The following is an excerpt from THIS IS YOUR BIRTH: The Informed Woman’s Guide to Birth Preparation, available HERE
Childbirth education usually mentions ‘Active Birth’. The idea behind this being, essentially, that the birthing woman is free to choose her position, move around if she feels the need and retains autonomy. Whilst some refer to this as constant movement, uprightness, swaying or even dancing, the use of the word ‘active’ is more about being woman-centred. The woman has ‘actively’ chosen her path, and is free to behave as she instinctually needs during her labour and birth. Sometimes, this means she wants to lay down, be in a bath, or sit quietly alone. Sometimes she wants to moan, or vocalize. And sometimes she is restless and needs to move constantly.
It is Her Birth, Her Way.
When it comes to the birth map accompanying her chosen birth, it too needs to be Active.
The language of the written birth document is as important as the research you have put into it.
A birth map has three parts: the fast birth pathway, the expected pathway and the contingency pathway. In each section you only refer to the necessary requirements for that pathway.
As an example, let’s consider an expected pathway, where the expectation is a natural (intervention free) birth.
“if baby is doing fine, I wish to have skin to skin for 2 hours immediately post birth”
“We will have 2 hours skin to skin immediately post birth”.
This is an evidence based decision. It fits the expectation of the intervention free birth. By including ‘if baby is doing fine’, you give the power over to the care-provider to determine what is meant by ‘fine’. If hospital policy is to do immediate checks on baby away from mum, then the determination of fine happens there. If it is important to you that the checks are done on you, you state that. You discuss it in advance with your care provider to ensure it is supported.
Another example, in this expected non-intervention birth, is the inclusion of ‘delayed cord clamping’.
‘We wish to have delayed cord clamping”
“The cord is to be left unclamped for X minutes”
“We are having a lotus birth”
And you can specify who will be clamping.
Again, it is important to ascertain what the policy is in your birth location, and choose your ACTIVE VOICE to reflect your decision, especially if your decision is contrary to the policy. Notice I do not use ‘your wishes’. These are not your wishes. These are your decisions. And choosing active voice reflects this.
Now let us look at a contingency pathway, where the determination has been made to have a caesarean.
“I would like to have gauze placed in my vagina, and the baby ‘seeded’ upon birth”
“Gauze is to be placed in my vagina, and the baby to be seeded”
Again, this will have been discussed in advance; you may find this is not standard practice (it is fairly new, and not widely accepted. If you are GBS positive you are likely to be refused this option). If they cannot accommodate this in theatre, you can then determine an alternative way to achieve this.
Likewise, you may still wish for delayed cord clamping. Again, determine the hospital policy in advance, and word your statement accordingly.
“We wish for delayed cord clamping”
“The cord is to be unclamped for x minutes”
You may even like to look into lotus options, as there are cases of lotus caesarean.
It is Your Birth. Your Way.
Using active voice gives your document the power that reflects the decisions behind it. These are not your ‘preferences’ or ‘wishes’. These are your Informed Decisions.
I would like to end with this meme, from Birth Monopoly.