Does anybody actually pay attention to birth preferences?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Yes! There’s an annoying misconception that medical staff snicker behind a pregnant woman’s back if she presents birth preferences. If you’ve found a care provider you trust, they should fully respect your right to set intentions for your birth — which you can do with birth preferences. During my son’s birth, the nurses respected my preferences so thoroughly I had to ask them to ignore some of them when I changed my mind.

However, some care providers do see birth preferences as a threat to their position of power. They see it as someone trying to tell them how to do their job. But the thing is, you’re not a patient coming in for a standard procedure. You’re a healthy woman moving through a natural, biological process that requires the expert knowledge of a doctor or midwife only if a special circumstance comes up, or if you decide you want intervention. You’re not there to receive the care provider’s standard protocol. You’re there to cocreate an everyday miracle with your baby, body, care provider, and birth companions. And you deserve to be at the helm. No one else does. Your birth preferences are a way to plant a flag that says, “Unless my health, or my baby’s, becomes tenuous, this is how I want my birth to unfold. And I reserve the right to change my mind at any moment.”

What to do

Remind yourself over and over again that it’s your prerogative to take a stand regarding how you and your baby are treated during and after birth. This is a sacred experience that you get to guide. Once you’ve tapped into your confidence about your right to lead your birth experience, do the following:

  • Create your preferences. Contemplate each aspect of the birth experience (e.g., onset of labor, active labor, baby’s descent and emergence, baby’s care, and your care after birth) and write out how you’d like it all to play out. My book Feng Shui Mommy has a chapter devoted to birth preferences and includes a sample list you can find here: yourserenelife.wordpress.com/birth-preferences/. This list a good place to start if you’re feeling overwhelmed by the prospect of creating this document.
  • Phrase preferences in a positive tone. Help prevent defensiveness in your care providers by writing what you do want them to do, instead of what you don’t want them to do. For example, you could write, “I would prefer to labor without medication” instead of, “Don’t offer me medication.”
  • Keep it to one page. Your care providers are more likely to read all your preferences if you fit them all on one page.”. This often means that only the most important preferences make the list. You can always verbalize minor preferences.
  • Share preferences with your care provider. Take your preferences to a prenatal appointment at least six weeks before your due date. Have your care provider go through each preference with you. If you’ll be delivering in a hospital, ask if any of your preferences go against hospital protocol. If they do, you could decide to change the preferences, or prepare yourself and your birth companion to advocate for the preferences the hospital may push against. It’s also important to acknowledge that in the event of an emergency, you’re willing to let go of preferences that would inhibit quality care.

If your care provider seems exceedingly unsupportive of your birth preferences, consider hiring someone else.

  • Have extra copies. While the list of birth preferences you gave your care provider should make it into your chart, it may not. Ensure the list is at your birth by bringing at least two copies with you to the hospital or birthing center. And when you arrive, make sure everyone is on the same page by going over the preferences with support staff.
  • Adopt an attitude of adaptability. Remember that just because you wrote the preferences doesn’t mean you will have the exact birth they outline. The unexpected does happen, but the combination of understanding that possibility and still creating preferences sets you up for an empowered and satisfying birth experience.
  • Be thoughtful about the preferences you let go of. If someone besides you suggests pushing aside a certain preference while you’re in labor, think it over before agreeing (unless it’s an emergency situation). It can be easy to just say yes to whatever’s suggested when we’re on the wild journey of birth, but pausing, asking questions, contemplating, then making a decision that feels intuitively right for you allows you to write the story of your birth, instead of being a passive participant.

One mom I supported ended up changing her mind about almost all her birth preferences because of various circumstances that came up. But because she was the one opting to let the preferences go, instead of being forced into the decisions, she has positive memories of her birth experience. She felt confident in making the preferences, and confident in breaking them.

An article in the Journal of Perinatal Education found that a woman’s positive and negative perceptions of her birth experience are more connected to her feelings and ability to exert choice and control during birth than to the specific circumstances of the birth.

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