/ April 29, 2016

Birth Plans

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Birth Plans - Blog Cover

While brainstorming for a fresh take on childbirth classes, a fellow midwife and I were in search of a way to turn birth plans upside down and shake them so that parents could really see them for what they were and to be able to embrace their birth outcomes in a better way. What’s going to make you feel good about how your labor and birth went? What would leave you feeling really disappointed or even devastated?

When they come to class, parents have usually already created a birth plan and made lists.  There is a compilation of what they want and what they do not want, covering everything from IV’s to music playlists. In one exercise, we give them giant cardboard blocks and post-it notes and they “built” their plan so that they could actually see it. Often times there are way too many blocks in their plan for them to hold!  Then, we would ask them to choose just ONE block. Which block is the most important? Sometimes there is a major focus on what they are hoping to avoid:

“No Cesarean”   “No Induction”    “No Epidural”

While they are perfectly good and even realistic desires, they don’t make good blocks to use as a foundation for your plan. What if you labor for days and become exhausted and are facing a cesarean? What if you are still pregnant at 43 weeks? So our mama puts down blocks saying, “No Epidural” or “No Induction,” and picks “Vaginal Birth” as her most important block. What happened? Sometimes something we were avoiding can become one of our most valuable tools. It’s tricky! Which block is most important?

How do you choose?

I encourage you to make a birth plan! They are a great way to make decisions about your care and know what to be discussing with your care provider. A good tip is to choose only one or two items that stick out as different than all of the birth plans that medical professionals will be seeing that same day or anything that is essential to you before printing it. Good examples of this are “I would like to try everything possible for a natural birth” or “Please don’t offer me an epidural, I will ask if needed” or  “I would like an epidural as early as possible.”

Then, take a good look at your birth plan and try to choose one theme or reason behind your choices. There is usually a deep desire or a fear hidden under that list of preferences. For example, it may not be the epidural itself but a fear of losing control of your body or losing control of the process that you are wanting to avoid. You might uncover a need to be a part of all decisions that are made during your labor.  A common desire that I resonate with personally is women wanting to choose what is done instead of feeling that something was done to them.

What is most important to you?

Honor any true feelings or hopes you have and be careful not to fall into the trap of what someone else might want for you or what you ‘should’ want. Like choosing a landmark to put in a map, the key part of your plan needs to be something that can withstand change and remain even if other elements change. Birth is life, which, as we all know, comes with planning and flexibility, grief and joy. We can plan and prepare, but then we have to navigate as the road appears before us. (Tweet this!) Uncovering that core piece is how we make a real “plan” that will affect how you feel about your birth, during and afterward.

There have been lightbulb moments when parents pick up the pen and make a new block altogether. A new, clearer vision emerges…

 “Healthy Baby”    “Being a Part of all Decision Making”    “A Peaceful, Loving Birth”

It is what they were trying to achieve with their lists in the first place! But this is more motivated and positive. More tender and sacred.

Birth plans can come true! More often than not, there are just a few minor tweaks and twists to the plan. Sometimes things take an unexpected turn. My heart breaks for mothers who mourn the loss of the birth they wanted. Birth is more than a healthy mom and baby, it is an important experience to us! (Tweet this!) If there are pieces of your birth that don’t go as you had hoped, it is okay to feel and express your grief for those pieces. My hope for you is to be able to look deep down inside those birth plans and find the most important part to you so that even if there is an outcome that brings grief, there will also be a choice that you made which you can feel good about.

Recently, a momma who took my Primed VBAC course gave me this feedback about her birth plan experience and I wanted to share. I have her permission, of course!

“I wanted to offer thanks for the birth plan part of your VBAC course. On Monday I gave birth to baby #7. I am a believer in birth plans after using one for baby #6 and having great success with one — it had helped me achieve a lovely, calm, unmedicated hospital hypnobirth. For this baby, I listened to what you said about birth plans and really connected with the idea of knowing your overarching goal. After all of my different birth experiences (c-section, VBAC vbac testimonyinduction, VBAC with augmentation, VBAC with epidural, hypnobirth), my “big picture” goal was to be in control of all my decision-making. Well, Monday found me having labored for 30+ hours after PROM, making very little progress, with contractions that were not coordinated enough or close enough together to get the job done. I had tried everything and I knew my body was not going to get there on its own. It was incredibly discouraging. I knew I needed Pitocin but also knew I did not have the reserves to manage that without an epidural. So after 33 hours of labor, I made the decision to go ahead with Pitocin and an epidural. Baby Lucy was born 1.5 hours later. So much of the plan I had hoped for went out the window, but I was able to feel good about my change of plans because it was 100% MY decision and I was completely in control. So although I am grieving the loss of the birth I’d hoped for, I am able to hang onto the fact that every decision was mine and I feel good about knowing my body well enough to adjust my plans to meet my baby’s needs. Thank you for planting that seed in my head because it ended up being such a gift to me.”

 Although we all hope and plan for birth to look a certain way, there is never any guarantee. What we can do is take the time to learn what is most important to us, learn about our options, and make decisions that will still get us to our ultimate goal.

Looking for a way to prepare your core for your pregnancy, delivery, and initial postpartum recovery? Check out our prenatal courses by clicking the images below…