But you can’t plan birth...
Have you ever had anyone tell you there’s no point in making a birth plan because you can’t plan birth? I’ve heard this over and over again. While it’s true that you can’t plan birth, that doesn’t mean you can’t have a birth plan. Let me explain.
One key point to remember when building a birth plan is that you can’t plan birth; birth is fluid and constantly changes and it opens parts of a woman that she never before knew existed, physically and emotionally – even if she’s had a baby or a few already. Each pregnancy and birth is as unique as the individual human who is joining this big world for the first time. Each pregnancy and birth will teach us something new about life, about our body, about many things we didn’t know that we didn’t know. Birth is raw. Birth is Real. You can’t fake this stuff. You can’t fake your way through it. You can’t have anyone else do this for you, even though it’s said that many people help, you still have to do the work! So we make a birth plan.
A birth plan is a way to keep track of what we want, what we don’t want, what we’ve learned about and what we’d like to find more information about. As you’re reading about pros and cons of an epidural, you’ll likely start to wonder what tools are available to help you cope with pain if you choose to not get an epidural. But you still want to finish reading about the pros and cons of the epidural, while not forgetting to check coping ideas and natural pain relief techniques. As you read pregnancy and birth books, blogs, articles, medical journals, wherever you go to get your info, keep a notepad handy. Jot down those thoughts you want to read about later, and keep going on those pros and cons. Maybe you will get around to searching for ‘tools for coping with pain in labor’ in 5 minutes; But maybe life happens and you don’t get back for 5 days. Then you may have temporarily forgotten. This is a common occurrence and how you get to be in labor without any idea of what’s going on.
I have written a guide to help you do this. This guide is a list of commonly done/used tests/procedures/methods/choices and an empty place for you to take notes on them so you can come back to them later. This guide is tool to help you learn what your choices are, and how to organize those in one place. It also contains some info about your rights, and how to help your doctor follow the evidence to help you get the care you want and the care you need; you working together with your care provider.
As you make your birth plan, your doula is an excellent resource to use – USE HER knowledge! But she (or anyone) should NEVER be your only resource! I let my clients borrow my books. And I try to purchase new books based on your interest if I don’t have any that appeal to you. I have 3 copies of a popular book (Ina May’s Guide to Childbirth). I also have saved articles written by birth experts – anywhere from a midwives with 20-30+ years of experience, to an OB who attends homebirths (YES! But not in Nebraska), to birth educators and doulas from across the world! I share any and all resources with my clients and my students! (check my calendar page frequently to stay updated on upcoming classes!)
As your doula, I do not tell you what to choose! I help you find articles to find information to make your choices. I tell my stories when asked. I ask you questions to think about things you may not have thought about considering. I help you form questions to ask your primary care provider so you can get the info you need to make an informed choice. The truth is that there’s a risk to everything. EVERYTHING. And you, the person with a baby about to come out of her body, is the one who’s ALWAYS in charge.
Please stop saying “My doctor wouldn’t let me!” – please tell me in what other circumstances its EVER ok for ANYONE to have physical or emotional control over your body? Hint: that’s called assault!
Your body. Your birth. Your choice. Always.
Birth plan brings empowerment!
How would a piece of paper do this?!?
…. Because knowledge is power.
A birth plan has nothing to do with putting your preferences on a piece of paper (although getting anything on paper can help, if you’re that personality type where things like that help). The power of a birth plan is actually in the knowledge you gain as you learn about the options you think you may want to allow or deny. And in knowing that these really ARE choices, that you have the right to say NO! and that in that right to say NO! you may have to fight some people for your rights. I HATE the thought of saying “go in fighting” – cuz that is NOT what we’re doing at all. Not. At. All. Let’s be clear here.
We’re not gearing up for a fight. What we ARE doing is preparing ourselves. We hope and plan for best, while preparing for the worst. This also applies to changing circumstances where our birth plan gets thrown out in the window in an emergent situation. Keepin’ it real. It can be a difficult balance at times.
In the event that we feel we’re being overpowered by someone who has a god-complex, we will need the knowledge of “this is my body, this is my birth. This is my choice!”
I love nurses! 2 of my best friends in the whole world, happen to be an RN, and they both work in a hospital and have stories of emergencies, some with amazing endings, others with sad endings. (because with life, death is a reality. Risk is a reality. None of us are getting out alive). I love listening to nurses and doctors tell stories of when their patients advocate for themselves and refuse treatments. You’re going to have a few different reactions, but here’s 2 that are common:
The first is “Fine. Not like I went to school for a decade or have ever seen this before. Just put your life at risk then. Whatever.” And they’re haughty and storm out.
The second is “I really believe this is our best course of treatment and here’s why [lists pros, usually leave out cons], and while it is your legal right to refuse, I really feel you’ll [die, suffer needlessly, whatever fits the situation, in birth they like to throw around ‘the dead baby card’] and I really strongly encourage you to do as I say you should do”. And they sit and stare at you with those eyes that make you feel like you’re 8 years old.
The second is often referred to as fear mongering. The first is just anger and arrogance being worn on their sleeve. The first is actually my preference, because they’re more open an honest about their feelings about it rather than being cunningly manipulative, or passive aggressive; both of which is unethical. With both attitudes, you may also get their personal fears being projected onto you.
We, as a society, have given the medical model of care the pedestal on which many of them stand so tall. We expect the doctors to save us. We get pissy when death happens, when it’s too hard, when life happens, since with life, comes death, or close calls.
