using these steps can help you, your partner, and your provider
- Introduce yourself and your birth team by name. Say something interesting or unique about each person. This will help your readers remember who is who.
Example: My name is Pat Benatar and my partner's name is Kanye West. We met skydiving over Buenos Aires 8 years ago and have been together ever since. Our doula, Janet Jackson, will be present for birth support.
- Next, introduce your care providers and express confidence in their care. In a succinct manner, describe why you have chosen this particular birth place. Express gratitude for the providers who will care for you. Gratitude is key. Your providers are people, too. They know they work for you. But, if they know that work is appreciated, they'll usually do their utmost to see that you are happy. That could look like this: We chose Mountain Haven Medical Center after touring many facilities. The nursing staff was so welcoming and the doctors and midwives come highly recommended. We are both confident that we are in wonderfully capable hands!
- Before you get into your preferences, explain your willingness to be flexible and work with all of your providers. The fastest way to see that your preferences are ignored is to assert that they are non-negotiable. Just like you want to be heard and respected, your providers want to know that you will listen to them and be open to their suggestions. Healthcare should be a conversation, not a hostage negotiation.
Now that you have laid an open, respectful, and grateful foundation, it is time to move into your preferences.
- Perhaps you could start this section by stating your birth philosophy. Do you feel that birth is normal, natural, and able to progress well without help? Do you feel that medical help will be needed at the earliest possibility? Are you somewhere in between? This is actually a good exercise in exploring how you feel about birth in general, even if you choose not to include it in writing.
- Once that is done, lay out what the ideal birth looks like to you. Are you surrounded by people you love? Do you prefer to be left alone? Would you like to be offered certain kinds of pain relief? Do you have emotional triggers that you would like to have avoided? Make sure to keep your language open by saying things like, "I would like to be offered..." rather than "I need to have..."
- Almost all births include interventions of some type. Some interventions are very low-impact, like being offered oxygen. Others can be life-changing, like having an emergency c-section. It is important to discuss your feelings on receiving various interventions. Consider including these three things:
- Interventions you want
- Interventions you would like to have delayed unless they are deemed absolutely necessary
- Interventions that you would like to avoid completely, if possible
Since this list will vary widely by person, it is important that you examine your feelings and discuss them with your healthcare provider to come up with the most reasonable list possible. Also, check with your preferred birth location to see if there are policies that may affect your plan. For example, some hospitals still prohibit eating and drinking while in labor. If that is very important to you, it may be worthwhile to discuss options with your provider, your birth place (or look into an alternative birthplace), and your partner.
- Next on the list is the difficult task of outlining what you would like to have happen in the event that your birth does not go as planned. What care would you like to receive in the event of an obstructed labor, a c-section, or a life-threatening situation for you or your baby? If a stay in the NICU is needed, do you want your partner to go with your baby or stay with you? If you have an additional support person or a doula, would you like them to stay with you at all times?
- Finally, return to your happy place, express confidence that all should go well and that you are happy to know you will be working together with the team you have chosen.
- Gratitude and humility will get you a lot. Exigent demands will not.
- Talk with a healthcare provider, a trusted friend, a doula, and/or a birth place staff member to learn about all of your rights and options.
- Be flexible. Be kind. Be open-minded. Be brief.
- Use your B.R.A.I.N. when contemplating interventions (Benefits, Risks, Alternatives, Intuition (what does your gut tell you), and No (when are you within your right to refuse)
Good things to say:
- I would like to discuss my care before it is administered. (A polite request to be informed)
- Please explain terms that may be new to a non-medical person. (A good way to ask that nobody talk "over your head")
- I would appreciate hearing the risks and benefits of every intervention and given time, if possible, to think before I respond. (A way to gently assert that you want to participate in your care)
How to say the same thing in a bad way:
- I am to be respected and consulted on every aspect of my care before it is provided. (Demanding language and not always possible.)
- Only use terms that everyone can understand. (Forceful language. Makes providers worry everything they say may be wrong.)
- Every decision is to be approved before it is executed. (May not be possible, and again with the demanding language!)
Pare it down to one page, or less. Studies show that people don't like reading long things. Okay, I made that up, but it's still true.
You can always run it by your provider and see if she or he has anything to add to it.