The dance of advocacy

A childbirth educator asks how she can continue to use best evidence and prepare women adequately for birth within the constraints of a hospital practice that pressures educators not to "rock the boat." This column discusses the challenge of advocating for normal birth and the dangers inherent in the advocacy role. Advocacy requires the childbirth educator to "dance" with many partners, including physicians and hospitals. Strategies for inviting colleagues and class participants onto the dance floor and teaching them the steps of the dance are explored. Guidelines for reducing risk and engaging women are discussed.