You’re pregnant, and now that the initial shock, excitement, and/or morning sickness has worn off, you’re starting to think about your birth. Maybe you’ve read every book on pregnancy and birth on your library shelves; maybe you’ve heard more of your friends’ birth stories than you can count. You’ve made yourself aware of your options for your birth, including who you want to attend your birth, where you want to birth, and how.
You may have heard about writing a birth plan; maybe you already have one drafted. You feel reassured by knowing your options, but there’s a part of you that wonders: What will happen if I don’t get what I want? What if things don’t go according to plan?
Birth plans were virtually unheard of just a few years ago. Now, most birthing women have at least considered creating one, and resources for doing it abound. In many ways, this represents a positive change in our culture: Women are beginning to realize that they can choose how, where, and with whom they birth. Birth plans can stimulate conversation about women’s preferences in labor and allow them to feel supported in birth. They help us shift away from the mentality that “doctor knows best,” and, indeed, from the notion that birth is a medical process. The increasingly popularity of creating a birth plan may signal that women are taking back birth, once and for all.
But my sense is that we’re missing the mark with birth plans.
Increasingly in my doula practice, I’ve noticed that many plans read like catalogues of birth outcomes that a woman wishes to select: “I’ll have this, this and this.” When shared with doctors, midwives, and nurses, some women’s birth plans incite an eye roll— perhaps because of their length, maybe their detail, or possibly the nature of their wishes. Other clients of mine have presented their birth plans nervously to physicians, wondering what their reactions will be. Some of these physicians will graciously tell them “that should be possible”— which, though initially pleasing to hear, ultimately insinuates that the control remains in the hands of the doctor, not the birthing woman.
In my birth practice, I’ve learned a few things that have caused me to want to change the way we think about birth plans:
1. Birth is unpredictable.
The longer I’ve been a doula, the less I realize I know. I am humbled, and my ego is quieted, on a regular basis by the raw power and sheer unpredictability of birth. This is probably the one thing that anyone who works with birthing women—doctors, midwives, nurses, doulas—can absolutely agree on, and it’s probably why the idea of “planning” one’s birth incites eye rolls and even frustration for care providers. It is simply impossible to plan what will happen. This is not to say that women should not know their options and prepare for birth, but that that preparation also needs to include how women want to respond to the unplanned.
2. Rigidity and inflexibility can be detrimental.
Being hell-bent on having your birth go a certain way plays some risky odds. Because birth is unpredictable, the odds of everything going according to plan are not always in your favor. Sometimes it’s easy to go with the flow when things go differently than you’d expected—maybe you had conjured images of yourself slow dancing with your partner to cope with contractions, but that particular technique didn’t end up working for you. That’s probably no big deal. But being completely devoted to the idea of birthing at home in the water, or getting an epidural as soon as you arrive at the hospital so you feel no pain, can lead to discord, disappointment, or even trauma if things don’t go as planned.
(Note: I believe that, as a society and as a culture, we have a long way to go before we truly take back birth. I recognize that there are a multitude of historical and sociocultural influences on what birth has become, as we know it currently. It is crucially important for women and birth workers to speak out against practices that are potentially unnecessary, and rooted in misogyny and the medicalization of birth. So, when I say that rigidity and inflexibility can be detrimental, I respect that a woman may feel she has limited or undesirable options to consider as a result of the culture and system within which she is birthing, but suggest that she find ways to hold her power and work within a system that is, unfortunately, not going to change overnight, rather than expect to reverse a culture that is too insidious and staid than any one person during any one birth can possibly alter.)
3. Most women’s true desires for their births are deeper than “outcomes.”
I have found that, ultimately, no matter what the individual decisions a woman makes about how she wants to birth, most of those desires and decisions are more deeply rooted in how she wants to feel during labor, and how she wants to be treated by the people supporting her.
That’s where this article comes in.
Most birth plans center around things like a woman’s stance on various interventions and comfort preferences around the treatment of the baby and mother in the immediate postpartum period, and her infant feeding choices.
All of these are considered outcomes, and outcomes are the most unpredictable facets of the birthing process. No one, not even the most experienced doctor or focused mother, can control or predict the outcomes of a birth.
Let’s dive in here. I’ve thrown around the word unpredictability a few times now, and it might create some edgy feelings.
