It has become very popular for couples to write a birth plan in preparation for their baby’s upcoming birth. Sometimes, couples spend hours writing down how they would like the birth to be, often not only what they want to happen, but also things they do not want to happen.
I imagine this is a way to try to capture a sense of control over the birth to come. It’s not unusual for these birth plans to be many pages long, and be quite detailed in all the things that the couple do not want to happen during the birth of their baby.
Whilst I am a big believer in couples being well informed about their options ahead of the “big day” - through taking antenatal classes, hiring a doula, learning about birth physiology, and having a good understanding of how their bodies work, to reading positive birth stories - I have to admit to being a little more sceptical about the “birth plan”.
The name birth plan suggests that one can, plan one’s birth. However my years of working as a doula, and my own experiences of childbirth, have led me to believe that the reality is, in fact, often quite the opposite - rarely does a birth plan go exactly to plan (although this is certainly not always a negative thing). The assumption that we can control what will happen and how everyone - including the baby - will behave, is I believe, not particularly helpful, and can lead to disappointment and frustration. I also think that it is extremely difficult for a woman and her partner to make informed choices about their baby’s birth. However, if they have someone there who can offer information that is evidence based and at the same time, explain in an objective way what the different options entail, whilst also pointing to research, it can make a huge difference
Birth can be a wonderfully empowering and positive experience, and despite it not always going as hoped for. I know many women who have had very positive experiences of inductions or “emergency” caesareans, despite these being things that nobody would put in their birth plan. Equally, I have seen couples feel demoralised after their “planned” birth somehow failed to materialise, and sometimes this disappointment started even before labour had begun.
I am not telling you for a second that you should not prepare for your labour and birth, however, I think writing down some birth preferences, focusing on more tangible things such as pain management preferences, whether or not you want your baby to be given Vitamin K, and stating a preference for such things as optimal cord clamping and immediate skin-to-skin contact after the birth, can be very valuable. I would urge every expectant parent to educate themselves about their options. It is a good idea to do research beforehand around inductions, for example, and discuss when you might decide to agree to one, or when you might choose to wait. It is also a good idea to research where you would ideally like to give birth, and stating that preference (although being prepared for that place to change at the last minute). When any medical interventions are offered, the risks of these interventions should also be mentioned so that you can decide what is right for you and your baby. It is a fact that there is nothing in life that doesn’t carry some tiny degree of risk and the same goes for childbirth.
It’s also a much better idea to write all the things that you would like to happen, rather than what you would like to avoid. Our brains find it difficult to register the word ‘don’t’ and you might unknowingly be putting all your focus on the things you don’t want. I’m sure you’ve heard of the statement “don’t think about a pink elephant” which is a way of showing that what you don’t want to focus on or think about is more likely to be in the forefront of your mind. It would, therefore, be much better to write down the things you would like so that those things are your focus.
In my experience, being well informed, with a good idea about your birth preferences and how best to achieve these, enables couples to surrender to the birth process in the knowledge that they know their rights and their options. When I say surrender, I don’t mean “give up and stop caring” of course, but rather the surrender where one becomes open and accepting of what unfolds in the moment, ready to meet any twists and turns in the road, and to meet their baby where it needs to be met.
I do know one thing for sure, if you don’t know your options, it’s very likely that any choices will be made for you, as hospital routines and guidelines will be followed and manage your labour and birth. If you know your options and have communicated them in a birth preference document, you will feel more empowered and confident, especially if you also have a doula with you who can support you and your partner in the way you would like the birth of your baby to be. So, surrender – yet be prepared!
A note on caesarean birth: In my view, there is little point writing about how you would like a caesarean birth to be carried out, unless you are having a pre-planned (elective) caesarean - in this case, I would recommend reading more about gentle, family-focused caesareans.
Kicki Hansard is a member of Doula UK, however any opinions expressed on this blog are personal views and not necessarily the view of Doula UK.