DO YOU HAVE A BIRTH PLAN?
Once you get to the hospital or birth center (or your birth team gets to your home), whatever you have written on your birth plan will need to be taken as a suggestion, not an edict. Babies have their own mysterious plans, and you need to be prepared to shift away from yours—quickly, and without resentment.
I remember marching up with my double-spaced, three-page natural birth plan in hand, and the look of annoyance on the nurse’s face as she read it—later, this same nurse would be my angel as she held my hand during the epidural.
Electronic candles and soft music are great, but get ready for the lights to come on. Prepare your birth plan as a way to establish your goals with your birth partner, and to share your hopes with your birth team, but please don’t try to tell them how to do their jobs.
WHO’S IN AND WHO’S OUT?
Part of the birth plan is deciding who will be in the room with you. This decision should not be taken lightly. For me, the prospect of giving birth highlighted the fact that I hadn’t grown up with a mother, and made me feel even more abandoned. I compensated by asking my aunt (my mother’s sister) to be with me during the process. My aunt has done yoga for most of her life, is a trained masseuse and therapist, and is super-duper calm. You would think this would make her a perfect birth coach, right? Wrong. You process a lot of emotions when you’re giving birth, and one of my biggest was going through a lot of anger at my own mother. For whom my aunt was, sadly, standing in.
During early labor, the shoulder and foot rubs were amazing. Later, at the hospital, I literally kicked her off of the bed when she tried to rub my feet. I felt horrible afterward, but my instinct may have been right: At that point, I only wanted to focus on my husband. We were so intensely bonded it was like falling in love all over again. I remember looking into my husband’s eyes and feeling like there was nobody else in the room, like we were standing on a mountaintop with a whole world of adventure in front of us. And, in essence, we were.
But if I had to do it all over again, I might just have worked with a midwife or doula. Although the two words seem to be interchangeable, they actually serve very different functions.
A midwife works with you through your pregnancy, offering prenatal care through regular appointments, delivering the baby, and providing postpartum support. The midwife basically acts in place of the obgyn, with one major difference: Her goal will be to minimize technological interventions such as inductions, and if obstetrical attention is necessary, she will be responsible for getting you into the care of an obgyn quickly and safely.
A doula , on the other hand, works with you and your birth partner to design a birth plan and prepare you for labor. She supports you through labor, working with whomever you choose to deliver your baby, where you choose to deliver. She can support a birth facilitated by a doctor or midwife in a hospital, birth center or home; she also follows up with support after the baby is born. Studies have shown that the presence of a doula reduces the likelihood of a caesarean section by as much as 22 percent.
The challenge for me with both of these options was money: We didn’t have any, and neither midwife nor doula was covered by insurance. Had they been, we probably would have at the very least worked with a doula. Most of the women I spoke to who had doula help during their pregnancies and births felt a level of support that I never experienced from the hospital nurses. In contrast, most of the nurses I encountered were truly amazing, but they also were subject to shift changes. And family members can sometimes be a little too close for comfort, as in my case. Sorry, Aunt Lake.
LOCATION LOCATION LOCATION
Once you decide who will be helping you deliver your baby, you’ll need to decide where that experience will take place. And this is a tricky one. I do know many women who have had amazing experiences giving birth at home. I also have a friend who had to be rushed to the hospital because of complications at her home birth; she and her baby could have died.
That experience kind of put it in perspective for me. I respect every woman’s choice to give birth where she feels comfortable, but I also feel that—especially for your first time—giving birth in a birthing center or hospital is safer. With that said, wherever you have your baby, you have to take steps so that you feel empowered. Make sure your birth partner and coach—if you have one—understand exactly what you want. Let them be your allies.
OWN YOUR LABOR
Let’s use early labor as an example: If you feel like you are progressing, but a nurse tells you that you’ll need to either 1. go home or b. begin an induction process, you have every right to tell her that you prefer not to have an induction but that you still want to be admitted to the birthing center. You have a right not only to demand this, but also to speak to her superior if she doesn’t grant your request. Use your voice, and make sure your team has your back. It’s your labor, whether you’re in your home or a hospital. Own it.
I know many women who’ve delivered naturally or with an epidural, vaginally or through C-section. And many of us have regrets. But when they put that baby on your chest, you don’t care how she got there. You are just grateful, thankful and full to the brim with love, absorbed by the beautiful creature that’s just emerged from your body.
There is no perfect childbirth. There is only labor, birth, baby—and baby trumps all.
Featured on “TODAY” and “CNN Headline News,” among others, Rachel Lincoln Sarnoff is a journalist, consultant and sustainability advocate. The former CEO of the non-profit Healthy Child Healthy World, Rachel was the co-founder of the online magazine EcoStiletto and authored a spinoff book, The Big List of Things That Suck. Today, she publishes MommyGreenest.com where she recently published a free eBook, The Mommy Greenest Guide to Pregnancy, Birth & Beyond.