HOW TO GET THE BIRTH YOU WANT

birth plans how to get the birth you want

I’ll be the first to admit, this title is a little misleading/click-bait-ey. No one – not me, not your partner, not your OB/midwife, not your doula – can guarantee that you’ll have your “ideal birth.” I heard from a wonderful childbirth education teacher that you can control a lot of things about your birth, including:

– Your preparation
– Your choice of care provider
– Your planned birth location
– Your reaction to the pain of labor and anything else that happens.

However, there is one thing that you simply can’t control…

YOUR BABY!!

Therefore, there is no way to guarantee any outcomes related to your labor and birth. There, I said it.

HOWEVER…there is a lot you can do to nudge your labor and birth in the right direction. I’ve listed a few of these items below. Let me know in the comments if I missed any of your favorite ways to prep for labor!

HAVE A PLAN

Pregnant parents often ask me whether I think a birth plan is necessary for their home/hospital/birth center birth. My answer is…maybe.

First of all, the term “birth plan” is a misnomer. Unless you’re having a scheduled cesarean, there is no “planning” for birth – the start, the end, or anything in between. So many things can go differently than what you planned, even things that seem obvious to you before the labor starts. That song you thought would be the perfect complement to labor may drive you crazy when contractions get intense. That glorious birth tub might actually feel all wrong when it comes time to get in.

The very best we can do is outline a set of birth “preferences.” Things you might want to know beforehand include:

Would you like medication, what kind, and when?
– What comfort measures would you like to try during labor?
– Who should be in your birthing space?
– What would you like done/not done immediately following the birth (cord cutting, skin to skin, etc.)?

At the very least, making a plan will force you to think through what your preferences actually are.

Should you write these things down into a formal document? Again, maybe. My advice is:

– If you will be birthing with the same care provider(s) you have worked with through your pregnancy (e.g. a midwife-assisted home or birth center birth), I think having a written plan is not necessary. Ideally you’ve chosen a provider whose preferences mesh with yours (more on that later).
– If you’re giving birth with a rotating “team” of providers (OBs, midwives, nurses), I think having some of your main preferences and ideas written down will help get everyone up to speed, for instance if there is a shift change while you’re in transition.

CHOOSE A CARE PROVIDER THAT ALIGNS WITH YOUR PREFERENCES

Planning an unmedicated birth, but your provider has a 90% epidural rate and a 50% c-section rate? You *may* be part of the minority that slips through, but, assuming you have options in your local area (that are covered by insurance), why take that chance?

I ran up against this exact thing when I was pregnant with my first baby. Growing up, the more I learned about labor and birth, the more I thought, “give me the epidural!” When I moved to Austin, I got in with the “most popular” OB/GYN clinic with everyone’s favorite doctor. However, the more I learned about the side effects of labor interventions, the stronger I felt about an unmedicated birth. When I brought this up at our 16-week appointment, the (male) doctor patted me on the knee and said, “Oh honey, everyone says that, but 95% of them beg for the epidural.”

Huge. Red. Flag. Not only was his phrasing condescending (“honey?”), but this man already assumed I couldn’t do it! That I would need him to save me from the pain and help me deliver my baby into the world. That I wasn’t strong enough to handle the pain. Is that someone I want by my side when I’m in transition? HELL NO.

After that visit, I immediately started researching alternative care providers. I settled on a home birth midwife whose approach meshed with my preferences based on the research I had been doing. By my choice of provider, I took so much stress of my labor off my shoulders. I knew I wasn’t going to have to face constant pressure to get medication during labor, and any choices she presented to us would align with my own preferences, even if we did end up going to the hospital. Some questions you may want to ask a potential provider are:

What percentage of your patients opt for medication during labor?
– What is your c-section rate?
– How often do you perform episiotomies?
– What is your policy around progression of labor? Are there time limits?
– What is your policy around time limits if my water breaks before labor starts?

Please note that this goes both ways. If you’re dead set on an epidural or other types of pain relievers, you don’t belong with a home birth midwife! The key here is figuring out the kind of birth you want, and finding the provider that gives you the best chance of achieving that.

And please don’t feel pressured to conform to anyone else’s idea of an “ideal” birth! The most important thing in the whole process is for you to be comfortable with your caregiver and your birth place. Some women don’t labor well in a hospital. I read two great stories from a woman who attempted home birth with both her kids but had to transfer due to lack of progress. Despite being a huge home birth advocate in her head, her heart didn’t feel safe there. It’s not important that your preferences align with those of your friends or people on the internet. But you DO need to have alignment with your provider.

