When it comes to parenting, even the best-laid plans can go awry and your baby will take the very first opportunity to show you who’s boss when making his or her exit from the womb. “It’s great to have ideas about what you do and don’t want during the birth but, on the whole, it’s the baby who decides the plan of action,” says Zoe Cresswell, midwife and Baby&Child expert. Even so, doing your homework before the big day is vital when laying the groundwork for dealing with the different scenarios you can find yourself in when delivering.
“It’s important to have gathered enough information while you’re pregnant to be able to understand situations that may arise quickly in labour,” says Zoe. “This offers a chance to think rationally about the options, before you are tired and in pain, outlining what you and your birthing partner have agreed would be your preferred course of action.”
Whether you are hoping to ‘breathe’ your baby out with the help of hypnobirthing techniques, are opting straight for an epidural, or are considering a planned caesarean section, compiling a list of preferences will help you focus the mind on the options open to you.
“Most mothers-to-be have a bit of an idea of what they do and don’t want to happen during labour early on in the pregnancy, but it is best to wait until the third trimester to actually write these down on paper,” says Shani Dean, midwife and founder of Hatched (www.hatched.ae), which offers private prenatal classes for couples, lactation advice and postnatal home visits. “This allows for the pregnancy to have established itself and the mother knows her options better at this time.”
Make sure you run it through with your husband, as he’ll be charged with championing your plan while you are in the throes of labour, as well as negotiating and asking questions as the birth progresses. Bear in mind that your plan can include preferences not just for the birth but also for you and your baby directly after delivery.
“Parents need to have discussed how they see their birth moving forward so that they are both aware of each other’s needs,” says Cecile de Scally, educator and midwife, BabySenses (www.babysenses.me). “Things can change as the pregnancy develops, so think of it as a work in progress that should be completed by 36 weeks.”
The very ritual of writing a plan is useful for inspiring you to reach out to your local birthing community for help and advice.
“A good antenatal class will ensure you have the right information to start asking questions of your doctor so that you also understand their way of assisting you in your birth,” says Cecile.
“You can seek information from your doctor, midwife, prenatal educator or doula, as well as close friends and family eager to share positive experiences and advice,” adds Shani. “Bear in mind, however, that advice from many different people can be confusing, so be choosy in deciding from whom you take information.”
Build your birth squad
Once you have a rough idea of what you want, it’s time to run it back past the experts who will be helping you meet your baby. “Your requests will need to be discussed with your doctor and midwife as not all options are available for everyone,” says Shani. “Women with a high-risk pregnancy, such as those with high blood pressure, will not be able to request a water delivery, for instance, as it is not safest medical practice for both mother or baby.”
The best thing to do is book a consultation with your midwife who will be able to run through all the details with you. “Your doctor may also cover some questions, but sometimes they can be pushed for time,” says Zoe. “There’s also lots of information on the internet, although not all of it will be relevant to giving birth in Dubai. That said, the benefit of the care system here is that you do get to know your doctor well before going into labour so you should have already had a chance to discuss a number of scenarios, asked a lot of questions and will have a good idea of how they practise. This makes it easier to let them know your preferred options.”
When it comes to fleshing out the plan, it pays to keep an open mind. “I find lists of dos and don’ts to be fruitless as there is little point writing ‘I do not want a forceps delivery’ if that is the safest option to offer you and your baby in an emergency,” says Zoe. “I personally believe it’s far more beneficial for couples to go to classes and gain all the information they can and start to formulate the type of birth they would like. Being well researched will help you write more realistic statements such as, ‘I would like to use water and gas and air as first-choice pain relief but may opt for an epidural after trying these’, for instance.”
Cecile adds, “Write about feeding and bonding afterwards too. Consider the father in everything and think about requesting Kangaroo Mother Care – or skin-to-skin care – which is currently a popular focus for couples.”
If you’re confused by all the options available, from delayed cord clamping to stem cell banking and harvesting the placenta, simply bring it back to basics.
“When outlining your preferences, it is important that you keep things true to your own values and what is important for your family,” says Shani. “With so many options and discussions on everything from having a natural birth versus opting for medication and breastfeeding versus bottle feeding, for instance, the information out there can seem like a minefield. As a rule, avoid trying anything that’s a fad. Keep your birth plan simple and close to the values and options that mean the most to you.”
However headstrong you are on certain subjects, you’ll need to remain open to what the experts suggest. “There are, of course, extreme cases where a woman can be very set in her ways about the type of birth she wishes for, perhaps involving her going against the guidance of health professionals, requiring senior practitioners to meet and help decide how to facilitate the woman and the birth she wants in the safest way possible,” says Zoe. “Another example would be a woman with a severe needle phobia. A birth plan written with her by health professionals could help the woman to have a positive and safe experience.”
Get your game face on
When those contractions kick in, digging your birth plan out of your hospital bag can slip your mind so make sure someone’s tasked to help. “It’s important to ensure your care provider communicates with you throughout,” says Zoe. “Talk to your birth partner in advance and make sure they know this is essential and can speak up for you if you are unable to do so yourself. All aspects of your delivery should be about informed choices. If you want any particular language used – ‘surges’ instead of ‘contractions’, for instance – then this should be communicated. Even in an emergency, consent should still be gained for a procedure such as an episiotomy.”
If your dream team gets switched on you at the last minute, a quick glance at your birth plan can give those around you a good idea of the type of birth you are looking for. Even if it all goes out of the window, don’t fret.
“There is no problem with writing a birth plan as long as the woman understands, as with all aspects of becoming a parent, flexibility is paramount,” says Zoe. “It’s great to have a goal for how you would like your labour to be, but don’t put pressure on yourself to move away from this if you want to. This does not mean you have failed.”
“Flexibility is the key for all parties involved,” agrees Shani. “Labour and birth are completely unpredictable and unique to each person and sometimes things will not go exactly to plan. Parents-to-be must be flexible and prepared that outcomes may arise other than first expected. Women who request not to have any induction of labour, for instance, may have to have this done if baby is showing signs of stress. On the same note, doctors and health professionals should also be flexible with normal routines if it is safe for the mother to achieve her labour goals.”
If you don’t understand what’s happening at any point, simply keep asking questions.
“Most intervention happens as it is the safest way to deal with the situation at the time,’ says Zoe.
Accepting that you may need to get on board with a whole different plan to the one you so carefully devised, although scary, is perhaps the best thing you can do for your sense of wellbeing. As Cecile wisely suggests:
“One of the best affirmations to use in your birth plan is, ‘I accept the turns my birth may take’.”