Elaborate birth plans are often the subject of mockery. How can you *plan* for something that’s inherently unpredictable? But there’s a difference between a rigid, perhaps overly idealistic plan for how your birth will go and open-minded, thoughtful preparation.
In our current healthcare system it’s vital that we be proactive in our care; studies indicate that when women are knowledgeable about what’s going on and have strong, respectful support from doctors or midwives, they are pretty happy with the way their birth went down, no matter how it went down.
Some women know they want an epidural as soon as possible, others would like to avoid medications. Some want to be alone with their partner, others know they’ll like lots of help. Some love high-tech hospitals, others seek a different kind of environment. All of us want a healthy outcome. All of us want “a healthy baby.” All of us would like to not tear, or at least not tear a lot. All of us want to feel safe and loved as we take on something so intimate and so challenging.
So on that note, here’s a list of tips to help you get the care you deserve, whether you look forward to birth or dread it.
1. Know What You Can (& Cannot) Control 1 of 10Unrealistic expectations can lead to disappointment but throwing your hands in the air and saying, "it's outta' my control" can leave you vulnerable and unprepared when challenges come your way.
Sure birth can be unpredictable--one childbirth expert I know says, "you get the birth you get." But you can control where you give birth, with whom, how much to educate and prepare yourself, and how you take care of yourself during pregnancy. Preparing for all the things you can control, will help you cope with things you can't control.
Photo: Heather White
2. Get a Good Care Provider 2 of 10While massively important, this can be easier said than done for a newly expectant mom. I've had countless conversations with women who, at the end of pregnancy, realize their doctor is not the right match. Here are some quick tips for picking a good care-provider:
If you are interested in laboring without excessive medical management, go with a midwife or doctor whose track record shows a strong support for natural birth; give birth in a place set up to support low-intervention birth, like a birthing center or a hospital with a low c-section/epidural rate.
If you are low-risk and on the fence about the epidural, consider a midwife or doctor with a low intervention rate. To learn your care provider's approach to birth, ask how many c-sections he or she performs? How many labor inductions, episiotomies and epidurals?
If you know you want an epidural, get a midwife or a doctor who works in a hospital with epidurals on offer and learn all about how to make the most of an epidural so you have the fewest side-effects/risks.
If you are high risk get an obstetrician who specializes in high risk pregnancies.
Photo: Melanie Pace
3. Read a Good Birth Book 3 of 10No matter what you want out of birth-- epidural, no epidural, hospital birth, home birth--read at least one good birth book that gives you a nonjudgmental, evidence-based spread of your options.
The book I co-authored, From The Hips covers many approaches to birth or read Erica Lyon's excellent Big Book of Birth. Sheila Kitzinger's books are also great.
Photo: Kelly Smith
4. Take a Good Class 4 of 10The best childbirth classes teach you many ways to cope with pain in labor from relaxation breathing to pain medication.
Some hospital classes are good but they tend to focus only on what the hospital does (epidural, IV, medication) and less on non-medical coping techniques.
Lamaze classes teach a range of options for coping (not just the breathing techniques you see in movies), Hypno-babies or hypnobirthing is a pain coping technique based on self-hypnosis that can be helpful if you feel very anxious about birth or very determined to give birth without pain medication. Bradley Method classes are "husband-coached" childbirth prep and appeal to some couples.
But there are lots of classes that fall outside a particular method, so ask your friends with babies what classes they took and whether they helped! If the answer is "no, the class did not help" look around some more.
Photo: Melanie Pace
5. Discuss Your Fears 5 of 10Here are some things women fear: pain, needles, pooping, losing control, scary outcomes, going to the hospital, not getting to the hospital in time, not knowing what's going on, not being tough enough or "being able to do it," not being treated with respect, not getting good care, not being able to move, not being able to get drugs, being given too many drugs, and the unknown.
Usually women don't fear all of these things but it's very normal to fear *something* after-all this is a big life-changing moment.
Discuss your fears with your partner. Talk to a doula or childbirth educator or a friend or your mother or someone else's mother who has experience with birth and has seen it work it out over and over again. Talk to your care-provider. If your care-provider brushes you off, consider switching practices. Seriously.
