‘You can’t plan your birth’. It might seem like a funny statement to make at the start of a post about writing your birth preferences. Birth has it’s own mysterious ways and we can never predict how in might go. That said, I want to make some comments and let you know about the discussion and the great ideas that came out in our Monday BaBs session about ‘writing your birth preferences’.
When you sit down to write what you would like and wont like during labour and birth, think about this exercise as a ‘motivator’ to learn about birth and the different interventions and possibilities that can occur during labour. You can never learn about all possible paths, but you can look into the most common variations and possibilities. You can learn about how others made a lovely birth space for them selves or how they communicated with staff to get treated in a respectful manner.
I think the most important way of thinking about your birth preferences is that it is a piece of paper that is going to inform a midwife, who would love to support you, just the way you would like to, about who you are. She wont know if offering you pain relief is supportive or discouraging for you unless you tell her in your birth preferences. So if you start at that point, you are already well on your way. Some of the questions you might ask yourself and write down for your midwife could be:
- Are you a person who have read and investigated lots of options?
- Are you a person who normally likes touch?
- Are you a person who appreciates the door to be closed and the lights to be dim, people to be knocking before entering?
- Would you like to do this as natural as possible or have you got certain things, like pain relief already in your mind?
Instead of writing I don’t want this and I don’t want that, I think it is a great idea to state that you are well researched and that you already know your pain relief options for instance, but that you would like not to be offered any. You will ask for drugs if you need them. Being offered pain relief in your most vulnerable state, is like offering a person on a strict diet a big piece of chocolate mud cake. The time many women are offered pain relief are in those moments where she is doubting herself and it can make her feel like no one else believes she can do it either.
It is important to think about the cascade of intervention. So if you are a person who really doesn’t want an epidural, it might be a good idea to look into natural induction or the risk/benefits of waiting for your baby to come by her/him self. What I mean is to make sure you don’t put yourself in a situation that will create the need for doing the things you most would like to avoid i.e being induced often creates the need for pain relief.
Think about the consequences of saying no to different intervention. For instance if you don’t want to be induced you have to be prepared to go over time, and to be patient about when your baby decides to come. So instead of writing I don’t want to be induced you could write that you are happy for the baby to come in it’s own time. And then spend some time investigating if that is safe or if there are other possibilities and alternatives.
Stating that you don’t want this or that unless medically indicated is useless. The medical staff will always have some sort of medical indication for you whether that is backed up in science or is just policy. And that is not something that you can easily work out while being in labour. Instead you can write that you would like all procedures explained to you or your husband and then you want at least ten minutes on your own to make your decision or to figure out more questions to ask. Very rarely are there a true emergency in labour, so there is nearly always time for you to make your decision in peace and quiet or to surrender in your soul to the fact that your birth might no longer be going in the direction you were hoping. This is VERY important for how women feel afterwards.
Another good thing about writing and working out what you find important in labour and birth is to match that with your birth place choice and carer. This is a great exercise in making lots of informed choices.
Another great tip that came out on Monday was to laminate your Birth Preferences and stick them to the wall in your birth suite with glue tag at a place the midwife comes across regularly. Maybe at the sink or at the blood pressure machine.
The most important message, which is what we come back to again and again at BaBs is that you have choice. No one can tell you what to do. They can give you their professional opinion, but ultimately you choose. It is your birth and your baby and your body and your responsibility to make those decisions. Statements like, “they wouldn’t let me go any longer” doesn’t hold water. You might decide that you don’t find that the benefits of waiting for your baby outweighs the risks any more and therefore you are now choosing to be induced.
Most women avoid making a caesarean birth preference, thinking they will manifest that particular outcome if they think about it. I totally disagree with that. Having looked into what scares you most and have a plan for that, will help you stay calm and grounded if it happens. It will also make it possible for you to put it aside in your mind and maybe even put that particular fear to rest. It has been dealt with.
I have (with permission) attached a copy of a birth preference template from Rachel Reed’s homebirth practice. Download here in Word format or pdf. This template has a number of common issues on it that you can elaborate on and investigate and write about.
Happy writing, deciding and investigating