Discover your choices
As a childbirth educator, I like to encourage people to prepare for birth by exploring all their choices. Knowing your options allows you to make informed decisions. It has been found that the women who are actively involved in the decision making process throughout their labour, are more happier with their birth outcomes, even if the birth was different to what they were hoping for. This means if women can navigate their journey and be involved with each decision, they are more likely to be happier if things take a different or unexpected turn. So, being aware of your options helps to prevent birth trauma.
Birth preferences rather than birth plans
As a doula when I’m working with parents, I prefer to call this process of working out what you would like to happen discovering your ‘birth preferences’ rather than writing ‘a birth plan’. I encourage them to write their preferences down and to discuss this with their care provider.
State what you are wanting in a positive way. Instead of a big list of everything you don’t want to happen, make it positive. For example, instead of saying ‘I don’t want continual fetal monitoring on the machine’, make it positive and say ‘I would like to remain active in labour and therefore would prefer intermittent fetal monitoring with a doppler’. This allows care providers to understand what and why you are wanting something. By keeping your language positive it also helps everyone get along a bit better (maintain rapport rather than being antagonistic).
Get out of your head!
When giving birth, it’s really important that you can ‘switch off’ your thinking brain and enter into the quiet place of your mammalian brain. This helps you focus in to the job your body is doing and also enhances the release of endorphins (your own natural pain-relieving hormone similar to morphine). By writing down your preferences, it can assist in this process. Your partner and care providers can understand your preferences without having to ask you every single detail. It will also save you having to explain things to any new care providers that come to help. In the hospital system, at shift change, the new midwife or obstetrician can read your preferences and have a better understanding of the type of birth you are hoping for. Rather than just doing what they always do, or just following hospital protocol, they can better understand your preferences and hopefully work hard to assist you in your wishes.
When exploring your options for birth, you may like to think about: your beliefs about birth, what kind of environment you would like to birth in (eg; a warm, dimly lit space that is quiet with soft music), who will be supporting you (eg; partners name, doula, midwife, OB etc), how you feel about fetal monitoring, how you feel about pain relief (eg; if you are intending to labour naturally you could say ‘I intend to use massage, hot water, heat packs, visualisations and the birth pool to cope with labour so please don’t offer medical pain relief unless I ask for it’). Other things to think about are; the use of syntocinon in the third stage (birthing the placenta naturally or managed?), what about skin-to-skin contact, delayed cord clamping and the injections offered to the baby such as vitamin K and hepatitis B. It is also good to think about cesareans. Even if that is the last thing you are wanting, it is good to explore your options. If a cesarean is required, it is still possible to have delayed cord clamping and often times skin-to-skin contact can be facilitated. It’s also good to talk to your care provider if they know how to assist with vaginal swabbing for inoculation of the baby with vaginal flora (see ‘microbirth’ for more information).
It is not really possible to know every single situation that may come up in your birth (nor do you need to know everything!). This is when having a framework for making decisions can be very helpful. My favourite acronym for this is ‘BRAIN’. This stands for Benefits, Risks, Alternatives, Intuition, Nothing. When we are presented with a choice that we haven’t thought about before, you can make a decision by asking: How it this helpful (beneficial)? Are there any risks? What are the alternatives (is there anything else I can try)? What does my intuition tell me? What if I wait or do nothing?
Take time during your pregnancy to look at your options for birth and create a birth preferences sheet. Make sure your birth partner knows your wishes and then let your care provider know so that everyone is on the same page when it comes to one of the most important days of your life.