I will confess that I went into my first pregnancy woefully unprepared! I hadn’t planned on having a baby, but life threw me a curveball and I had to learn fast. Unfortunately, I hadn’t grown up in the most birth-positive household. I had been taught that babies were expensive time-suckers and that I shouldn’t be so quick to want one. I was also told that I wouldn’t be able to handle motherhood or the pain of birth. Not exactly the most supportive environment.
So, when I realized that my spouse and I were expecting our first child I made several errors in how I went about planning my birth. Truth be told, these are very common errors, and many new moms make them because our culture has told us that’s how it’s done. We don’t question it.
But I really wish I had known there was a less stressful way of planning and taking charge of my birth experience, so I’m hoping that this list will help you avoid the same pitfalls that tripped me up that first pregnancy.
Note: If you’ve already done some (or most of them) don’t beat yourself up about it; you still have time to pivot and choose a more empowering path.
Finding a Care Provider Takes More Than a Google Search
I peed on a stick, found out I was pregnant, then called the first female family doctor I could find. She wasn’t attending births, unfortunately, and so I was referred to the local maternity clinic. I knew nothing about them, didn’t know what their care model was, and didn’t even have TIME to ask any questions. Then, I chose a midwife practice by just googling midwives in my area and called the first place on the list.
As a result I didn’t hire the exact right care provider for ME. I thought all midwives were the same, but that’s not true. The practice I was with wasn’t actually a good fit for my needs and the rest is history, as you know.
Choosing a care provider isn’t as simple as asking who your friend used, going with whichever OB/GYN your family doctor refers you to, or showing up at the local maternity care clinic and assuming you’ll get the care you want. What I didn’t know at the time is that individual and group practices all have different philosophies and preferences in how they attend births. These aren’t often outright stated at the first visit, and unless you know to ask and what to ask before you hire your care provider you might later find that their idea of a “good birth” isn’t the same as yours. Some practices do have a website that can give you an idea of their hidden policies, such as if you come across a FAQ page that states that a birth plan isn’t necessary, or that if you go 10 days past your “due date” you will be offered induction. That OB clinic I went to had policies like that, and I know exactly what kind of birth I would have wound up having if I had stayed with them.
It’s also important to note that just because you hire a midwife doesn’t mean you don’t need to be cautious of who you’re hiring. Midwives don’t all practice the “Midwifery Care Model”, unfortunately. Some of them are “Medwives”, that is to say they are more likely to follow hospital protocol and suggest interventions such as induction or labour augmentation (speeding up labour with drugs or breaking your water). They might even neglect to tell you important information that would lead you into declining a recommended care plan that is against policy or their preferences.
Remember that you are the sole decision maker, and that care providers are HIRED. Treat your first visit like an interview, not a first appointment, and pay attention to any red flags or gut feelings that this care provider might not support your birth vision and impose their own.
Planning a Homebirth and Taking Charge of Your Birth Are NOT The Same Things
It helps to avoid the unnecessary interventions and vaginal exams if you plan a homebirth, but the tricky thing about hospital politics and how midwives work in Canada is that often even if you think you are not under hospital policy…you are. Registered midwives have a long list of things that they are expected to do, and they have protocol to follow. When they have been called to a birth at home, they still have to call the local hospital where you registered to let them know a homebirth is taking place. This means you are “on the clock”. There are also restrictions on who is “allowed” to have a homebirth; and if you deviate from the textbook in labor, even if it’s not a real emergency, your midwife might have to consult with an OB anyway.
That’s if something doesn’t come up in pregnancy that leads your midwife to tell you that you can’t have a homebirth, even if that something is based on an unreliable ultrasound scan. Or maybe you just go past 40 weeks, or they tell you you’re having a “big baby”. I didn’t know that in order to have the birth I wanted, I had to Take Charge of it. I was under the impression as a newly expecting mom that midwives would just automatically tell me the truth and one of mine was telling me that it was no longer safe for me to birth at home. I had NO idea that there were hidden “rules” at work, but by my second pregnancy I learned and was prepared not only to ask the questions about the risks to ME and my baby, but also what hidden policies or expectations the health authority had that could put my midwife at risk. I ensured that she understood from the start that while I didn’t want to get her in trouble, I was going to do things my way and I needed to find the “loophole” for us to both get what we needed.
