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(Open in a new page: HOW MUCH SHOULD I INVEST IN BIRTH PREPARATION?)
TIME AND ENERGY The amount of time and energy you invest in your birth preparation can make all the difference between it being INFORMED and up to chance. Between a positive experience and a traumatic one. Investing nothing could be seen as leaving your birth to chance could be seen as 'going with flow' and 'not setting yourself up for disappointment'. Expect nothing and you can't be disappointed, right? This is the approach taken by many who have been told to 'leave their dignity at the door', this approach, however, can leave you very disappointed, and even traumatised. You have the right and responsibility to make Informed Decisions regarding what happens to you and your baby. The more time and energy you invest into this, the better off you will be. If you are planning a pregnancy, you can start the Informed Birth Preparation process before you conceive. This may involve reading extensively, joining groups, attending meetings or even conferences and seminars, webinars, and online courses. Immersing yourself in 'birth culture' so that you can discover the options that appeal most to you. There is no one way. If you are already pregnant, you have less time to dwell on your different options. You may find yourself having to make decisions fairly early on. For example, you may be encouraged to 'put your name down' on a places-limited continuity care program. This may not make any sense to you, but doing it means you have the option. You can always opt out. Chances are, the first thing you do on discovering your pregnancy, is to see your GP to 'confirm it' and find out your options. This may result in learning many things, or it may result in coming away with a handful of test referrals and no information. Standard Pregnancy Care is fairly limited in giving you full options and understanding. It is up to you to find out what works best for you. You can start with the Recommended Resources, and search the blog articles to get you started on the path of Informed Birth Preparation. Creating a Birth Map takes time and consideration. THE BIRTH MAP: Boldly Going Where No Birth Plan Has Gone Before takes the guess work out of this process, giving you the insights and questions you need to effectively invest your time and energy in your birth and beyond preparation. When you SIGN UP to my newsletter, or register for the Member Area, you will have access to current information and support. FINANCIAL INVESTMENT Many people will think nothing of spending thousands of dollars on a wedding. They recognise the importance of the day, and do what they can to make it as wonderful as they can. If weddings were 'public funded', you would get a very simple service at a registry office. And whilst this is a good option for the 'no frills' approach or those with limited funds... in that it gets the 'job' done...it does not allow for a personal touch or acknowledge the significance of the event. Like weddings, just because you spend a lot does not guarantee you get what you want. You need to choose each element; the education, the location, attendants, care-givers, contraction management, interventions, photography(?), post-partum support...this all takes careful consideration. You need to understand each element in order to make Informed Decisions. When it comes to financial investment in birth; consider your personality, your education needs, the outcome you want, your circumstances, your support network and the options available to you. Let's look at your financial investment options:
(open in a new page: I AM UNSURE ABOUT THE COST INVOLVED IN HIRING A DOULA. WHAT ALTERNATIVES ARE THERE?)
(open in a new page: WHAT IS A DOULA?)
A doula understands that you are a unique person, and that you deserve personalised and continuous care. Think of a doula as a 'birth mentor', because I see the role as being the 'one who has gone before', you gain from the hindsight, from the experience and from the research and further education your mentor has. A birth mentor guides you, but does not direct you, as you become the expert in your own experience. The guess work is taken out of your planning, saving you time and easing any anxiety, leaving you confident and informed. You have the Right to an Informed Birth. The birth mentor fills a gap that has developed over several generations. As birth has become more medicalised, much general knowledge of normal birth has been lost. Where once we would have turned to our mothers, sisters, aunts for guidance and support, we now find that they are as lost as we are in what to expect and how to prepare for this very important transition. So in one way, your doula is 'rent-a-sister'. A very awesome, experienced, supportive sister. The birth mentor understands this knowledge, has reclaimed it, has become immersed in all things birth and parenting and has walked the path. The birth mentor is constantly seeking evidence and knowledge and understands that becoming a Mother is a very personal Journey. A birth mentor does not tell you what to do, but will make sure you know all your options, offering continuity of care and unconditional support. The doula does not replace medical care, the role is complementary, ensuring that you receive holistic and personal care during your pregnancy and transition into parenthood. Can you birth without a doula? If you can answer YES to all the questions below, that is FABULOUS! You are one of the rare and fortunate people who have the support and knowledge we all need and deserve. If you find yourself answering NO, the doula or birth mentor is the solution. Meet a few doulas and find one who you feel a connection with. Doulas offer different packages and usually offer payment plans. Asking friends to contribute to a doula instead of gifts at a baby shower is also a great way to ensure you get the support you need. The value of a doula (birth mentor) is in the birth preparation support, the more time you and your partner can spend with your doula during pregnancy working through your options and developing a rapport, the better. For some people, a few preparation sessions, guided by their copy of THE BIRTH MAP, are all they need to prepare for a DIY birth. For others, the presence of a doula at the birth is invaluable. During birth, the doula supports the partner, helps to create an intimate and comfortable space and reassurance. The doula is often the only familiar face, and she is a consistent presence throughout pregnancy, and into the early weeks with your baby. Some doulas will also offer additional services, including postpartum care. (open in a new page: I HAVE MY PARTNER/BEST FRIEND/MOTHER/AUNT SUPPORTING ME - WON'T A DOULA JUST GET IN THE WAY?)
