by Dr Mama-Aso Peprah
What is a birth plan?
Creating a birth plan is process whereby a mother reveals her hopes and expectations of her birth experience and relays this information to the health care team often in the form of a document.
A birth plan was implemented to give women control of their birth process – especially in the clinical settings where labour ward rules and constant monitoring restrict movement. As an OBGyn, I know that these measures are implemented to ensure safety of mother and baby, however, this has resulted in the medical fraternity medicalizing birth.
What is the purpose of a birth plan?
Women have had to reclaim their bodies, their process, and say no to the high rate of caesarean-section. Creating a realistic birth plan is associated with a better childbirth experience: feeling like there is support and control in labour; less fear of labour and birth; reductions mental health symptoms and higher chance of vaginal delivery (1).
The birth plan favors everything natural, undisturbed with no interruption.
And here is where the problem lies: labour and birth very seldom go according to plan. It never happens when you are ready. The place is never quite what you expected, and the timing is very unpredictable. We write these beautiful and sometimes unrealistic plans- mine was 4 pages long by the way- based on all the videos and social media posts that we have seen. We expect our experience to be the same.
This is where I believe the trauma of birth begins: When our expectations of our birth are not met at all. We feel cheated of this beautiful and wholesome experience that we are promised and if we don’t have it then we feel we have failed as mothers.
Therefore, I advocate that instead of preparing these lavish and unrealistic plans, that we rather create various birth scenarios and prepare our body and minds for any of the eventualities.
So how do we prepare for this unpredictable experience that changes within seconds? How do we draw up birth scenarios?
- Your Ideal scenario:
- This is where your plan goes exactly how you planned or even better than you expected.
- Worst case-scenario:
- This usually involves you or baby being in trouble and requiring an emergency procedure.
In all honesty, the experience you have will probably be somewhere in the middle of the two, and it is important to hash out the details of both or all scenarios so that no matter how your baby is born, you have an action plan on hand.
So, as you create the plan, answer these three questions proposed by Judith Lothian about your birth experience (2).
- What will I do to stay confident and feel safe?
Confidence comes with preparedness. The birthing process is so unknown and daunting, the only thing we have is knowledge. Therefore, try read, read, read as much as we can from different sources. You must however be mindful about the origin of the sources of information. Discern if the information is provided by one persons’ experience -because you can learn from others’ stories- and when it is evidence-based medicine, where the stories of multiple women are recorded and analyzed. I would then recommend that you reflect on what you have learnt and chose what advice or voice is in line with your value system.
This question also speaks to the choice of your healthcare provider who will do your delivery. Do you trust their knowledge, skill and that they respect your needs above their own as long as it is safe for both you and baby? What happens if your healthcare provider who you have come to know over 9 months is on holiday when you come to deliver?
The place where you give birth is also important. The people that help you need to offer a service is medically sound but also holistic.
- What will I do to find comfort in response to my contractions or anxiety pre c-section?
I’ll say this from my own personal experience, that the ability to get through contractions lies in your breath. Medication and alternative methods to deal with the pain are all helpful but none of these methods will ever give you a pain -ree experience. Contractions last a maximum of 45 secs. So, if you minimize it to that and count and breathe- you are one step closer to the end.
If you are having a caesarean-section I also recommend deep breaths to help deal with your anxiety and to help with pre-oxygenation prior to the operation. In my experience I find mothers who are overly anxious are often the ones who don’t respond well to the anaesthetic and have a higher chance of being put to sleep instead of being awake to see their baby being born.
- Who will support me through labour, and what will I need from them?
Your choice of birth partner is important. It does not have to be the person who contributed to conception. Sometimes that person doesn’t want to be there, they may be too nervous and then you find yourself helping them instead of them helping you. If you are going with your partner, empower them by involving them in your journey and reading as well. The decisions are best made together, so you are on the same page, and your partner can advocate for you during the birth process. Having a doula present during your birth may also be a good avenue to explore.
So, parents: What does your birth scenario look like?
If you are an expecting parent and are not sure where to begin in designing your birth scenarios, we here at The Nurture Hub can help you do just that. Let us assist you in creating options that you are comfortable with and confident in.
Some helpful resources to get you started:
References:
1.Birth Plans: The Good, the Bad, and the Future. Judith Lothian.
