A Better Kind of Birth (Plan)

This is a guest post written by Meaghan Grant, certified doula & co-owner of Toronto Family Doulas. 

For many expectant moms, writing their birth plan feels like a milestone in their pregnancy. It is a sign that labour is getting closer and you are going to meet your baby soon. Birth plans are often the next step after taking a prenatal class, especially if you are planning to birth at a hospital that provides a birth plan template. But as a doula I am asked all the time, “Are those birth plans really effective?”.

And honestly? No. They aren’t.

That’s because too often birth plan templates are based on medical preferences, which are precisely the parts of birth that aren’t predictable! And when a birth plan focuses on procedures rather than experiences, it can lead to disappointment and confusion. This wasn’t part of your plan!

While it can be tempting to write a birth plan that focuses on interventions and medical pain management, those are not the things that make for a positive birth experience. Rather, I encourage my clients to focus on experiences and emotions, because those are the things we have some control over.

So, if you aren’t going to focus on medical preferences, what should your birth plan include? Follow the three C’s!

1. Comfort

Hospitals can be scary places for a lot of people, even when you are there for something as wonderful and exciting as having a baby. Our environment can have a huge impact on how we experience birth, not only physically and emotionally but also hormonally. The environment should evoke feelings of comfort as much as possible, in order to support your mental health and help those hormones!

 For example, did you know that low lighting can actually help your labour to progress? That’s because melatonin, the hormone that helps us sleep and is produced when it is dark, is linked to oxytocin, the hormone that causes labour contractions. Similarly, bright lights can raise your cortisol, a stress hormone that can dampen the effects of oxytocin. That doesn’t mean you need to, or should, give birth in the dark! But dimming the lights, using flameless candles or fairy lights, and asking staff to use as few lights as possible while you labour can make a big difference!

Other things that can make the environment one that feels safe and welcoming include music, comfortable bedding (I always suggest a cozy blanket!), pictures that remind you of family or positive feelings, or other comfort items from home. While you don’t have to write these down in a formal birth plan, planning to have them with you can create the environment you are hoping for.

2. Communication

Who you have around you during birth isn’t always in your control, especially in Canada where our healthcare system works on a hospitalist system and the doctor who attends your birth is based on who is on shift that day. But knowing that you have your partner, your doula, a friend, your mom, or any other support person with you can make a big difference in your experience. The people around you can perform several important roles. They can help with your physical comfort. They can support you in advocating for your needs and asking questions. And they can make sure you have time to feel comfortable with recommendations from medical staff. Your support team is there to help you communicate with medical staff. They are also there to give you encouragement and reassurance throughout the entire birth process.

Most hospitals have limits on how many support people you can have with you, so ask before you plan to have a family party in your birth room.

3. Complications

On, in other words, “When Things Don’t Go as Expected”. This can be a tricky category for birth plans because it is easy to fall into focusing on medical preferences. But very few people plan for a caesarean birth, want to be induced, or get excited for major changes to their hoped for birth. So how do you plan for the unexpected without focusing on the medicine? Circle back around to Comfort and Communication. What are your biggest concerns around complications? Is it knowing what is happening? Make a plan to ask for staff to explain what is happening at every step. Are you concerned about being alone? Make a plan for having a support person with you (you may need to discuss this piece with hospital staff in advance). Perhaps you are disappointed about not seeing your baby be born or having skin-to-skin right away. Discuss those concerns with the staff and your support team and include some of those most important experiences into a birth that has unexpected elements like induction or the need for the NICU.

When you focus on feelings instead of outcomes, it changes your birth plan in profound ways. It takes it from a clinical document that probably won’t be looked at in detail, to a personalized document that helps your entire team to know you and support you physically and emotionally. Birth is such an emotional process and traditional birth plans ignore emotional health all too often. By focusing on the three C’s, you can plan for a birth that is emotionally supported and safe. And that sense of support and safety can carry you through whatever medical outcomes or changes occur.