Many people feel that their birth team is complete by having a loved one with them. For some women it can be enough, particularly during the birth. The reality for most, however, is that whilst this support is loving, it is often inadequate for making informed decisions. The preparation process is greatly enhanced when a doula works with you and your support person/team to ensure you are supported in the best possible way. Given you are Wonder Woman (awesome, powerful, capable), let us assume your birth partner is batman (no need to get caught up on gender here, batman could be your partner, your mum, a friend). Batman needs Robin. Robin is the helpful side kick. Batman gets to be the 'hero', with Robin quietly supporting. A doula supports your partner in supporting you. A doula provides:
A doula's skill is often invisibility - there, but not there, gentle reminding and suggesting, never instructing or taking over. The time you spend together in preparation means that during labour no-one needs to interrupt you, they just follow your instructions using your birth plan. A Birth Map is a very through plan, covering all possible pathways. During the planning phase, each persons role will be detailed, so that no-one hinders You and gets in anyone's way. (open in a new page: I DON'T WANT A STRANGER AT MY BIRTH, WHY WOULD I HIRE A DOULA?)
We often accept that we will have random medical attendants at our birth, without question, especially in the public system where we do not pay. Research shows that continuity of care makes an enormous difference to birth outcomes. Doulas provide the best source continuity of care. In the months leading up to your birth, you will spend significant time with your doula, developing a relationship and an understanding. The doula is far from being a stranger, after your partner/supporting loved one, your doula will be the most familiar person in the room. More than that though, and of great importance - she is familiar with you. Having worked with you on your birth plan she will be intimately familiar with your desires, needs and your informed decisions. Her focus is You. (open in a new page: WHAT IS A BIRTH PLAN?)
What is a birth plan? Why should a pregnant woman plan her birth? Is a birth plan for everyone? Generally speaking, a birth plan is a written document that a woman provides her care givers outlining her 'intentions' for her labour and birth. They are often used by women who have very clear ideas about how they wish to be treated, and what interventions they wish to be offered (or not), during labour and in the hours post birth. Forget the Birth Plan - you need a Birth Map! For many a birth plan is given 'lip service', it is part of the tick-box approach to birth preparation. There are many free 'proforma' plans available, and these may be helpful for setting out your plan, but it is the research that you put into the plan that makes the difference. Informed Birth Preparation is the fundamental difference, not the piece of paper called a ‘birth plan’. When we don’t know the questions we need to ask, it is hard to know how to begin. It is often assumed that our care providers will give us the information we need, and the time we need to make informed decisions, but the reality is we are often told things on a ‘needs to know’ basis, which does not allow time to make informed decisions, let alone create a 'birth plan'. For example, if a woman were to go past her estimated due date, she may feel pressured toinduce, she is at a fed up and anxious stage of pregnancy, and may be experiencing fear and hearing many horror stories about going 'over due', not to mention all the "have you had that baby yet?” comments…it is very difficult to make an informed decision in these circumstances. The process of Informed Birth Preparation , however, considers this scenario (along with many others) well before the due date, and creates a game plan (Birth Map) to follow. Informed Birth Preparation creates a personalised Birth Map using:
The process is done in conjunction with care providers. Your support team will be familiar with your decisions, and able to stand by you as you proceed on your terms. The written document (usually called Birth Plan) contains your Informed Decisions. (open in a new page: WHAT IF THINGS GO WRONG?)
What if things go wrong? Doesn't a birth plan just set women up for disappointment? 'Birth Plans' can indeed set up a woman for disappointment if they make these mistakes. A Birth Map, however, is an original document developed over several antenatal appointments in conjunction with care providers, allowing time to consider options and weigh up the risks and benefits to make informed decisions for various possible pathways. It has a built-in contingency plan. Not because things will ‘go bad’, or because it is even likely too. The contingency is the insurance, the backup, the ‘just in case’. It protects you from on the spot decisions. It means you are more likely to recognise and understand any deviations from your expectations, and respond calmly and appropriately having made informed decisions in advance. It is Your Birth - Your Way, no matter what. (open in a new page: WHAT MISTAKES DO WOMEN MAKE THAT MEAN THEIR BIRTH PLANS DON'T WORK?)
