When we think of birth plans, we often think of all of the things that happen at the actual birth. We need to broaden that discussion and think about how your prenatal care impacts your entire birth experience.
Evidence-based care begins with shared decision making
How do you want to approach decision making about your prenatal care? Midwives strive to provide an environment where the client and midwife share the decision making about prenatal care. What this means is that the midwife provides the client with information, discusses that information with the client, encourages the client to do her own research, and then they come together again to discuss choices. The midwife and client discuss the client's needs and desires, and then balance that with evidence and the midwife's professional expertise, in order to come to a decision the client feels good about.
How does this impact your birth? When you know your provider's norm is to engage you in decision making, you know that your wishes will be taken into consideration if something comes up unexpectedly during your birth. Rather than having something done to you, your provider will do for you. Big difference.
Time is precious
How much time does your care provider spend with you during your visits? What happens during that time? Midwives tend to have long visits (usually 30-60 minutes) with their clients. This gives the client ample opportunity to ask questions and learn more about ways she can stay healthy and maximize her baby's health. Often, education is wrapped in discussions the client and midwife have about everyday happenings in the client's life. They talk about nutrition, perhaps sharing recipes and resources for wholesome foods. They talk about stressors and how to manage that stress. Time is spent getting to know what is normal for the client, so that something abnormal sticks out like a sore thumb.
How does this impact your birth? If a provider takes time with you prenatally, she is likely to take time with you during your birth. You are less likely to feel rushed or like you're on a clock during your birth if your provider has demonstrated that she will give you the time you need during your prenatal care.
Respect for your body
Does your provider ask before touching you? It seems like such a small thing, but it is really important. If your provider asks before touching your belly or taking your blood pressure, the control over your body remains with you.
How does this impact your birth? If your provider doesn't ask permission to touch you, how can you trust that your body will be respected during the birth? Sometimes, things come up unexpectedly during birth, but it is rare that there would not be time to involve you and ask your permission before touching you.
Your family is part of your care
Does your provider engage with your family during your visits? Does she ask them if they have questions? Does she encourage your children to help during the visit?
How does this impact your birth? If your goal is a family-centered experience, it is really important that your care provider establish a relationship with your family. If she includes your family in your care, you know you have a provider who cares about helping you have a family-centered experience.
Access to care
Does your provider make it easy for you to contact her outside of your visits? Some providers have really tight boundaries around their personal time. While everyone needs to have boundaries and guard their personal time in order to avoid burnout, you need to know that you can contact your provider about concerns and questions that can't wait until your next visit. How will you do that? Are you able to email her directly? Can you text her or call her with questions?
How does this impact your birth? If you have a provider who is accessible between visits, it's easier to figure out how to figure out if you're in labor, manage prodromal labor (labor that is long and isn't progressing), and when to come to the birth center (or when the midwives should come to your home).
Openness to your ideas
Does your provider encourage you to provide a birth plan? Some providers feel threatened by birth plans and will belittle their importance. This is a big red flag.
How does this impact your birth? If your provider is not open to your ideas prenatally, she is much more likely to ignore your wishes during your birth. If you are to have the birth experience you want, you need your provider to be open to your ideas and to hear you when you tell her what you want for your birth.