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01

Birth Principles Workbook: A Soulful Alternative to a Birth Plan

Author // Jessie Harrold, C.D.

You’re pregnant, and now that the initial shock, excitement, and/or morning sickness has worn off, you’re starting to think about your birth. Maybe you’ve read every book on pregnancy and birth on your library shelves; maybe you’ve heard more of your friends’ birth stories than you can count. You’ve made yourself aware of your options for your birth, including who you want to attend your birth, where you want to birth, and how.

You may have heard about writing a birth plan; maybe you already have one drafted. You feel reassured by knowing your options, but there’s a part of you that wonders: What will happen if I don’t get what I want? What if things don’t go according to plan?


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Birth plans were virtually unheard of just a few years ago. Now, most birthing women have at least considered creating one, and resources for doing it abound. In many ways, this represents a positive change in our culture: Women are beginning to realize that they can choose how, where, and with whom they birth. Birth plans can stimulate conversation about women’s preferences in labor and allow them to feel supported in birth. They help us shift away from the mentality that “doctor knows best,” and, indeed, from the notion that birth is a medical process. The increasingly popularity of creating a birth plan may signal that women are taking back birth, once and for all.

But my sense is that we’re missing the mark with birth plans.

Increasingly in my doula practice, I’ve noticed that many plans read like catalogues of birth outcomes that a woman wishes to select: “I’ll have this, this and this.” When shared with doctors, midwives, and nurses, some women’s birth plans incite an eye roll— perhaps because of their length, maybe their detail, or possibly the nature of their wishes. Other clients of mine have presented their birth plans nervously to physicians, wondering what their reactions will be. Some of these physicians will graciously tell them “that should be possible”— which, though initially pleasing to hear, ultimately insinuates that the control remains in the hands of the doctor, not the birthing woman.

In my birth practice, I’ve learned a few things that have caused me to want to change the way we think about birth plans:


1. Birth is unpredictable.

The longer I’ve been a doula, the less I realize I know. I am humbled, and my ego is quieted, on a regular basis by the raw power and sheer unpredictability of birth. This is probably the one thing that anyone who works with birthing women—doctors, midwives, nurses, doulas—can absolutely agree on, and it’s probably why the idea of “planning” one’s birth incites eye rolls and even frustration for care providers. It is simply impossible to plan what will happen. This is not to say that women should not know their options and prepare for birth, but that that preparation also needs to include how women want to respond to the unplanned.


2. Rigidity and inflexibility can be detrimental.

Being hell-bent on having your birth go a certain way plays some risky odds. Because birth is unpredictable, the odds of everything going according to plan are not always in your favor. Sometimes it’s easy to go with the flow when things go differently than you’d expected—maybe you had conjured images of yourself slow dancing with your partner to cope with contractions, but that particular technique didn’t end up working for you. That’s probably no big deal. But being completely devoted to the idea of birthing at home in the water, or getting an epidural as soon as you arrive at the hospital so you feel no pain, can lead to discord, disappointment, or even trauma if things don’t go as planned.

(Note: I believe that, as a society and as a culture, we have a long way to go before we truly take back birth. I recognize that there are a multitude of historical and sociocultural influences on what birth has become, as we know it currently. It is crucially important for women and birth workers to speak out against practices that are potentially unnecessary, and rooted in misogyny and the medicalization of birth. So, when I say that rigidity and inflexibility can be detrimental, I respect that a woman may feel she has limited or undesirable options to consider as a result of the culture and system within which she is birthing, but suggest that she find ways to hold her power and work within a system that is, unfortunately, not going to change overnight, rather than expect to reverse a culture that is too insidious and staid than any one person during any one birth can possibly alter.)


3. Most women’s true desires for their births are deeper than “outcomes.”

I have found that, ultimately, no matter what the individual decisions a woman makes about how she wants to birth, most of those desires and decisions are more deeply rooted in how she wants to feel during labor, and how she wants to be treated by the people supporting her.

That’s where this article comes in.

Most birth plans center around things like a woman’s stance on various interventions and comfort preferences around the treatment of the baby and mother in the immediate postpartum period, and her infant feeding choices.

All of these are considered outcomes, and outcomes are the most unpredictable facets of the birthing process. No one, not even the most experienced doctor or focused mother, can control or predict the outcomes of a birth.

Let’s dive in here. I’ve thrown around the word unpredictability a few times now, and it might create some edgy feelings.

It’s a scary thought. In our lives, we usually experience very little of the unknown. Thanks to Google and smartphones and other technologies, we have a great amount of information at our fingertips, which equates to increased predictability and perceived control over the situations we find ourselves in. Birth isn’t like this. Not knowing what will happen makes most women uncomfortable or anxious.

The interesting thing about the unknown—the part that I invite you to explore—is that nothing that requires our bravery, our advocacy, our hard work, and our determination, and potentially results in our pride, our courage, and our connection to our power, is predictable. It is the act of stepping into the unknown—not the potential for pain, or its intensity—that makes birth one of the most important rites of passage in the human experience.

Empowerment, in birth and in life, comes not from fighting against things that are, but in finding the strength and grace to accept what is and thrive anyway. So, what are birth principles?

Birth principles are based on your fundamental values and deepest beliefs about yourself and about birth. They underpin your outcome-related desires for your birth. Wellthought- out birth principles will make your individual decisions around how, with whom, and where you want to birth easier, for those choices are inherent in your principles. Being clear on your birth principles will help you to enter the process of labor and birth with the confidence in your own resilience, knowing that you have the ability to thrive. The questions on these next pages are intended to help you gain that clarity.

The following questions are meant to prime you, to shift your thinking about your birthing process into a new realm. Answer them as instinctively or as methodically as you need to. Revisit them after a long walk in the woods, a steaming bath, or a heart-to-heart with your support person, if you need to. Be curious and exploratory in the process.


To download a copy of the Birth Principles Workbook, please visit nalumanawomens wellness.leadpages.co/birth-principles


Sharing Your Birth Principles

It’s up to you how you wish to share your birth principles with your support person and your care providers. Much of this process will allow you to find your own clarity. Being clear on your principles will help to inform the individual decisions and choices you make concerning your birth. It will inform how you navigate the events that unfold, the people that surround you, and the space that you’re in. Use these principles as your North Star. Check in with them often, and allow them to guide you in your birth journey.

May you know strength.

May you know support.

May you know love.

Journey well, mama.



Pathways Issue 55 CoverThis article appeared in Pathways to Family Wellness magazine, Issue #55.

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