One: Be Prepared
Childbirth Education Class
A childbirth education class is an important empowerment tool that allows you to make informed decisions about your pregnancy, birth, and postpartum journey. There are many options for childbirth education. Find a class where the instructor and content resonates with you. Local childbirth classes can be a great way to get to know other expecting families in the community and build a connection with a birthworker such as a doula or midwife you are considering hiring for your birth. A quick Google search can give you some websites to check out, ask around in your community, or contact a local perinatal professional for their recommendation.
Create a Birth Plan
A birth plan is a communication tool that outlines a set of intentions and wishes for your birth. It is a great way to explore your preferences and options for your birth and provides a handy document to communicate your wishes to providers who may not have cared for you during the prenatal period.
Where do you want to give birth? Who do you want to be there? What kind of comfort measures do you want to use? What kind of interventions are you comfortable with for yourself and your baby, and under what circumstances? What would you like to happen to your baby after birth? Do you want delayed cord clamping? Do you want skin to skin bonding time with your baby immediately after birth? There are many tools for creating a birth plan online. Some childbirth education classes help you create your birth plan. If you would like a little extra support and guidance creating a birth plan, many doulas and some midwives provide this service.
Know Your Birth Rights
Know that all basic human rights apply to you while you are birthing. You have a right to say no or decline medical advice. You have a right to request a change of provider, or leave the birthing location. You have a right to know all your options, ask people to leave, and not to be touched. The Birth Rights booklet can help you learn about your rights and explains how to advocate for them.
Two: Find the Right Provider and Birthing Location
Each hospital, birthing center, or home-birth midwife has a unique set of policies, procedures, and way of practicing that may or may not feel right to you. Many hospitals and birth centers have rotating staff so that the provider you see for prenatal care may not be the same provider who attends your birth. Even home-birth midwives have a back-up provider in case they are not available during your birth. Make sure you ask about who would be present at your birth if they are unavailable, and ask to meet them if you would like. Most facilities will allow you to take a tour and meet the staff so that you feel more at home when you arrive during labor.
Consent-Based and Trauma-Informed
A good provider should take time to answer your questions, listen compassionately, and provide non-judgmental information and support.
A good provider should practice in a consent-based, trauma-informed way, meaning that they always take time to ask for your permission before touching you or starting an intervention, explain the procedure, risks, benefits, and alternatives, answer your questions, and give you permission to stop at any time should you change your mind.
Look for the 3 S’s: seen, safe, and soothed to feel secure about your provider and birth location.
Seen: Does the provider take time to listen to you, answer your questions, and discuss your birth plan? Do you feel like your provider understands and respects you, your family, and the birth you would like to have? How does this provider react when you disagree with their suggestion, or decline an intervention?
Safe: Do you feel safe at this location and with this provider? Do you feel like the birthing location and provider has the knowledge and tools to help you through a challenging birth, or if any emergencies arise?
Soothed: Does the birthing location and provider make you feel nurtured and cared for? Do you feel like the birthing location and provider can help you feel calm, grounded, and empowered through the emotional and physical challenge of birth?
Three: Advocate for Your Birth Plan
You and your partner are wonderful advocates for yourself, your baby, and your birth. This is your body, your choice. You chose this birthing location and/or provider, and you are paying them to use their expertise to advise you on your medical decisions. You have the ultimate say so on what interventions you chose or decline, although, not all providers respect this human right. The acronym BRAN, from How to Heal a Bad Birth, can help guide a conversation with your provider and help you advocate for your birth plan.
Benefits: What are the benefits of this intervention?
Risks: What are the risks of this intervention?
Alternatives: Are there any alternatives to this procedure?
Nothing: What would happen if we did nothing? (Or do we have to act now?)
Sometimes, during a challenging part of a birth or during an emergency, it can be hard for you or your partner to speak up. Doulas are trained to advocate for you and your birth plan during labor, and are a third party who can remain calm and collected while they help you communicate your needs to the provider.
Four: Continuous Support
The evidence for continuous support during labor is overwhelmingly positive. While your partner, family, and friends may be wonderful assets to have on your birth team, a doula is a trained professional who provides physical comfort techniques such as massage and aromatherapy, wisdom and suggestions about position changes that may relieve pain or help labor progress, and emotional support and advocacy so that you and your partner can focus on having your best birth. Dr. John Kennell is well known for his famous quote about doulas “If a doula were a drug, it would be unethical not to use it.” While having a doula at your birth is an incredible support, doulas also provide care during pregnancy and the postpartum period. Some doulas provide care across the reproductive journey, while some specialize in one area such as birth, postpartum, fertility, bereavement, adoption, or termination.
Five: It Takes a Village
Family & Friends
Reach out for support. Parents weren’t designed to care for a newborn by themselves! It is draining to devote your full attention to care for a newborn 24/7, especially when balancing the demands and expectation of work, family, other children, a social life, and find time for self-care. Phew!
Family and friends often want to help, but don’t know how. Think about who are your “doers”; who would be great at taking care of tasks, like a load of laundry, walking the dog, or making your family a hot meal. Create a list of chores and to-do’s and tape it to your front door so that people can pick out a task they feel able to help with when they come by for a visit.
Think about who are your “listeners;” who would pick up your call at 4am? Who would come over to talk and watch the baby while you shower or nap? Who would listen calmly with an open heart as you bawl your eyes out because you miss your old life?
Think about who offers compassionate, wise advice, and who you won’t call because they give you unsolicited critical feedback on your parenting. Setting boundaries in postpartum can be liberating. Put a note on your door outlining your expectations for visitors, such as, “We are so glad you stopped by! You can support our new family by picking a task from the list below to help with while you are here and limit all visits to no more than 30 minutes. Please, no questions about our decision not to breastfeed. Thank you for your support!”
Professional Support
There are many providers who specialize in helping birthing people that would love to support your wellbeing during the postpartum period such as postpartum doulas, lactation consultants, Pelvic floor PT, body work massage, craniosacral, acupuncture, chiropractic care, postnatal yoga, mental health therapists, and many more. Your body has just run a 9-month marathon and is in much need of some TLC!
Consider hiring a postpartum doula to care for your baby during the night, help with light housework, and provide newborn support so you can catch some z’s, have some alone-time with your spouse, or get out of the house. Depending on their scope of practice, many postpartum doulas can also offer infant education, help with breastfeeding, offer emotional support, and make referrals to other great resources and providers in the community.
Birth story processing. Having a safe, non-judgmental, and supportive space to tell your birth story and process how you felt during the birth, whether it was empowering, terrifying, or both, can be very healing. Journaling is a great place to start. If you find that you are replaying uncomfortable scenes from the birth over and over again in your mind, you feel numb, scared, hopeless, sad, or just unlike yourself after birth, therapy can help. You are not crazy, you are not alone, and you can get well. Look for a therapist who specializes in perinatal or reproductive mental health to connect with a supportive professional who “gets it.” Postpartum Support International and the Birth & Trauma Support Center offer support resources and a referral database to help you find a provider who “gets it” in your area.