It’s also important to understand the hospital politics in case of emergency, or should you simply change your mind about homebirth. In the rare case that you do end up needing to transfer for legitimate reasons, you don’t want to go into the hospital unprepared. You need to learn the tools to advocate for yourself and understand how the system works and what your options are EVEN if you don’t end up needing to use those tools. I’ve found that knowing how to advocate and make decisions, while understanding the inner workings of the system puts you into a position of POWER in your birth. Regardless of what emergencies come up, if any, knowing that you were the one in control and made the right decision free from fear or pressure from external sources can ensure a more positive birth, even if you end up going to the hospital.
Your Birth Partner or Your Doula May Not Be Able to Protect You
I’m going to tell you a secret: doulas witness obstetric violence all the time. They do their best to protect their clients, but ultimately they are not the ones making the decisions. YOU need to be confident and understand your option and your rights, and YOU need to know how to advocate for yourself. Your doula can help support you and remind you of your options and decisions you made, and they can be a witness should there be any level of coercion or abuse in your birth so you can later file a complaint. But your doula and/or your partner can be kicked out of the birth room if your care provider feels they are interfering. YOU can’t be kicked out of your own birth though, and YOU need to know how to protect yourself. You can’t rely on others to do it for you.
My husband is a tough guy, and when it comes to protecting his family he’s fierce. Few would mess with us while he’s around, but in the hospital that powerful man was reduced to staring helplessly, unsure what to do, when I was wishing he could read my mind and help me get off my back. I was pulled to the bed, and when the nurse and midwife said they wanted me up on it, he helped them. When the nurse told him to hold my legs so I couldn’t brace myself and push up the incline of the bed in an attempt to get off my back, he complied. He admitted afterward that he didn’t know what to do. I had told him many times that I didn’t want to birth on my back, but we never knew that the hospital policy would take over what we wanted and ultimately leave us feeling powerless.
My homebirth might have turned to a hospital transfer if I had not been aware of my rights and known that I had to fight for those rights. It’s not enough to expect others to fight for you; you need to be able to fight for yourself, and consider your birth partner and doula as your witnesses and backup, should you need it.
Your Reading Material Shapes Your Mindset
There are so many great childbirth books out there and What to Expect When You’re Expecting isn’t one of them. If you’re looking to stay afraid and compliant then sure, by all means read it, but for taking charge of your birth and feeling confident that you could birth any time, anywhere, with or without your care provider, that book doesn’t help at all.
Like most newly expecting mothers, I was gifted a copy of that book by my own mother. It was sort of a family tradition of sorts. My aunts read that book, my mother read that book, my stepsister probably got a copy, and now I had one. For nine months I read each new chapter and each month I found new things to worry about. The tests were presented as things that you could “expect” and there was nothing about risks, benefits, alternatives, or even declining. The birth chapters freaked me right out.
Sadly, I was recently browsing the shelves in Indigo and that book was the most prominently featured title in the parenting section. Ina May Gaskin’s “Ina May’s Guide to Childbirth” had all of 3 copies, and they were seemingly thrown in as an afterthought. In contrast, What to Expect’s series had a full 2 shelves. If you’re going to get any childbirth books, your best bet is to shop online or ask your doula or midwife if they have a lending library you can make use of. I included some more empowering books at the back of my free PDF Guide to Avoiding Unnecessary Interventions, but I also mention my top 4 books in my Reset Your Mindset Challenge in the third video, which you can find in my Free Facebook Group Empowering Moms in Pregnancy, Birth, Postpartum, and Beyond.
Not All Childbirth Classes Teach Physiological Birth
You want a class that prepares you for physiological birth and teaches you that you have options. It’s not enough to just hold some ice in your hand and breathe. What you really want to know about is your rights, how the system works in your area, coping methods you can use while at home, the different paths a physiological birth can take, how to make decisions, and it should have some information for postpartum and breastfeeding as well.
I was fortunate that the midwife practice I was with in my first pregnancy offered free mini-classes each week for clients. I got more out of those classes than I did out of the ones my mother had paid for that were run by the health nurse of the local hospital. I will also note that out of the “graduates” of that class, I was the ONLY mom who had given birth without any interventions and the only mom with a midwife.
The classes I find have the most value are the ones taught outside the medical system. Classes taught within the system often are subject to censorship of anything that the local health authority doesn’t feel is “important enough” for the public to know. Risks of the epidural may not be permitted to be discussed, or they are glossed over. There may be more emphasis in the classes on being a “good patient” rather than understanding one’s rights to bodily autonomy and informed decision making. By choosing a class outside of the medical system, you may gain information on the true practices and policies of your local health authority, what options and rights you have, REAL coping methods for labour that work with birth’s physiology instead of against it, and depending on the type of class you may even learn about breastfeeding and postpartum care.