It may sound counter-intuitive but a "positive" conversation about birth involves talking about fear or "negative" things. A doula I know once told me, "I love it when a woman talks about her fears. It means she knows she's standing at the bottom of a big mountain and she's dealing with it."
Photo: Melanie Pace.
6. Get Support 6 of 10None of this stuff is meant to be done in isolation: birth, newborn care, motherhood in general. It's actually a relatively modern idea that moms should go through a lot of this alone. Looking back over time and across cultures, there are lots of rituals set up to connect mothers with friendly, practical community support. It really does take a village. But these days our village is often something we have to coordinate, which can make it harder. It can feel like you're reaching out for help because you can't handle it.
But a mother who seeks support-- in pregnancy, in labor, with a newborn-- is, in fact, handling it.
Photo: Kelly Smith
7. It’s Not Just Epidural or … Suffer 7 of 10There's a myth out there that any woman who wants to go without an epidural is a brave, tough, crazy-person, masochist, resilient super woman or just delusional. Alternatively, a women who gets an epidural is sensible but a wuss.
But here's the thing: a woman who plans to give birth without an epidural isn't hoping to just suffer. In fact, she's very likely doing a LOT to prepare for the pain. In labor, she may have continuous labor support from a doula or get in a tub that will help ease the pain and pressure. She might get massage and reassurance from a doctor or midwife who is especially well-trained in non-medicated births. She likely move a lot and not lie on her back.
And a woman who gets an epidural is not a wuss. She, like her friend in the birthing tub with the doula, is merely using one of many pain coping tools.
We have to all step outside the epidural vs no epidural contest and realize that ALL WOMEN NEED TO COPE IN LABOR, it's just a question of what coping is going to work best for you and then how can you make that happen! (See #2)
8. Take Care of Yourself During Pregnancy 8 of 10Good nutrition and regular exercise can make a significantly positive impact on your pregnancy, birth and recovery. Working out doesn't have to be an obsessive commitment either. Take long walks when you can, swim, sign up for a regular prenatal yoga class... there are lots of ways to stay fit and active every day that don't require hours and hours with an expensive personal trainer (though that's fine, too).
Same goes for eating. You don't have to take on a diet mentality (diets don't work and staying too thin during pregnancy is bad for the baby). Research shows that a diet of real food high in whole grains, lean proteins, fresh fruits and vegetable and low in refined carbs/sugars and saturated fats is always the way to go. (Don't freak out if all you want in the first trimester is a bagel, either, you'll be fine with bland food for a couple months.)
Photo: Betinna N/Flickr
9. Remember, Birth is s Normal Bodily Function 9 of 10Most women in America in 2012 could use a little deprogramming when it comes to childbirth. Many of us were raised to believe that birth is a screaming-emergency-waiting-to-happen. This comes from TV, movies but also from a culture where birth takes place in hospitals, alongside sick people. But as Dr. Jacques Moritz, head of obstetrics at St Luke's Roosevelt Hospital in New York City, recently told the New York Times, "Pregnancy is not a disease, it's a condition." Pregnancy and birth may not be as mundane and effortless as swallowing or peeing, but it is a normal physiological event.
Most of the time birth works quite well-- especially in a healthy population-- and when it doesn't we have sophisticated knowledge, skills and technology to help. Heading into the last trimester it can be very helpful to read stories about how birth works and what happens to a woman's body in labor.
Photo: Koren Albright
10. Know That Kindness & Respect Matter 10 of 10Surveys and interviews with mothers suggest that a positive birth experience is not based on how you did it-- with epidural, without epidural-- but whether you were treated with respect at a time of intense vulnerability. So think about who you pick for a care-provider. There are lots of "good doctors" but some of them are assholes. Don't hire an asshole because you think he or she will give better medical care.
Think about whether you hire a doula to be with you throughout so you don't feel alone and worried. Bring your partner to a birth class so that he or she learns what to expect and how to be present for you. And pay attention to what you read and who you talk to around the time of birth.
Photo: Melanie Pace
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