Ditch the Birth Plan. Focus on Your Birth *Priorities*

What’s important for you to have a satisfying, empowering birth experience?

Labor and birth are wondrous. And freaking hard. And basically unpredictable. The only sure thing is that in the end, a baby is born.

Surrendering to this ambiguity is not easy—we are a culture that is uncomfortable with the unknown. We thrive on planning and feeling in control. So how do we plan for what is arguably the most mysterious yet important life event of all? Education, research, exercise, carefully choosing birth location and medical provider are all helpful—but nothing will guarantee a desired outcome. So we create birth plans based on our dreams and desires to share with providers—but might this set up expectations that may ultimately not be met, for complex reasons that no one (including the medical provider) can control? Worse, might a birth that does not align with the “plan” leave the birthing person feeling disappointed and even traumatized because their vision didn’t match the actual experience? 

Why we like priorities

Truth: Preparation and planning do not guarantee a birth outcome. Birth unfolds however it unfolds; it rarely goes as we expect. However, we can control our narrative around birth, and how we frame it. When a woman feels safe, supported and heard, surrounded by birth workers who respect her and practice shared decision-making, disappointment and even trauma are minimized—regardless of the path labor takes.

Emily and I propose creating a list of birth preferences that you can share with your birth team so that they understand how what you need to feel supported emotionally and physically, regardless of the onset of unexpected or unwanted medical interventions. First, make a list: How do I want to feel during my labor and birth? What feelings are most important to me?
Examples:
“I want to feel safe.”
“I want to feel relaxed.”
“I want to feel the love and attention of my birth attendants.”
“I want to feel no/less pain.”
“I want to feel energetic.”
“I want to feel free to focus inward when I need to.”
“I want to feel comfortable vocalizing however I need to.”
“I want to feel free to move around as my body tells me to.”
“I want to feel respected.”
“I want to feel like I have a say in my care.”
“I want to feel free to cry/get angry/shout/laugh/whatever.”
“I want to feel a connection to my baby.” 

What will help you manifest those feelings?

Then ask yourself: What will help me manifest those feelings? For example:
Feeling safe: Choosing birth attendants I trust, sharing my fears with my provider(s) and my team.
Feeling relaxed: Low lighting, quiet music, aromatherapy, conscious breathing, positive affirmations.
Feeling the love and attention of my birth attendants: No distracting technology in the room, not leaving me alone (coordinating breaks), physical closeness as I request, keeping fear-based/unhelpful emotions out of my birth space.
Feeling no/less pain: Heed my request for an epidural and/or pain meds when/if I ask for them.
Feeling energetic: Fun music, squatting, positive affirmations, suggest that I drink/eat 
Feeling free to focus inward: Heed my request for no chatter, recognizing when I am not able/willing to answer questions, sitting quietly next to me, talking *to* me instead of *about* me; avoid asking me too many questions.
Feeling free to vocalize: Respect my need to make as much noise as my instincts direct me to, try joining in with me and continue if I don’t ask you to stop.
Feeling free to move around as needed: Suggest that I change positions, give me room to move, get me a portable monitor. 
Feeling like I have a say in my care: Explain my options for any interventions, respond if I ask for help, give me time to decide.
Feeling free to emote: Don’t minimize my feelings or try to talk me out of them, simply validate them without judgment or agenda. Encourage me to let it out!
Feeling connected to my baby: Respect my desire to be alone and bond with my baby right after birth, don’t ask to hold or feed my baby, leave the room quickly and quietly if I ask.

Release expectation on the outcome

 Once you’ve identified what’s important to you, you can begin to release your hold on a specific outcome and be open to whatever emerges during this mysterious, incredible, life-altering event. And sharing your priorities with your birth team will help them give you what you need to stay present and motivated, and to avoid suffering. The result: You feel supported and heard no matter what path your birth takes. When all is said and done, that’s the best plan of all.

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