It’s a scary thought. In our lives, we usually experience very little of the unknown. Thanks to Google and smartphones and other technologies, we have a great amount of information at our fingertips, which equates to increased predictability and perceived control over the situations we find ourselves in. Birth isn’t like this. Not knowing what will happen makes most women uncomfortable or anxious.
The interesting thing about the unknown—the part that I invite you to explore—is that nothing that requires our bravery, our advocacy, our hard work, and our determination, and potentially results in our pride, our courage, and our connection to our power, is predictable. It is the act of stepping into the unknown—not the potential for pain, or its intensity—that makes birth one of the most important rites of passage in the human experience.
Empowerment, in birth and in life, comes not from fighting against things that are, but in finding the strength and grace to accept what is and thrive anyway. So, what are birth principles?
Birth principles are based on your fundamental values and deepest beliefs about yourself and about birth. They underpin your outcome-related desires for your birth. Wellthought- out birth principles will make your individual decisions around how, with whom, and where you want to birth easier, for those choices are inherent in your principles. Being clear on your birth principles will help you to enter the process of labor and birth with the confidence in your own resilience, knowing that you have the ability to thrive. The questions on these next pages are intended to help you gain that clarity.
The following questions are meant to prime you, to shift your thinking about your birthing process into a new realm. Answer them as instinctively or as methodically as you need to. Revisit them after a long walk in the woods, a steaming bath, or a heart-to-heart with your support person, if you need to. Be curious and exploratory in the process.
Tapping Into Emotion
These questions explore how you want to feel during your birthing process. Your response could be a list of adjectives, or draw upon your previous experiences, or be a story you write about the vision you have of yourself birthing. Play, here, with what feels authentic and meaningful to you.
How would you like to feel while you’re in early labor?
How would you like to feel as you actively labor?
How would you like to feel when you are pushing your baby into the world?
How would you like to feel in that first special hour after you’ve had your baby?
Navigating External Influences
When you respond to these questions, think about the environment within which you want to labor and the people you want there supporting you. It may be helpful to return to any visualization you did in the previous questions to help you explore these ideas.
How do you want the room to feel when you are in labor? What does it look like? What is the atmosphere like?
How do you want others in the room to treat you?
Whom do you trust when it comes to your birthing experience?
Stepping Into the Unknown
You may be required to navigate any number of unknowns during your birth process. Some of these may pertain to the specific outcomes you desire, be they your preferences around intervention, pain management, or any other aspect of your labor and birth. While these may be outside the realm of your control, the way you respond to them is up to you.
How do you feel about the unpredictability and unknown in labor and birth?
How would you like to meet with unexpected situations, or situations that are out of your control, during your birth?
What resources, support, or tools do you need to accomplish this?
What three character strengths do you have that will serve you well during birth?
What types of situations bring out these strengths?
How can you stand in your power during your birth?
Understanding Your Beliefs
The birth principles you establish will be grounded in your beliefs about birth, your body, and yourself. Take some time to reflect on what you believe to be true.
What do you trust when it comes to your birthing experience?
What do you know to be true?
What are your core beliefs about birth?
Your Birth Principles
You’ve thought about how you want to feel during your birth. You’ve visualized the setting and surroundings in which you want to birth, explored how to strongly step into the unknown, delved into your strengths and how you can stand in your power, and you’ve uncovered your core beliefs. You’ve spent this time in a place beyond the individual choices and outcomes you desire for your birth, and you are ready to take what you’ve found and channel it into a few key principles you can hold central during your transition from pregnant woman to new mother. Take some time to look through your responses throughout these workbook pages.
Do you see any common themes?
What ideas or statements make you feel grounded in your feet, strong in your core, and light in your heart?
What do you want, most deeply and essentially, for your birth?
Here is some space to explore. If you want, you can complete the following prompts, or you can explore your ideas on a blank page. Brainstorm, use words, draw, color, write a poem: Express your desires in the way that resonates most deeply for you.
Sharing Your Birth Principles
It’s up to you how you wish to share your birth principles with your support person and your care providers. Much of this process will allow you to find your own clarity. Being clear on your principles will help to inform the individual decisions and choices you make concerning your birth. It will inform how you navigate the events that unfold, the people that surround you, and the space that you’re in. Use these principles as your North Star. Check in with them often, and allow them to guide you in your birth journey.
May you know strength.
May you know support.
May you know love.
Journey well, mama.
This article appeared in Pathways to Family Wellness magazine, Issue #55.
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