We are so far withdrawn from life, that we forget the key to life is the humanity that lies between birth and death.
Doctors are amazing, knowledgeable humans. I doubt that anyone went to medical school wanting to be controlling and manipulative. They likely wanted to help individual people.
So here’s the problem I see that we are up against these days in medical birth: the system. Not the people who are IN the system. But the system itself.
It’s way too big to address in this blog post – which is supposed to be about the benefits of a birth plan and I know this looks like it has nothing to do with a birth plan, but keep following please. I’ll bring it back around!
Please don’t take my word on this – ask your doctor the following questions:
· How long did you take learning about natural, unmedicated birth, as it happens in nature?
· How many unmedicated births have you been a witness to? (no pain meds, but actual zero meds)
· How many homebirths have you been a witness to?
· How many homebirth midwives have you talked with about how birth looks in a woman’s own environment, where she’s the one in charge of what’s happening?
· What’s your opinion on homebirth? (the reason for this, is because if they’re opposed to a woman’s right to choose where her birth takes place, are they really going to ‘let you’ be in charge of your birth?)
Do their answers sound like they’re trying to satisfy you? Do they brush you off as if you don’t need an answer (to anything you ask?), or say that you can “talk about that later”?
Think: If your doctor isn’t interested in talking about your concerns during a prenatal visit, what makes you think they care what your opinion is when you’re in labor?
Reread that question.
That is why we make a birth plan.
You need to know what you want, so you can start with a provider who fits what you want. That way, you don’t have to fight for your rights in your birth room, and you don’t have to wonder if your care provider is going to be honest, or try to push you to do what they want.
I’ve personally witnessed a doctor telling parents they “can do what they want” in xyz situation and then a complete 180 in the birth room. It’s referred to as “bate & switch” and its VERY common! Common enough to have a term put on it! It makes me so sad and angry! It often results in women thinking their body is broken in some way, that the doctor saved the day, or that they almost died, or any number of other believes. And while those can be true, it’s rare. And what’s actually true, is that birth works more often than it fails. And we DO need a system where doctors understand that they are there for the RARE occasion when that help is needed. (research how the UK does birth!) The truth is that 2/3 of the cesareans that are done in the United States are completely unnecessary.
You must educate yourself to be able to advocate for yourself so you know when you need to stand up for yourself.
A doula can help with the education, as can taking a birth class that is independent from a hospital!
A doula is a person who knows you, knows your plans, your preferences, knows what relaxes you, what causes you anxiety, your triggers, your fears. A doula is someone who can be a translator, if you will, and help you communicate with your care team. She encourages you, provides comfort measures that do actually reduce pain many times! She helps your partner (husband, mom, sister, aunt, etc.) to know how to help you. She’s only there for you. She has no hospital policy to guide her. She works for you. And she doesn’t leave at shift change. Some doulas take notes for you, but she’s not required to do charting, so she can focus on your needs!
I love nurses, as I’ve already stated. And not just my good friends who are nurses, but they have helped me to have a bit of an inside perspective. Nurses work their butts off. They have so much to do, so many rules to follow to keep their jobs, to not get yelled at by doctors. They have to know which doctors like things which ways and be able to switch up how they’re doing things based on which room they’re in because they know the doctor is going to come in and have an opinion on how things were done. They have to chart. They may have many patients to care for at the same time – depends on size of hospital at times. They have bureaucracy and policies to follow, because they need their jobs. They usually love their job and their patients and birth. They sometimes feel their hands are tied. But there are also those who sometimes feel that you need to do things their way, because they’ve had all this education and you know nothing (ofcourse!) and they do the fear mongering we talked about earlier to get you to do what they feel is best. And those nurses, oh, we love them too. They come from a place of caring, just the same as the others, but they’re opinionated people in general. So then we’re back to remembering that they’re all human beings; human beings are all capable of saying yes or no, and capable of respecting those who disagree with them. Obviously some have more practice and are better at it than others. And when in labor, you can still respectfully get your voice heard.
There’s also the times where you get the best nurse in the county/state/whatever but she’s having a horrible day and even though she’s trying to not bring it to work we’re all human and we take our emotions with us.
It’s a really big pot when you think about it. And we can all circle the wagons to respect and assist the birthing woman, following her lead. None of the politics should ever have a place in the birth room, and yet here we are. So we plan.
They have policies and procedures. So.. …. We plan. They have hierarchy and attorneys and board members, and insurance companies and politics that never ever ever should ever have any place in any birth room ever. And yet... … here we are. These things and more are always present if you birth in a hospital setting, and sometimes in a birth center too. So… … we plan.
You can purchase my guide to help you ‘Write your hospital birth plan’ here! And you can contact me to book a personalized education session with me to go with it! Mention this post to get a 30 min free video chat session with me!
Marsena Beck lives in south central Nebraska with her husband and 6 kids; she is a Birth and Postpartum Doula, Childbirth Educator, Lactation Counselor who loves talking about birth, breastfeeding, mothering, homeschooling, and being a doula in Nebraska. She understands the frustrations of not having a birth you wanted and the freedom that comes from an empowering birth. She's had three births with family doctor, one with a midwife (CNM) and a doula, two unassisted births at home; one of them she was completely alone, the other she had a friend/doula/photographer. She's a homebirth advocate, and shouts to the world that yes! homebirth in Nebraska is an option! She also loves helping moms to have that "homebirth in a hospital" experience, as she had with her 4th baby. She loves working with moms as they walk on their parenting journey.