The following is an excerpt from THE BIRTH MAP: boldly going where no birth plan has gone before
Childbirth education usually mentions ‘Active Birth’. The idea behind this being, essentially, that as the birthing woman you are free to choose your position, move around if you feel the need and retain autonomy. Whilst some refer to this as constant movement, uprightness, swaying or even dancing, the use of the word ‘active’ is more about being YOU-centred. You have actively chosen your path, and are free to behave as you instinctually need during your labour and birth. Sometimes, this means you want to lie down, be in a bath, or sit quietly alone. Sometimes you want to moan, or vocalise. And sometimes you are restless and need to move constantly.
It is Your Birth, Your Way.
When it comes to the Birth Map accompanying your birth, it too needs to be Active. The language of the written birth document is as important as the research you are putting into it. Keep in mind your Birth Map has three sections: 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 non-intervention 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 unclamped for X minutes”
“Do not clamp the cord”
It is important to ascertain what the policies are in your birth location, and use 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, made in conjunction with your care providers. Using your active voice reflects this.
Now let us look at an expected pathway, where the determination has been made to have a caesarean, where it is known that both mother and baby are well.
“I would like to assist my baby out”
“We are having a Maternal Assisted Caesarean”
This needs to be discussed in advance; this is not standard practice. Alternatives may be to lower the curtain, and to have immediate skin to skin. You may even discuss the possibility of leaving the cord unclamped. These examples are not standard, so you cannot wait until the moment to request them. They require advanced preparation. You would include them in your Birth Map knowing they were possible and agreed to.
It is Your Birth. Your Way. No Matter What.
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.