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Birth Plans

Welcome to my three-part blog about making your birth plan.

Do these comments sound familiar?

“I’m just going to go with the flow”
“I’ll sound like a diva if I write a long birth plan .”

We all know someone who made a birth plan but everything went out of the window. Which is a bit like writing a list for Santa and getting NOTHING on it when it comes to Christmas Day. It kind of leaves you feeling disappointed and thinking ‘What was the point of doing that?’.

And you might have heard things like ‘Just you wait until you’re in labour, you’ll be begging for pain relief and then you’ll realise what a waste of time it was saying you wanted a natural birth’. And so you take the advice from your friends and don’t make one.

And the whole thing is very frustrating for birth workers like myself. Why do we think there is value in creating a plan for birth? Where is it all going wrong?

Firstly because if you state ‘ I want a natural birth’ and leave it at that you’re not making a plan. That’s a wish not a plan.

Secondly because labour isn’t predictable you need a plan B ( or even C).

Thirdly because you have so many more decisions to make than just how your birth turns out.

So, how could you make your plan so that it is more effective? Imagine you are planning your wedding and you really want the weather to be all blue skies and sunshine. Do you plan your day 100 percent convinced that the weather will turn out how you hope? No of course you don’t! Instead you make a plan B for in case it rains. You don’t take a risk and not book that marquee and you have a stash of umbrellas ready just in case.

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You plan your wedding WISHING for the perfect weather, but you are realistic and you make a back up plan in case it starts raining. So, applying the same principle when making a birth plan your your goal can be a natural birth but you also make contingency plans in case labour changes. You also research how you can maximise the chances of having a natural birth. So that its more than just wishing and it starts to become a smart, more achievable plan.

See how instead of starting with the attitude that its all going to go wrong so there’s no point making a plan you can start to research aspects that you can control? Along the way you’ll also learn loads. Being informed is empowering and much better than sticking your head in the sand and hoping for the best!

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So lets look at the example of wanting a natural birth. What strategies are there to achieve this and make it more than just a wish? You might have heard it’s better to be upright and active in labour and not lie on your back. So you write in your birth plan that you want to as be upright and mobile as possible ( check out U.F.O). But did you know that it can actually be useful at times to lie down and rest? Labour can be a very long process. So it’s important to manage your energy and not burn out at the start. Having a lie down and a doze at the beginning can help you in the long run. Sometimes labour can stop and start over a number of days ( latent labour) and being prepared for this can help give yourself permission to catch up on much needed rest instead of going mad bouncing on your ball and wearing yourself out.

If you understand that a real birth usually takes a lot longer than a birth in a soap it can help you to cope. So, read about what the cervix needs to do and how the contractions make the work happen. First time births can last on average 12-18 hours ( not always, there are exceptions where women have much faster and also much slower labours).

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Find out why staying relaxed is more effective than tensing up each time you get a contraction and HOW this can be achieved over, say 18 hours. You might want to learn and regularly practise some breathing techniques to work on calming yourself, or attend a weekly pregnancy yoga class where you practise helpful posture and breathing methods every week. Have a look at self-hypnosis known as hypnobirthing courses such as the one I run for couples where you’ll learn how to use your mind to control how you respond to the contractions. As you practise what you learn in pregnancy you might notice you start to become more confident about birth.

Do you know what comfort measures ( pain relief) are available that you can use to achieve a natural birth? Starting whilst you are at home? Do you know what hormones will naturally help in labour and how to enhance their production? What can you put in your birth toolkit to help with this? And so by finding out the answers to these questions you’ll be learning much more about how your body (and mind) work in labour. And you are on the road to making that goal of a natural birth more achievable.

As with wedding planning there isn’t a guarantee labour will turn out the way you hoped even if you have all this in place. However its all helpful stuff and not a waste of time. So back to your plan B. What if you find that you do want medical pain relief after all? Would you prefer to ask for it yourself or would you want your midwife to suggest it to you? Some women feel that having it offered by a midwife can make them doubt their ability to cope and mess with their head. So, they prefer to feel more in control and write in their plan something like
“I am hoping to use as little medical pain relief as possible….. However, if things change then I will ask for it. Please don’t offer it to me”.

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Did you know that there are some things that you can decide upon no matter what sort of birth you have?Like this example that came up yesterday when I was teaching my hypnobirthing course to a mum and dad (live online in lockdown). Their first baby was born by caesarean. They were reminiscing back to the moment in theatre when their son was born and a member of the team announced, ‘It’s a boy’! We talked about what they want to happen this time. Hopefully it will be a vaginal birth but it might be another caesarean. Regardless of which, this time they want to find out the sex of their baby themselves in their own time. This can happen wherever and however you birth your baby; you can meet your baby, have a look and be the first ones to say those magical words ‘It’s a girl/ boy!’ And you will have this memory forever.

In this instance your birth plan could say something like:
“We want to find out the sex of our baby for ourselves. If I have to have a caesarean birth I still want us to be the first to find out. Please don’t tell us”.

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It’s important that these sorts of preferences are written down so that you don’t forget to tell the staff. In labour, you’re usually quite busy focusing on dealing with the sensations in your uterus to be able to talk through the detail of your wishes, and it can be quite disturbing and annoying to be asked loads of questions in labour!
It’s important that what you want or don’t want is heard and understood by the midwife, or the team looking after you. They will take the time to read through your plan when you meet them, or your birth partner can tell them.

Even if you find that labour progresses very quickly and there isn’t time to tell your midwife by having thought about it and made your decisions, you are clearer about speaking out like Susan:

‘I had written my birth plan but there wasn’t time for the staff to look at it. But because I had thought about it beforehand, I was able to tell them in the moment. It made me feel more in control and able to speak about what I wanted.’

I hope this has got you thinking more positively about the usefulness of a birth plan and started you on the path to make your own. In parts 2 and 3, I’ll be explaining where to get information from about the many choices you have and the different ways you can create your plan.

See you next time.

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With thanks to @betterbirthuk for their inspiring insta story comparing planning for a wedding with planning for a birth!

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