Some of my favorite reads when figuring out what kind of birth I wanted to have were The Thinking Woman’s Guide to a Better Birth (Goer) and Birthing From Within (England & Horowitz).

TAKE A CHILDBIRTH EDUCATION CLASS

One of the absolute best ways to help you get the birth you want is to EDUCATE yourself (and your partner!). There are so many options here – Braley, Lamaze, Hypnobirthing, Birthing From Within, the class at your hospital. Your choice of class will depend a lot on what you want from your labor. If you’re planning a standard hospital birth with pain relief and other interventions, I encourage you to at least take your hospital’s childbirth education class to learn about the options available to you, their potential risks, and when they may and may not be available to you.

If you’re planning to have an unmedicated birth, then you definitely need to go the extra mile to educate yourself about the phases of labor and ways to cope with the pain. Why? In a hospital setting, you may be swimming upstream. Even if your place of birth is 100% supportive of unmedicated birth, you still need to be aware of the signs and symptoms of labor, how the different phases of labor might feel, and have a strategy to cope with the pain. In fact, I’ve heard of some doulas that won’t take on a client unless that client is signed on for some type of childbirth education!

Many doulas, midwives, and hospitals offer their own childbirth education. If you are working with them, you may want to take just to become more aware of how that particular individual works and how they approach labor and birth. When I was pregnant with my second baby, my husband and I took the childbirth education series with my midwife as a refresher.

However, I encourage you to look around for the method that aligns with your views and that makes you feel the most comfortable. We took Bradley classes to prepare for our first child, and I absolutely loved the focus on relaxation and support from the birth partner. I know women and doulas that swear by Hypnobirthing. I’ve since learned that the exact method isn’t as important as long as it teaches you to RELAX during birth. In my humble opinion, having an unmedicated birth basically boils down to getting out of your head, slowing down your breathing, and stepping out of the fear-pain-tension cycle. Any method that helps you do that is wonderful.

HIRE A DOULA!

I recommend this most strongly for anyone delivering with an OB in the hospital or even a team of midwives in a birth center (or home birth practice). A doula can serve as a consistent presence throughout your pregnancy and birth. Ideally you should discuss your major preferences for labor and birth with your doula and practice some comfort measures beforehand. Your doula can help communicate your preferences if you’re faced with a new member of the team mid-labor.

Studies have shown that people having “continuous support during childbirth experience:

– 25% decrease in the risk of Cesarean; the largest effect was seen with a doula (39% decrease)
– 8% increase in the likelihood of a spontaneous vaginal birth; the largest effect was seen with a doula (15% increase)
– 10% decrease in the use of any medications for pain relief; the type of person providing continuous support did not make a difference
– Shorter labors by 41 minutes on average; there is no data on if the type of person providing continuous support makes a difference
– 38% decrease in the baby’s risk of a low five minute Apgar score; there is no data on if the type of person providing continuous support makes a difference
– 31% decrease in the risk of being dissatisfied with the birth experience; mothers’ risk of being dissatisfied with the birth experience was reduced with continuous support provided by a doula or someone in their social network (family or friend), but not hospital staff.”

If any of these are important to you, I highly recommend you reach out to a doula in your local area. Similar to your OB or midwife, make sure that your doula supports and aligns with your birth choices!

I strongly feel that if you do everything on this list, you will have the best chance of having the birth you want. Of course, there is that little variable known as your baby that could throw a wrench in even the best laid plans. But at least you will know that you and everyone on your team did the best they could, and you’ll feel comfortable that any interventions were what needed to happen in the moment.

What do you think? Is there anything you would add? Do you have any questions? Let me know in the comments!

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Meagan Noble Health Coach

Hi, I'm Meagan.

I'm a full spectrum doula and wellness coach helping you thrive through birth, baby, and beyond. Learn more about me here.

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Meagan Noble Health Coach
Meagan Noble

CERTIFIED DOULA (DTI)

Meagan is a full spectrum doula and wellness coach helping families follow their intuition to discover balance in family life. With her focus on ancestral practices, relaxation, and self care, she guides her clients to a calm, confident, and connected birth and postpartum experience.