Now that I have your attention, let me explain. Many parents-to-be will create a detailed birth plan in the weeks before birth. Or, perhaps they will just feel like they should have a birth plan and copy one they found online. Parents walk proudly into the birth space with birth plan (or copies of the birth plan for every person present) in hand, ready to serve as a shield of armor against the things they don’t want to happen during labor.
Expecting your typed-up manifesto to speak on your behalf is a bit like passing notes with someone at school to resolve an argument. Or, to put it in modern-speak, like working out a disagreement over text. There is nothing as powerful as face-to-face, human-to-human communication. Handing a birth plan to a doctor, nurse, or midwife is a bit like bringing in a proxy to speak on your behalf, putting distance between you and the people in charge of your care. Speak directly to them, they are there to help! Human connection, flexibility, and compassion are what make us communal beings. Stay in the moment and work collaboratively with the people around you!
Ok ok, I know…you might not be able to elaborate on your desires for birth in the middle of a mind-bending contraction. This is where your husband, partner, doula, or birth companion may come in handy. Have an honest conversation with them. Let them know what matters to you. Ask them to help you navigate the world of medical-speak and choosing the next best thing as you make your way through Labor Land. If your partner has never been comfortable speaking up to authority, it’s not realistic to expect that all to change overnight. Consider bringing in more support, finding someone who can politely but firmly ask for more information, more time, more alternatives.
Bringing a baby into the world is a lot like creating a clay sculpture – not everything is going to turn out exactly as you imagined it. It doesn’t mean you shouldn’t have a goal or an idea of what you’d like to happen! It also doesn’t mean you should throw the whole lump of clay out the window the first time something unexpected happens. It does mean that you would be well served to stay agile and flexible, riding the wave of labor and doing the best you can in each moment to cope and stay connected to yourself, your support people, your baby, and the process of giving birth.
One of the best ways to get the things you want from your birth experience is to go to the provider and location that offers those things. Are you hoping for an unmedicated vaginal birth? The hospital that is friendly to mothers following their own cues during birth would probably be a better choice than the one with the 60% cesarean rate. Are you wanting to labor in the water? Go to the hospital or birth center or home birth midwife who can help you with that.
One of the first and most important steps in your pregnancy is to find a provider and birth space that aligns with your desires. If you need to change providers, it’s as simple as making an appointment with the midwife or doctor you do want to work with and having them send a request for your medical records. No big break-up necessary!
For some people finances make their first choice for a birth provider or location out of the question. This is actually where a birth plan can come in handy – BEFORE THE BIRTH. Writing down the things that are important to you can help you organize your thoughts during a heart-to-heart with your provider about what matters most to you for your birth experience. Again, face-to-face communication will go a long way in establishing rapport and negotiating what can be done to make both parties feel as safe and satisfied as possible. It’s a good idea to be accompanied by your partner or another support person for these types of conversations, just like at the birth.
So what kinds of things are valuable to consider as your prepare for you birth? What might be helpful to discuss with your doctor or midwife? What might be useful to research to see if it’s important to you?
- Movement during labor. (Hint – a provider who says, “You can move around in labor if you really want to but you’ll probably want to stay in bed,” is probably not familiar with/comfortable with unmedicated birth. If that’s your goal, keep interviewing providers.)
- IV fluids vs. hep-loc.
- Continuous fetal monitoring vs. intermittent monitoring.
- Comfort level for working with doulas.
- Alternative pushing positions.
- Skin to skin time with baby in the Operating Room after a cesarean birth.
- Delayed cord clamping.
- Birth space that’s supportive of breastfeeding.
If you’re unfamiliar with the above try a quick google search, or better yet, take a well-rounded childbirth class. No need to earn a Masters Degree on all things birth. It’s not a test to pass! It’s a winding road to navigate as best you can each step of the way. The doctors, midwives, nurses, and doula you’ve hired are there to help you figure out medical procedures as in depth as is needed in any given moment. Get a sense for what each is about, and go talk to your provider about how you can work together to help you through labor and postpartum!
Nikki Shaheed CD(DONA), Certified Birthing from Within Mentor