Birth Plans...

Detailed Birth Plans

I often wonder what is it about detailed birth plans that make labor and birth so difficult? In my 30 years as a midwife, I have never seen this document improve the quality of care or the outcome of birth.  In fact, it is always the reverse. It  seems the more detail in the plan, the  less likely someone is to birth without intervention.  

So the question is WHY? As a yoga teacher, I would assume that writing your positive intentions  down on a piece  of paper would be beneficial. After all, I often talk in my prenatal classes about affirmations and writing down positive thoughts, successful outcomes. Smart  intelligent women research birth plans on the internet and in good faith print them to reinforce their wishes to their provider.  Possibly one of the reasons this backfires is because the scripts on the internet microanalyze every facet of labor and birth, giving women scenarios to worry about they never thought to consider. The other issue is that women are encouraged to write birth plans rather than talk to their providers about what their views are on intervention and promoting natural  birth.

When my patients ask me if they need a birth plan, my response is usually, “No, because there is nothing you could want that I  would not normally do."  I tell them that while I cannot control how labor goes, I can control that they be supported throughout the process.  I also want them to share with me their views and visions for their birth. For example, whether they are definitely planning an epidural, whether they are going to wait and see, or whether they think they absolutely do not want an epidural.  This helps me guide them in labor.  If a woman tells me she  is absolutely sure she wants one, then I know to suggest the optimal time to take  it.  If she tells me she would prefer not taking one, then if she is progressing quickly but suddenly feels anxious (usually signifying transition is coming), I know to tell her to wait just 10 more contractions and then reevaluate. However, I also tell them that even if they are absolutely sure they don’t want one, I will encourage it if I believe it is in their best interest.  My suggestion is always to visualize the way they would like labor to go, to see it flowing and easeful, and then to accept there may be  detours along the way. 

Most importantly, I feel that as a society we are not encouraging women to trust their intuition, their bodies, and their ability to birth. I encourage women to prepare for birth through prenatal yoga, meditation, breathing, and childbirth classes.  Katie and I started Spiral Path Yoga to give women the information and support they need to fully enjoy and embrace their pregnancies and transitions to motherhood. Both in and out of the office, I work to support and help as many women as I can experience positive, healthy pregnancies and prepare for birth. If a woman tells me she still feels the need to write a birth plan, I suggest she write down on paper her WISHES, a POSITIVE document of what she would like her labor and birth to be as opposed to writing down all the things she doesn't want. 

Suzanne Arms wrote in the 70’s, “Childbirth is an experience in a woman’s life that holds the power to transform her forever. Passing through these powerful gates –Each in her own way—Remembering all the generations of mothers Who walk with her. She is alone—Yet not alone.”

 

The IN-Between

The IN-Between

I had a busy call this Monday, helping and supporting 5 women birthing their babies. As busy as I was, I had time to sit with my mothers, to be in their space, and observe the quiet. Sometimes the most meditative moments I have in a week come when I sit with a mother in the throes of labor. Women rock, they moan, they breathe, and then…there is quiet. The space between contractions when women gather their strength and prepare, for the next contraction, for the next phase of their lives.

The IN-BETWEEN… the space in-between contractions, in-between being a pregnant woman and a mother, in-between being a couple and parents; these are important transitions and require contemplative space.

It is incredibly important to respect this time. All too often I see visitors, care providers, support people chattering and talking in a manner that is not supportive to the laboring women. She needs the quiet to draw upon all her reserves, her incredible mama strength. She needs to know that she is the most important and only focus of everyone in the room. Only then can she use her intuition to move in a manner that allows her to birth her baby. 

When I was a young midwife in training, I was told by a preceptor that when you enter a laboring woman’s room, you must leave your own issues, moods, concerns outside so that you can support her energy in a positive manner. I have found this to be true over and over. There are times when a woman is stalled in labor and I have asked a particular “support person or persons” to step out and she will spontaneously become fully dilated and birth her baby.

I love observing a woman as she proceeds with her “labor dance,” rocking and moving, looking completely inward with the quiet only broken by her own sounding, or requests for support or nourishment. I know she gathers her courage, her strength, maybe acknowledges her fear during the in-between one contraction and the next. For me, this time of stillness, of being with women in all their power gives me joy but also insight into my own intuition, my soul knowing and sometimes the strength to continue to the next laboring women and the next…