A Weapon Called the Word. Birth Plans Are Not Predictions.

As a doula I find the large majority of my conversations outside of my working life also revolve around birth. I’m cool with that as it’s obviously one of my favourite subjects. These conversations are often a great learning experience for me. Hearing other people’s thoughts and stories helps enrich my own knowledge and often theirs. Just sometimes, these conversations leave me somewhat riled.
I recently had a brief exchange with someone in a social situation who had a mutual friend with me. Our mutual friend was expecting her first baby and had spoken to us both about her plans for the birth. As a doula, I instinctively don’t discuss these things with others without expressed permission from the woman in question, but this lady began to talk about our mutual friend’s birth plan. “I love how she’s got this birth plan and it’s all natural” she began and looked at me with a smile. She went on “I said to her, I think it’s great that you’ve got this, I really do, BUT….” I felt my stomach drop “if it all goes wrong, don’t worry, just focus on the baby…” here it comes “because that’s what matters.”
I gently began to explain why birth plans were important while said woman’s phone began to ring and my four year-old began tugging on my arm. I became flustered as she nodded unconvinced and the exchange was quickly over. I have mulled this over for days in my head, thinking about what she had said. Apart from her words seeming hugely patronising, she really truly thought that she was helping. So here it is, my first blog post about why this kind of talk really doesn’t help.

So I feel the need to explain what birth plans are about, because clearly there is some confusion. Birth plans are not predictions. They don’t assume everything is going to be fine. They are tools to help women navigate the maternity system; to have a voice about what kind of care they wish to receive. They contain “what ifs….?” and contingency plans. They are drawn up for the exact reason that birth can be unpredictable and families that take the time to do this, go into the birth room feeling more confident than if they didn’t. When things don’t go the way that you really hoped they would, there are still options that can improve your experience. How can this be a bad thing?
The power of a birth plan isn’t the actual plan, it’s the process of becoming educated about your options says Jen McLellan of the “Plus Size Birth” Blog.
Never a truer word spoken but to elaborate on that; birth plans are directives. They empower you and having this stuff in writing means in your most vulnerable moments, those moments where you find it hard to articulate yourself, your birth partner can help. They know your story and they understand your wishes and they can effectively communicate that to your care providers. Birth plans build a team. They are useful for everyone.

Here’s the thing. When you warn women about the possible dangers of birth and remind them of its unpredictability, this is nothing new. Everything you’ve said, they have thought about. I don’t know a single first time woman who didn’t spend part of their pregnancy worrying about this stuff. Who didn’t lie awake in bed at night, stressing about what could happen and questioning whether they could really do it. And this isn’t surprising, the vast majority of media representations of birth are negative, dramatic and damn right terrifying. We’ve had a lifetime absorbing birth fear. The downside doesn’t need reinforcing. It’s the norm.

There are little pockets of change like The Positive Birth Movement which aims to help women feel empowered and confident about their births. BBC 2 recently aired an excellent documentary “Birth All or Nothing” following the contrasting experiences of four women who had made informed choices about the way they wanted to birth. But on the whole, the prevailing narrative in Western society is that birth is scary.

If you’ve had a baby, like it or not you are in a position of power. Pregnant women will look to you for the answers. You went through this and you survived it. Here you are right up there on that pedestal. Your words will become a meme, they will etch themselves on a pregnant woman’s brain. It’s important to get it right.
This is the point where I want to reach out to those of you who had a less than positive birth yourselves. Maybe things didn’t turn out the way that you planned. Maybe it was down right horrible for you. Your feelings are valid and your story needs to be told. Just not to her. Not now.

I know you’re worried for her because of what happened to you and that is completely understandable, but this is exactly why birth plans are good. We know that what really makes a positive birth is feeling listened to and respected whatever the outcome is. Birth plans are instrumental in this.

There is so little space for women to talk about their experiences and all too often people make it clear they don’t want to hear it. Fobbing us off with a phrase like “all that matters is a healthy baby” (a phrase which needs it’s own separate, very long blog post.)  I see this anecdotally every time I explain to someone what I do. No matter the age or background, whether the experience was good or bad, women spill their stories to me. They talk with passion and emotion like it was only yesterday. Women don’t forget.

As doulas we put a lot of work into debriefing our own experiences. It’s not appropriate for us to bring our stories to someone else’s birth space, so we tell each other. We are lucky. We get that opportunity and we are always listened to.

This could be considered radical but what I want to suggest is that you support your friends in their choices. You behave positively about their intentions and if you find that it’s bringing up stuff for you, write it down or find someone (who is not pregnant) who can actively listen and debrief with you. When you look at her birth plan and feel the need to point out the bad stuff that ‘could happen’ what she hears is that you don’t believe in her and you don’t think she can do it. She’ll feel demoralised and whatever the outcome of her birth, it’s likely you won’t be the one she comes to to talk it through. This isn’t your story, it’s hers, and she needs you to be strong for her.

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