The plans that are ‘thrown out’ generally fall into four categories: 1. “I would like a natural birth, unless intervention is deemed necessary ". This vague and uncommitted ‘plan’ misses the point and purpose of an informed birth plan. 2. The free online template plan, This tick-box approach tends to lack real understanding of the options and without giving much thought to its workability, often not adequately run by care providers only to discover during labour that staff cannot honour the plan. 3. The Declaration of War, putting staff off side and creating an uncomfortable birthing environment, often resulting in a traumatic experience. I have heard midwives scoff at these determined birth plans and then line up the woman for ‘the works’. 4. The inflexible plan. A birth plan fixates on an ideal without considering contingency, with any deviation considered a failure. The language of the birth plan can impact it's effectiveness. (open in a new page: WHAT SHOULD BE INCLUDED IN AN INFORMED BIRTH PLAN?)
An Informed Birth Plan (Birth Map) is an original document developed over several antenatal appointments in conjunction with care providers, allowing time to consider options and weigh up the risks and benefits to make informed decisions. The written plan can outline the techniques intended to use, allowing support people to follow this guide, rather than interrupting to ask questions to ‘just check’. The plan makes it clear what is wanted generally, but also allows for truly informed consent or refusal. By negotiating and determining in advance the circumstances where certain procedures may (or may not) be considered, the mother is able to relax and concentrate on birthing. General Considerations included might be regarding positions, water birth, assisted ‘pushing’ and environment. Informed inclusions may regard vaginal examinations, cord management (or even lotus birth), baby to chest, baby-led attachment for breastfeeding. There are many optional, but routine, procedures that need to be considered in advance and require informed consent or refusal. When intentions deviate from ‘routine’, the birth document becomes particularly important. A workable birth document will have been agreed to in advance, so the mother should not have to ‘fight’ for Her Birth. For many women, an Informed Birth Plan, is unachievable without help. A workable plan is the result of informed preparations and it is often overwhelming and restrictive to gather relevant evidence-based information, let alone know what question to ask and when. My book THE BIRTH MAP: Boldly Going Where No Birth plan Has Gone Before includes an introduction to the purpose and reasoning behind a birth map, suggested resources and provides a series of questions to facilitate the preparation process. It is divided into the different stages of labour and consideration of a labour that deviates from expectation. It has a built-in contingency plan. Not because things will ‘go bad’, or because it is even likely too. The contingency is the insurance, the backup, the ‘just in case’. It protects you from on the spot decisions. It means you are more likely to recognise and understand any deviations from your expectations, and respond calmly and appropriately having made informed decisions in advance. A doula - a personal mentor – can support you in your birth preparations, providing you with evidence-based resources and taking the guess work out of birth preparations. You do not need to reinvent the wheel, you can draw on the experience and knowledge of those who have gone before. Using THIS IS YOURBIRTH and considering doula support is the most efficient way to approach birth preparations. It is Your Birth Your Way. (Open in a new page: BRADLEY METHOD, LAMAZE, HYPNOBIRTH, CALMBIRTH, YOGA, ANTENATAL CLASSES... WHAT IS THE DIFFERENCE AND WHICH ONE IS FOR ME?)
A recent study showed that the "Complementary Therapies for Labour and Birth study protocol significantly reduced epidural use and caesarean section." The 'complementary therapies' used by researchers reflect those used by various private childbirth educators. Hospital-based antenatal education does not allow for the depth these complementary therapies offer, so whilst you can gain some insight by attending your (usually free) hospital offered classes, the investment into a private class can make a significant positive difference. So how do you decide which class or classes to attend, whether you can read 'the book', or do the online course, or invest in doula care? There are group classes for woman and their birth partner to attend together and classes aimed at Dads Only. Some classes focus on a particular method, such as breathing or meditation, others cover a range of movements, combined with breathing. You may choose based on the recommendation of a friend, or because you are drawn to a particular technique. If it feels right for you, chances are, it is. For many, the appeal of attending group classes is meeting like-minded people at the same life stage. Some people find the thought of attending group classes appalling. Others find simply getting to a class difficult. Some have reluctant partners. For these people, they have the option of private classes (sometimes in their own home, with a doula or birth education specialist), online courses, print books, e-books and audio (podcasts, books, cds). Childbirth Education focuses on preparing you physically for labour and birth. The topics covered include techniques and methods to help you manage your contractions, and to aid your birth partner in supporting you. You will learn about the biology of birth, and what you can expect physically during labour and birth. There are also classes, and resources, that help you prepare for beyond birth. 'Early Days' courses and Breastfeeding Education provide understanding into normal newborn behaviour. This is sometimes referred to as the 'fourth trimester'. As with Childbirth Education Classes, hospital-based breastfeeding and early days classes are usually limited in depth and do not offer on-going support. The Australian Breastfeeding Association offers Breastfeeding Education Classes during pregnancy and on-going support through your first year. Where does INFORMED BIRTH PREPARATION fit in? Informed Birth Preparation is the 'before' that complements the 'during' and 'after' education, completing the Triad of Birth Preparation. Informed Birth Preparation prepares a Birth Map, with various pathways; your expected pathway includes your 'during' birth education. |
