Why Does Birth Support and Your Birth Preferences Matter?
Over the years, I have heard expecting families say, "I'm just going into birth without a plan because I know birth is unpredictable and my care provider will do what's right for me." But, will they? How can they do what's right for you if they don't know what's important to you? In the same right, would you leave every detail of your wedding in the hands of wedding planner; never having discussed the colours you like, the theme that's important to you, how guests should be seated, what venue you'd prefer? Not likely; even if you left the majority of the planning to their expertise you would still have given them a list of your preferences and what is a hard "no" for you. The same goes for birth. If you have zero vision of how you would like your birth to look you have a much greater chance of suffering from birth trauma. Having birth preferences mapped out, prior to labour beginning and sharing them with your doctor, nurses and/or midwife will let them know what's important to you in a "normal" vaginal delivery (and in the case of a cesarean/other birth complication scenario). Not having a [flexible] birth plan is like driving on a dark road with your headlights off.
What about birth support and what does this look like? Birth support doesn't have to be a doula. It can be your partner, friend, sister, mother, father, etc. But, they should be informed about the process of labour and birth and how to help you cope. A partner shouldn't romanticize birth and see it, only, as an intimate experience between the two of you. They need to know that it's emotionally and physically exhausting for the both of you. While you're working hard, they will need to fuel up/eat and I guarantee you that they will fall asleep, at some point, and make you angry. This is where a 2nd support comes in handy. When one runs out for bite to eat, the other can step in and massage your back, get you to the toilet, ensure you're drinking enough fluids, hold your hand and ground you when you feel overwhelmed. A lot of a support person's role is holding space - it's observing you and deciding what you need, in that moment. It's understanding that they talk to you between contractions and be quiet as soon as one begins. It's reminding you of your birth plan when you're feeling like your falling off the rails and asking you if there are any adjustments you wish to make to it. Its understanding the difference between experiencing the normal discomfort of labour and when you're slipping into suffering. It's advocating for you when you no longer have the wherewithal to do it for yourself.
Have great birth support who uplifts you, empowers you, helps you to calm and relax your body is worth their weight in gold. On the flip side, having someone who doesn't know how to advocate for your rights, who stresses you out, is more of a spectator than a help, can make your labour more challenging. Many years ago, I attended a birth of baby who's mama was an inmate. I was correctional officer and my job was to ensure she stayed in the hospital and no unauthorized visitors came in or out of her room. She was allowed to have her mother and boyfriend, with her. At around midnight her mom had to leave and care for her animals. Her boyfriend went to sleep. I was stationed at the door and could see her, writhing in pain, clutching the bars of her bed and trying to rub her own back. I couldn't just stand there and do nothing so I asked her what she needed. She said she needed to use the washroom and asked if I would help her. I got her to and from the bathroom and applied counter pressure to her back, I showed her how to breath so that she could ride the wave of the contraction. At about 3am, she was in transition and crying out for her mom. I called her mom and she came back to the hospital but had no idea how to handle her daughter's discomfort. She silently cried and looked at me for help (while the boyfriend slept through it all - lol). I guided her mom on hip squeezes and counter-pressure and we got her daughter into a comfortable position for when it came time to push. Near the end of my 16 hour shift, this woman's mom came up to me and handed me this fresh little baby and hugged me. She said, "Meet my grandson! We couldn't have done this without you...I would have sat in the corner and cried but you showed me how to be useful. I thank you with all my heart." And this was one of the solidifying moments in making me want to become the best birth support person that I could be. And every family I support teaches me just a little bit more on how to achieve this goal.
Bottom line: Be prepared for birth and the most common birth scenarios. Be knowledgable about labour, birth and what you hope for. Be confident and not fearful. Have a strong birth support team who understand you, what you need and how to bring you comfort. Make a birth preference list of what you want - from dim lighting, minimal cervical checks to what you would prefer in a cesarean section; understanding the need to be flexible doesn't equate to giving up your rights.