Deciding your Birth Preferences

Recently I suggested in our Pregnancy Yoga Class for ladies to think about writing their birth preferences, one expectant mum who was full-term asked “how do I do this, when my midwife and NHS antenatal classes have not mentioned it?”  I was surprised to hear this.

Birth is unpredictable and no one can say with certainty exactly what type of birth you will have. However you have a number of choices.  For you to be able to make an informed decision and give consent, you need to have an understanding of what’s involved, the pros and cons etc..  It is then for you, as an individual (with medical consultation) to weigh up the risks and make your decision – I’ve talked about consent here.

Writing out your birth preferences or ‘intentions’ may not be for everyone and some disagree, suggesting that doing so prevents women from being open minded about all options and even that it is bound for failure.  I think one should always be open minded about all options and deciding your birth preferences doesn’t preclude this.  Neither is birth about winning or failing – I’ve talked about that here.

Isn’t it positive to take the time before your big day, to think about, research, review and ask questions from your medical providers about all your options – as appose to hearing medical-staff offer you an option in the ‘heat of the moment’ and it being the first time you’ve been asked to think about it – during labour?

Whether or not you have a good or bad birth experience isn’t all down to whether you have your ‘ideal’ birth – it’s also about how you are made to feel throughout labour and birth – I’ve written about that here.   That you feel listened to, respected, are able to understand what is happening and feel included in the decision making process and are well cared for is important.  This can impact your postnatal health and birthing experience.

Benefits of deciding your Birth Preferences

Here are some:

  • Taking time to consider your options and deciding what you would like for the birth of your baby can be a valuable and empowering exercise – it highlights you have choices.
  • A great way for you to learn about your options, it’s an opportunity to communicate and discuss labour and birth with your birth partner (if you have one), so they can better understand what you would like, enabling them to better support you during labour and birth.
  • It gives you more understanding and enables you (& your birth partner) to feel more secure and prepared for whatever may arise.
  • We are all individuals and this will help your medical care-providers to understand YOUR preferences and to support you.
  • There is no judgment in this, you don’t have to stick to it rigidly, you can change your mind – any many women do !

Birth educators often recommend writing your birth preferences for each of three scenarios (1) your ideal birth (2) birthing with Interventions and (3) a Caesarean birth.

The Natural Caesarean

You may think that all Caesarean’s are done in exactly the same way and there is no choice.  However the Natural Caesarean technique shared in the video below is a family centred approach.  Postnatal depression rates are higher in women who have had a C-birth and breast feeding rates are lower.  The Natural C-Birth hopes to counter this by bringing baby into the centre of the birth, allowing mum to see baby during delivery, have skin to skin contact and be able to breast feed sooner.

For example in preparation for the natural C-birth, drips can be placed in the non dominant arm to allow mum to support baby for skin to skin contact; ECG dots can be placed away from the chest enabling mum to breast feed and cord clamping can be delayed.

In 2015, 1 in 4 births were by Caesarean Section.  So even though you may not want a C-birth, it may be helpful to think that if it did happen, what are my C-birth preferences and to discuss them with your medical care providers.

Doula Lindsey Middlemiss explores the natural C-birth in more detail here and very kindly shares a draft C-birth, birth preference document here.

Kelly Bonyata shares suggestions to help nursing after a C-birth here.

Birthing with Interventions

Would you want to be induced and are there alternative options to Induction?  Induction can require constant monitoring which can impact your ability to move and use different positions (as practiced in yoga) – this can affect your pain levels.  What are your choices regarding pain relief and how may they impact on labour and birth?  What are Instrumental births and do you have other options? By understanding your options and the scientific evidence behind them, it will help you to make an informed choice of what you would prefer to happen in such a scenario.  During labour, you can always ask for 5 minutes of privacy so that you and your birth partner can discuss any options offered, without feeling pressured.  If it’s an emergency and you don’t have time for that, your medical providers will let you know !

Don’t forget the BRAIN anagram which can help in asking the right questions to aid decision making.

Your Ideal Birth

This may be a C-birth, waterbirth, active birth, birthing at home or in a birth centre, a hospital birth, having candles, a darkened room, aromatherapy, your favourite music playing……..etc. There are so many choices and we are all individuals.  Respect you.

Tips on creating your Birth Preferences 

  • Your birth preferences should reflect the type of birth YOU would really like
  • Put it in writing, type it out so it’s easier for others to read
  • Begin with a brief introduction – a couple of lines as an overview of what is important to you
  • Keep it short and relevant, 1-2 pages long – to give caregivers a reasonable opportunity to read it
  • Put your requests in bullet form and add a brief explanation of why you want it – to demonstrate your understanding of making an informed choice and helps caregivers to better support you
  • If you have questions, write them down and ask your GP, midwife or Consultant about them.  Print out your birth preferences and show it to and discuss it with your midwife (and medical team).  When you are ready, you can ask for it to be added to your file.  Keep spare copies with you, so that you have it to hand on your big day.

A good article sharing more information to support you in writing your birth preferences is shared by Kelly Wider here.

Legality of Birth Preferences

Birthrights provide that your birth preferences set out your preferred plan of care during labour and postnatally but it doesn’t have any formal legal status.  That said, it should be respected by health care providers unless you consent to a different care plan.

Think positively about your body and your ability to birth your baby.  Respect and honour you, let go of any judgment.  We are all individuals and women have very different and varied birth preferences.  Understanding your options so that you can make informed decisions, can help you to feel more confident and included in your decision making process.  This can help you to feel more positive about your birthing experience, even if it is not your ideal birth.

Though I haven’t used it, the NHS website has a page dedicated to Birth Plans, sharing details of options, considerations and an online tool to help you create your own.

With the many techniques shared, the practice of Pregnancy Yoga can help you to remain present and focused in each moment, so that you are aware and empowered to make decisions as events unfold with an attitude of openness and acceptance.  To join our Pregnancy Yoga Classes click here.

“Although this was not the birth I planned for my baby, I was able to adjust to and accept the changes. The breathing techniques learnt in class were invaluable and helped me to stay calmer than I could have imagined. I see this calmness in my baby every day.” Kindly shared by Toni, a new mum and our former Pregnancy Yoga Student, July 2016

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