So you’re planning a natural birth, and you’re starting to realize that heading to your chosen birth place, iPod loaded with relaxation tracks in one hand and a stack of copies of your well-researched birth plan complete with bullet points and stock photos of beach scenes, might not get you the warm reception you were hoping for. Should you scrap the idea of a birth plan to avoid ruffling feathers, or should you stand with your hands on your hips and declare that you have rights?
Probably neither. It’s a tricky spot to be in – realizing that you do have the right to make choices about your labor and your child’s birth – and treatment thereafter – all the while recognizing that doctors and midwives and nurses are people too, trying to do their jobs, and knowing that a stressful, high-conflict environment is not conducive to relaxation nor to a healthy, positive labor and birth experience. (Not to mention that if you can stand there with your hands on your hips like that, you probably left for the hospital too soon – but that’s another post for another time!) The fine art of positive communication with your birth team means you’ll need to balance assertiveness with tact and kindness, and explain your wishes with a willingness to hear the other person’s reasoning.
Before we even start in on ways to do that, I’d like to throw in a little side-note public service announcement: Positive communication will only get you so far. Starting with a care provider whom you trust and who is generally on the same page as you regarding the type of birth you desire must come first. Sometimes your attempt at positive communication while sharing your birth wishes will reveal that your doctor or midwife is, in fact, on a completely different page from you, and possibly not even in the same book. This situation probably cannot be fully corrected with positive communication, so be glad you found out ahead of time and take it as an opportunity to explore your options and find out what other care providers in your area might be a better fit for you. Don’t be afraid to make that jump to the care provider that’s a good fit. Who is going to carry what happens the day of your child’s birth for the rest of their lives? (Hint: It’s not the doctor.) That’s right, you and your baby. It’s one of many “deliveries” to the care provider, but it’s the only time you’ll give birth to this baby, and it’s the only time this child will be born.
OK, back to the subject at hand: positive communication. For a lot of couples, the first time this really starts to be important is when they start talking about their ideal birth scenario with their doctor, a conversation often initiated when they show up with a birth plan at a third-trimester prenatal appointment. If you’re at that point in your pregnancy now, that’s a fine time to start. But if you haven’t gotten to the point where you’re working on that yet, discussing questions and concerns with your doctor at your next few visits is an even better way to begin practicing that fine art of balance I mentioned earlier. The following guidelines will serve you well at prenatal visits, while deciding how to phrase your birth plan, and of course when communicating with your care provider, nurses, and other staff during your stay at the hospital. It’s important for you and your partner to use the guidelines, since during labor you may not be able to speak for yourself at times.
The first principle to keep in mind is to remember that you’re dealing with a person who has feelings. Think about being at your place of work and having someone approach you with a question about why you do things a certain way. Depending on the tone, the wording, and the body language of the asker, you might feel happy to answer and explain, or you might immediately begin to feel defensive. Yes, you are dealing with a professional, so he or she should maintain professionalism (and if they don’t that’s on them), but wouldn’t you rather have that professional look forward to conversations with you rather than internally bristle when they enter your room? Starting and ending the conversation with a sincere compliment or other positive statement (sometimes called a “compliment sandwich”) is a great way to start. You can thank the doctor for being thorough, or be appreciative that they take the time to answer questions – anything relevant, but be sincere.
My next suggestion is to be straightforward. Explain exactly what your question, concern, or request is, without wishy-washy language or apologies. Phrases such as “I’d like to know…” or “It’s important to us that…” communicate your desires clearly without abrasiveness. Words like, “Our birth hopes…” or “…if that’s ok with you – I don’t want to be a bother” may communicate to the listener that the things you are discussing aren’t too important to you, and that you probably won’t put up much of a fuss if they don’t happen.
Next, listen to their side. Really listen; don’t just watch their mouth move while you formulate your next argument. (Maybe you would never do this, but I know myself…) There may be reasons you are not aware of for your care provider’s advice, or more recent research than you had access to. Perhaps he or she can provide you with some literature or references you can look up on your own. And it could be that you hear what your care provider has to say and don’t find therein any reason to change your mind. But if you want to be listened to, then you need to listen too.
Another thing to remember is to avoid making demands or being bossy. This goes along well with my first point but I think it requires its own paragraph, and this is where that balancing act comes into play. It is possible to be assertive and straightforward without being demanding. For example, when it comes to writing a birth plan, think about the difference between, “I have prepared for a natural birth; please do not offer pain medication. I know what is available to me,” and “DO NOT offer pain medication.”
My fifth suggestion is to ask for help. At prenatal visits, that could take the form of asking for more information or literature on a topic you are having difficulty coming to an agreement on. When writing your birth plan, it could include prefacing the sentence about pain medication in the previous paragraph with, “Please help me use natural methods such as the tub or birth ball to cope with labor.” During labor it could be as simple as asking the nurse for help filling the tub or how to use the controls on the bed. Your nurse is there to help and most nurses sincerely want to help. If you let her know what kind of help you need, she can be an invaluable part of your birth team. During labor it could also take the form of, “Please help us understand,” if a detour from your birth plan is being suggested.
Sixth is to remember names, especially in labor. Your doctor may not be the one on call, and you most likely have never met the nurse before. Jot down names upon arrival and at shift changes. At many hospitals, staff will do this for you on a whiteboard in your room, but if they don’t, have your partner or doula write it in a notebook or on the whiteboard, and then remember to use those names. It makes for a warmer, more personal feel and shows your consideration for the feelings of your birth team – you made the effort to remember their names.
Finally, remember to be polite. “Please” and “Thank you” are the magic words, so use them!
Following these seven points should go a long way toward a positive relationship between you and your birth partner and those who will be caring for you during pregnancy and birth. In addition to this just plain being nicer for you and for them, it will facilitate better and more thorough communication, contribute to a peaceful labor environment, and make it more likely that your desires will be honored*.
So in summary,
- Remember that you’re dealing with a person
- Be straightforward
- Listen to their side
- Avoid making demands
- Ask for help
- Remember names
- Be polite!
*Unfortunately, once in a while a situation can arise where even if you’re sweetness itself, your legitimate concerns and wishes aren’t being respected. Choosing a care provider wisely as discussed early on in this lengthy post makes this an even more remote possibility. If this happens though, please don’t take this post to mean that I think you shouldn’t at that point put your hands on your hips and demand your rights. Do what ya gotta do! And then say, “Thank you!” – because, you know, keeping it positive and all. And there is just some satisfaction in that, isn’t there?