Birth and Fear Part 2: Being Heard and Respected

I have spent some time asking for feedback from moms about what their greatest fears were (or are) regarding childbirth.  There are several that came up again and again, and today's post will address one of those as I continue this series on birth and fear.  

Fear Number 2 is this:  "What if my wishes are not respected?  What if no one listens to me and what I want for my birth and my baby?"  

Childbirth is deeply personal, and most women, as soon as they are aware that they are expecting, begin to feel very protective of that little person growing inside of them!  After all, this baby is not only part of you, but you are feeling the weight and responsibility of taking care of yourself in a totally new way!  This is the first step into motherhood:  You are responsible for another human being!

Here are a few ways to help you have some control over the birth process (because let's face it, birth is completely unpredictable!) and help make your wishes known and heard.

Have a birth plan.
Let me first preface this point by saying that there is no way to completely plan for childbirth.  If there's no necessary reason for a planned induction or cesarean section, then the expectant mom is watching the days tick by on the calendar wondering if today is the day her baby will arrive.  This can be a grueling time as her body aches, she's hardly sleeping, she's filled with nesting urges (sometimes at the oddest times) and is feeling the need to get her bag packed (if she's having her baby in a hospital or birth center) and the nursery stocked.  The good news is pregnancy lasts approximately nine months, so there's lots of time to plan and prepare!  

A birth plan is one thing a mom can do in advance that will help her feel more "in control" of what happens to her and her baby once the delivery is imminent.  Birth plans are a great tool, and most doctors and nurses are respectful of them if they are kept "short and sweet." By that I mean that it's not always a great idea to walk into the hospital or birth center with three typed, single-spaced pages of details for them to try to follow.  Many women don't always realize that doctors, midwives, and nurses are often tending to multiple patients on their shift, and so they really won't have time to read every detail.  Here are a few pointers regarding the birth plan:

• ​Find some good templates online use them as a guideline in writing your own.  There's a great, comprehensive checklist here to help get you started. 
• Pick your top 10 "non-negotiables" in your birth plan to discuss with your doctor or midwife at your 36 week prenatal appointment.  This will give him/her time to take note of what your wishes are ahead of time and not in the delivery room when things are getting busy and baby is on the way.   
• Go over your birth plan in detail with your partner and doula ahead of time, for it is most important that the people closest to you know what your wishes are so they can help support you in them when the time comes.  At the 36 week prenatal visit, I spend at least an hour going over my client's wishes for her birth during our birth planning session.  This is immensely helpful to both myself and her partner as well as to her as she thinks through each detail of what is most important to her.
• Bring a condensed version of your birth plan with you when you are in labor and kindly present it to your nurse.  Again, keep the list short and sweet with the most important items listed first for them to see.

Stay flexible.
As I stated before, there is absolutely nothing that is predictable about birth.  So many things can and will happen that may alter your perfectly laid plans, and for those of us that have a hard time "letting go" this can be very difficult to handle.  Let me share a personal story with you to underline this point.  

With the birth of my second child, I had a plan.  Everyone knew my wishes, and I expected that it would pretty much be a repeat of my first-born's birth.  It was the drug and intervention free birth that I had hoped for, and I assumed all would work out the same with my second.  But as the birth progressed, it was becoming abundantly clear that my baby boy was not going to cooperate with that plan!  After hours and hours of no progress and doing all I could naturally to bring on contractions (by now my water was already broken), it was clear that using pitocin to stimulate labor was necessary.  The pitocin definitely brought on more consistent and strong contractions, however, my doctor soon realized that my baby was not in good position because of the immense pain in my lower back, nor was his head in optimal position to help further dilation (I was "stuck" at 4 centimeters dilated and he was apparently stuck too in poor position!).  After a couple hours of pitocin, I was not progressing and was getting frustrated by the minute.  The time came when the doctor knew that I was getting exhausted.  I wasn't coping well.  The baby started to show signs of distress.  I was not tolerating things well.  This whole progression of events was something I knew could happen but I was not prepared for it happening to me.  At that point, I was at a fork in the road.  The doctor suggested an epidural, in hopes that I could relax a little and rest, but even more, that my pelvis would relax and the baby could descend.  

I'm grateful to say that the epidural was effective.  Had the final stages of birth gone any longer or gotten any harder, I would have likely ended up having a cesarean section (the doctor said I was moments away from needing one).  It was not what I had planned.  I had very mixed emotions about how things went with that birth and it took me a while to reach a place of acceptance for what it was instead of what I wanted.

The point is this:  I was so thankful I had a support system of people who took my hand and said, "We need to be flexible.  What you are trying to do is not effective and we need to change course.   You're not a failure.  You're doing the best thing for you and your baby."  As it turned out, an epidural was the best thing for me and my baby.  And flexibility was key.

Have support.
You may notice a recurring theme here, and it's not just because I'm a doula.  The fact is, birth outcomes are significantly better and more satisfying when you have a doula at your side.  A doula, along with your partner, will know your wishes before the birth takes place and be able to support you every step of the way.  She will assist you as you navigate the birth process and help you make informed decisions as things progress.  She will encourage you and be your biggest supporter as she partners with your care providers to help you and your baby receive the best care possible.  She will make sure you feel heard and respected, and will encourage you to find your voice when you may be afraid to speak up for yourself.  

I believe that if you are proactive and you've taken the time to formulate a birth plan, commit to being flexible through the labor and have an excellent support system in place, you can be confident that you will be heard and your wishes will be respected when the time of your little one's arrival is upon you.  

Thanks for reading!
~Happi

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