This is the story of a Birth Plan that was not used. A Birth Plan that was carefully made, was informed and detailed, but was never even looked at during the birth.
This is the story of a cup of tea, left to go cold.
Rebecca* was determined that her birth would not 'go with the flow' , meaning that she was not going to leave it to chance. She felt very nervous, fearful even, of a birth left in the hands of her medical team - even though she trusted them. In order to relax into childbirth, Rebecca needed to feel in control. She found the best way to do this was to create a Birth Map.
Unlike many Birth Plans, a Birth Map has several pathways, a choose your own adventure Birth Plan. At key (predictable) points decisions need to be made. These decisions will lead down different paths, with different possible outcomes. Creating a birth map means, quite literally, mapping out all the possibilities. Reading the entire choose-your-own-adventure book in advance, seeing all the different pathways clearly, rather than waiting to read the book in labour, means the decisions are informed. Sure, it takes some of the 'adventure' out of the story, but it also takes out the stress and worry.
This approach gave Rebecca a feeling of control that brought a calm to the birth, not just for her, but also her partner and her midwives.
Partners report that the 'if this, then that' approach offered by a Birth Map means that they feel useful, informed and assured. A calm partner helps keep the birthing woman calm.
Midwives love the practical nature of a Birth Map. A birth map is a series of simple statements: Informed Decisions. The process of creating the Birth Map involves many discussions, and whilst the decisions belong to the birthing woman, the collaborative approach means all parties are working together towards a common goal. They develop an understanding of each other and when a birthing woman makes a decision that does not align with hospital policy, it is done so transparently and confidently.
The Advanced Decision making means that there will be unfollowed pathways - like cups of tea left to go cold. It also means, that whichever pathway is followed, it is on the birthing woman's terms. It is the making of the tea that matters, not whether or not it is drunk.
Just like a cup of tea, the Informed Birth Preparation process is about communication and reassurance. And just like tea, there are many possibilities. Many different 'tastes' if you like. And, if you recall the 'tea consent analogy' from 2015, just because the tea has been made in advance, you do not need to drink it.
Rebecca's sense of calm, and feeling of control, that arose with her Birth Mapping, allowed her to 'slip into the zone'. She was Informed, Supported and Confident. She felt safe. Her partner knew what to do, felt involved and capable. Her midwives knew her decisions were informed. Rebecca's birth was dignified, respectful, personal. Rebecca described the birth positively, and said it helped her transition into parenthood confidently.
A positive birth, as described by a new mother, is not about the type of birth. It is about how she felt. The common thread of positive births is that the Mother was Seen, Heard and RESPECTED. She understood what was happening, as it was not happening to her, but because of her. When a woman and her partner experience a positive birth, it carries over into their parenting. the risk of PND reduces, her willingness and confident to seek support when needed increases.
Beyond the Birth, Rebecca had a 'fourth trimester plan'. This was set in motion before the birth with a 'Gathering of Women' with the focus on Food and Help rather than baby stuff.
The Beyond the Birth preparations are an important part of Birth Mapping. It helps align expectation to reality and set up support networks. Again, parents may have several pathways open based on their circumstances and personal philosophies. Beginning with an understanding of normal newborn behaviour, parents can build the foundation that best supports them. The 'Gathering of Women' is one way to help set up this support network. Some parents have a 'gathering of support' that includes menfolk. There is no one way! The key to 'Beyond the Birth' preparation is acknowledging the realities of life with a newborn and ensuring that a support network is in place. These preparation cover newborn behaviour, breastfeeding, relationships/sex and day-to-day practicalities. If they are not first-timers, the preparations will also consider preparing for a sibling.
The reason for this level of preparation is that you can not ASSUME anything. If our baseline for birth is 'a healthy baby', we are ignoring the very critical aspect that a baby needs a 'healthy mother'. This means physically and mentally.
We should also not ignore that mothers need 'healthy partners' and support.
We also need to acknowledge that careproviders need to be 'healthy'. This includes a respectful workplace, that allows them to support their clients unhindered by insurance-driven policy.
All these aspects can be achieve through Informed Birth Preparation.
The Birth Map brings together the needs of all parties, framed around the autonomy of the Birthing Woman.
*not a real name