"How can I make sure we continue to make the RIGHT DECISIONS on the day?"
"There's no such thing as the right decision,
just the decision you make at the time"
This is what my Mum used to say to me when I was fretting about stuff in my 20s. Obviously now I can barely remember what those angst ridden issues were, but this saying, it's really stayed with me. And as I see more and more birth-ie social feeds telling women what to do ('challenge your induction!', 'don't consent to vaginal examinations!', 'give birth at home!' etc., etc.), it comes back to me again and again.
Let's go back to basics. What does sensible mean? According to Cambridge Dictionary, it means 'Based on or acting on good judgment and practical ideas or understanding'. If you're pregnant right now, the sorts of practical ideas and understanding you're going to want to have in order to make a good judgement will include;
What do I really know about birth, and how reliable are my sources? (Here's a fun starter for 10!)
What does physiological birth mean?
Where can I get real information about birth, and how does it actually apply to me?
When I think about birth, what is my worst case scenario?
What does 'Good' mean to me? How 'Good' can birth really be?
Start to gather those insights and you'll be in good shape for making informed decisions - and, of course, informed consent.
Birth, though, isn't always straightforward. It throws curve balls aplenty. The Big Bad curve balls (like shoulder dystocia, or emergency caesarean birth) get plenty of press. In fact, they own far more of the popular imagination about birth than statistically they have any right to.
What we talk about less are the insidious little changes that affect how women feel about being pregnant and birth, and which can alter her attitudes and experience. As a starter for 10, the last few weeks of pregnancy can be very uncomfortable - indigestion, disrupted sleep, inability to reach your toes... - all these little things can add up to a whole world of discomfort and frustration. There's the huge hormonal load we're dosed with in the final weeks, that can make us feel teary and fidgety, like a cat on a hot tin roof. There's the reality of the immense change you're about to embark on - and while that can be exciting, it can also feel daunting and intimidating. During labour itself, it's not just the 'Big Medical Emergencies' that affect women - it can be sickness, or tiredness, or the heat or the intensity, or how vulnerable or bold or excited we feel, or a new midwife or a difficult journey, or not wanting to leave home, or.....well, frankly anything.
What I'm trying to say is, while you may take the rational view that birth is a physiological process, and feel confident in your mindset and your coping strategies.... you may also gratefully welcome a sweep once you are 40+5. And there is absolutely nothing wrong with that, because your SENSIBLE decision isn't simply the rational one you agree with your birth partner in advance of labour. It's the decision, made calmly and confidently, in the moment, with the benefit of ALL the information you need. ALL the information means; the biological stuff, the risk implications, and your instincts in that moment, right there. Your feelings are valid too.
While labour is really super simple in some ways (because our bodies really are designed to do it), in others the multi-axial complexities mean that sticking to your rationally defined principles isn't always the best way forward. It's rather like a studio mixing desk - despite the similarity of input, the variety of subtle changes that can affect the outcome are almost endless.
The only principle I hold is that women should not suffer in labour. And that means that sometimes it's right and proper for your plans to change. For some of my recent clients that has meant transferring to hospital from a planned home birth, and moving from a planned VBAC to a planned caesarean birth. All the sensible, right, appropriate decisions to have made in the moment.
What's most important is that this is YOUR experience. That means adaptability is as important as holding space in the birth nest. That emotional resilience means as much as oxytocin. In short, there is no right way to do it, and you are not falling short if ultimately your baby arrives in a different way than you expected.
The point I want all women to hear is; motherhood should be respected, however it happens. And if you don't respect yourself - the work you did, the effort you made, the decisions you took - it is harder to demand that respect from others. You have every right to feel proud, because motherhood should augment us, rather than diminish us.
Charlotte Edun is a doula, hypnobirthing practitioner and Positive Birth Movement Factilitator. She has 3 children and practises in West Kent.