Navigating pregnancy and childbirth can feel like an overwhelming journey, particularly amidst ongoing concerns about the state of modern maternity care. However, antenatal educator Megan Rossiter offers a powerful counter-narrative: while you can’t control birth, you can significantly influence the experience.Rossiter, author of the new book Birth Power, acknowledges the public conversation around the "poor state of modern maternity care" but stresses that this offers little comfort to those currently pregnant. "Stepping into the system, crossing your fingers and hoping for the best simply won’t get you the kind of birth you’re hoping for," she warns. "And while we can remain ever-hopeful that ongoing investigations lead to improvements in maternity services for the future, they’re not much help if you’re already pregnant."Through her book and the inclusive Birth-ed Method antenatal course, Rossiter aims to equip pregnant women with practical tools to reclaim agency over their care choices. Megan Rossiter, founder of Birth-ed (Alamy/PA)She emphasises the profound importance of personal autonomy: "Having autonomy and agency in the choices that are being made during your pregnancy, birth and postpartum is everything when it comes to care and feeling emotionally safe."Challenging the common refrain that "all that matters is a healthy baby," Rossiter argues for a more holistic view. "But what about you? The way you give birth matters, because it impacts everything, and the weight of this experience ought to be mirrored in the weight that we give to its preparation."While acknowledging the many variables in childbirth, she firmly states: "Don’t misinterpret this to mean we have no influence over how things unfold, that the choices we make don’t have a ripple effect, or that the power in the birth space should belong to anyone but you."A crucial step, Rossiter explains, is differentiating between what can and cannot be controlled. "Unfortunately, this isn’t always clear-cut," she notes. Women typically have influence over aspects such as their planned birth location, comfort measures, accepted interventions, the environment, birth partners, preparation, screening, and planned interventions. Conversely, total control is often elusive for factors like the sensation of birth, the natural onset and duration of labour, the baby's position, sounds made, comfortable positions, staff on shift, unforeseen complexities, or "the plans of Mother Nature herself." Her advice is clear: "And so I encourage you strongly to take control of the aspects that you can, but to let go of the things you cannot."So, what practical steps can be taken to maximise control over the birth experience?Calm the nervous system Rossiter highlights that stress and a heightened nervous system can impair decision-making, as the brain prioritises survival over rationality. "So before we even explore how to make a choice, we need to consider how to calm your nervous system and get you back to a place where you can think clearly," she advises. If possible, step away from the clinical environment to make decisions. If not, "ask your clinician to step away so you can make the decision in your own time and way." (Alamy/PA)Taking time, even sleeping on major decisions, is encouraged. Simple acts like getting fresh air, seeing something green, a stress-relieving shower, slow deep breathing, or grounding techniques (focusing on five things you see, four you touch, three you hear, two you smell, one you taste) can help. "Or try anything that makes you feel safe, from a big hug to a phone call with someone you trust," she suggests.Gather information before making decisions Rossiter introduces the acronym ‘I ADAPT’ as a framework for informed decision-making:Instinct: What does it feel like you should do? Advantages: What are the upsides to both accepting and declining this choice? Disadvantages: What are the downsides to both accepting and declining this choice? Alternatives: If I didn’t do this, what else could I do? Package of care: How does this choice impact other birth choices I have? Time: What if I waited? For 30 minutes, three days, a week? She recommends utilising care provider expertise alongside independent research from national guidance, research papers, independent experts, charities, or peer support. Advocacy and communicating choices "Being informed and knowing what you want is pretty useless if you don’t know how to actually get your choices supported," Rossiter observes. Her tips for self-advocacy include:Bring support: Take someone to appointments, ideally someone who is not emotionally swayed, communicates clearly, and understands your priorities. Approach with curiosity: Instead of accusation, ask questions like, "If you don’t feel confident in what you’re being told or have heard conflicting information, ask if they could point you in the direction of some further reading, and if they’ve considered another perspective." Allow time: Make it clear you’re happy for the midwife or doctor to take their time to gather information. Prepare questions: Write down questions and key points before appointments, as "Reading aloud is significantly easier than remembering everything in stressful conditions." Document discussions: Ask your care provider to write down their suggestions and reasoning, or note them yourself, to ensure clarity and balanced information. Seek second opinions: If you receive recommendations from a consultant obstetrician, consider asking another consultant or senior midwife for their perspective. Formalise plans: Write down your birth plans, ideally signed by the clinician involved in agreeing them, to avoid repeating conversations. Rossiter concludes by framing these skills as foundational for future parenting. "Pregnancy is the start of a lifetime advocating for these babies of ours, and the skills you’re learning now will serve you for years to come." Front cover of the book Birth Power by Megan Rossiter (PA)She expresses excitement at seeing "so many women in pregnancy waving goodbye to the people-pleasing tendencies of their past and stepping into a bold, brave and assured new version of themselves."Birth Power by Megan Rossiter is published by Bluebird, priced £16.99, and is available now.