rectal pressure and can't stop pushing.

00:06:25.540 --> 00:06:27.139
She needs a bed right now.

00:06:28.019 --> 00:06:33.620
To escalate to someone in charge, you can say, we need the labor and delivery charge nurse, please.

00:06:33.779 --> 00:06:36.980
Or we need the labor and delivery team to come now.

00:06:37.220 --> 00:06:41.220
Or this is an emergency, who can activate the OB rapid response?

00:06:41.459 --> 00:06:50.019
If they still delay care, you can say, please document in her chart that we requested an Imtala medical screening exam and care was delayed.

00:06:50.259 --> 00:06:58.259
That last sentence sounds very formal, but it communicates, I know this is a legal protection and I'm asking you to acknowledge what you're doing.

00:06:58.500 --> 00:07:03.699
Most staff will move faster when they hear OB rapid response or Mtala.

00:07:04.259 --> 00:07:07.540
Advocating in the moment is hard, especially when you're in pain.

00:07:07.699 --> 00:07:11.540
So let's talk about what you can do now while you feel calm.

00:07:12.019 --> 00:07:22.259
You can save a script in your phone, create a note titled Hospital, My Rights in Labor, copy a few of the phrases we just talked about so your partner can pull it up instantly.

00:07:22.500 --> 00:07:24.500
Talk with your support person ahead of time.

00:07:24.660 --> 00:07:28.980
Tell them if I'm doubled over and saying the baby is coming, I need you to speak up for me.

00:07:29.139 --> 00:07:32.980
You can also tell them your job is not to be polite, your job is to get me help.

00:07:33.220 --> 00:07:36.819
Ask your hospital or provider how OB emergencies are handled.

00:07:37.060 --> 00:07:44.100
At a prenatal visit, you can say, if I walk in in active labor, who is responsible for getting me to labor and delivery?

00:07:44.339 --> 00:07:48.420
Do you have an OB emergency code or rapid response at your hospital?

00:07:48.660 --> 00:07:51.620
You're not being difficult, you're just gathering information.

00:07:51.860 --> 00:07:59.860
Consider bringing in a sample printed card, something like, I am in labor and requesting an Imtala medical screening exam and stabilizing treatment.

00:08:00.019 --> 00:08:03.220
Hand it to the front desk or triage if you can't talk.

00:08:03.540 --> 00:08:05.779
And remember, you can ask for someone else.

00:08:05.939 --> 00:08:12.660
If you feel ignored, you can ask for the AD charge nurse, the house supervisor, or the labor and delivery charge nurse.

00:08:12.819 --> 00:08:14.980
You're allowed to say, I don't feel safe right now.

00:08:15.060 --> 00:08:17.379
I need someone who can help me immediately.

00:08:17.540 --> 00:08:21.699
Now I also want to speak directly to my black moms and families watching this.

00:08:21.860 --> 00:08:33.059
We know from research that black women are more likely to have their pain minimized or dismissed, more likely to experience delays in care, and more likely to have preventable complications.

00:08:33.379 --> 00:08:40.100
You should not have to fight to be believed, but I'd also want you to have every tool possible to stay safe.

00:08:40.420 --> 00:08:59.779
Knowing phrases like I am in active labor and need to be seen now, this is an obstetric emergency, or please document that you're delaying my Imtala screening exam and stabilizing care can give you and your support person something concrete to lean on if you feel like you're not being taken seriously.

00:09:00.019 --> 00:09:02.659
You deserve to be listened to the first time.

00:09:02.899 --> 00:09:05.860
And these tools are here to back you up if you are not.

00:09:06.019 --> 00:09:10.580
No mother should be left screaming in a wheelchair while people argue about paperwork.

00:09:10.820 --> 00:09:16.659
You deserve urgency, compassion, and care that follows the law and respects your humanity.

00:09:16.899 --> 00:09:24.419
My hope is not to scare you, but to equip you so that if something feels off, you have words, options, and a plan.

00:09:25.220 --> 00:09:32.980
If you'd like my Imtala rights guide for you to save to your phone or print and bring to the hospital, comment rights, and I'll send it to you.

00:09:33.220 --> 00:09:34.899
You are not asking for too much.

00:09:35.059 --> 00:09:39.539
You are asking for what you are owed by law and as a human giving birth.

Mini Episode: Know Your Rights In Labor

Listen On

Recent Episodes