If time is a factor for you, there are many online classes now available that allow you to study the material on your own, while gaining support within a larger online community. Gone are the days of having to practice breathing exercises in a room full of strangers!
Your “Due Date” is a Guess Date
I have some news for you…you are probably not going to give birth on your “due date”. In fact, there is only about a 5% likelihood that you will give birth at 40 weeks. If you’re like my sister, then you might be one of the few that give birth before 40 weeks and avoid the stress of waiting entirely, but don’t count on it happening and if it does happen, then be pleasantly surprised. It’s more likely that you will hit 40 weeks and not go into labor. I know, it was such a let down for me the first time too. I was already cheated out of my homebirth and I was anxious to just get birth over and done with, so when I hit 40 weeks I eagerly watched for that first labor sensation. I mistook back cramps for labor and wound up wasting the whole day trying to “get things going” only to have it all fizzle out by noon. Then I assumed that maybe I would have him in time for Mother’s Day (3 days past my “due date”) but nope, he didn’t want to come then either. I went for a sweep that Tuesday, but it didn’t work and I just wound up feeling crampy and irritable all night because of it. Finally, at 40 + 6 I went into early labour and by 10:55pm the next night he was born!
I will also note that if my son hadn’t arrived at 41 weeks I had an ultrasound scheduled for that same afternoon and if he hadn’t arrived by the next appointment on Tuesday, then the midwife would have discussed my options, including induction. I knew already that I was going to refuse induction, but one of my friends was also a client in that midwife group and she went to 42 weeks. I now know that had I gone past 41 weeks I would have been put under extreme pressure to induce, like she had been. I will also note that neither of us knew that we had the right to refuse and fight for our right to supportive care.
My point is this: your due date is a guess date, and can be off as much as 2 weeks! You can go to 42 weeks, and even a little past that if you’re comfortable. The risks are often greatly exaggerated. If you want to know more about induction, Dr. Rachel Reed has an excellent book “Why Induction Matters”, and Dr. Rebecca Dekker shares the Evidence for Going Past Your Due Date.
“Go With The Flow” is NOT a Physiological Birth Plan
Honestly, I was fortunate to have been born with a stubborn streak that doesn’t allow me to go with anyone’s flow but my own. I feel that this stubborn streak is what kept me from being 100% compliant with what the midwives and overseeing OBs wanted me to do, however I also know that not everyone can hold their ground the same way.
If you are the type to just do whatever someone else tells you is best, because of how you were raised, then it can be difficult to stand up for yourself and go against your care provider.
There is a huge difference between going with the flow of your body or going with the flow of what your care provider and hospital’s plan is. Depending on where you are choosing to birth your baby, you may find that your care provider manages every step of the process. They plan for you to arrive in early labor, they hook you to monitors, they restrict movement and possibly food and drink as well. They determine how much progress you need to be making before they try to “speed up” labour. They decide how long you are “allowed” to labour for before they perform a caesarean. They might also decide whether or not you are “allowed” to hold your baby immediately, when the cord gets clamped and cut, and even whether or not you can “successfully” breastfeed.
Don’t go with their flow.
Birth is unpredictable, but your body and baby are the ones in charge. Birth in a hospital where the doctor thinks they are in charge of managing every aspect of your birth is uncomfortably predictable. In fact, it is so predictable that we have a name for all the management in birth and the outcome: The Cascade of Interventions.
Protect Your Head Space
Some people cannot help themselves and like to scare pregnant first time moms. It’s not nice or helpful to do this, and yet it is so common. I got told many times that my birth plan wasn’t going to work out. I was told that I would change my mind and beg for the epidural. I was told that I wouldn’t care how the baby got out, as long as it was healthy. My confidence was undermined the whole pregnancy, and I had to fight back with my own evidence, trying to educate people who really didn’t care to learn anything. It was exhausting. I don’t recommend it.
Just smile, say “thank you, but I’m not comfortable talking about this right now” and change the subject.
Your birth plan is none of their business, and you have a right to protect your headspace from anything that could undermine your confidence.
If you can, surround yourself with positive birth stories. Read about the “Impossible” births that have happened at home with twins, breech babies, triplets etc. Inside my free facebook group I often share stories from other groups I belong to. It’s the proof we need that our bodies are amazing and we can do anything.
Resist the Temptation to Join “Due Date Groups” on BabyCenter
When I was pregnant with my first baby I joined all the due date groups on all the birth and pregnancy websites. I signed up for the emails. I read everything. But in the end, I got a bunch of mainstream, medicalized birth information. I didn’t learn anything about Informed Consent, and worse, these groups were a place where “alternative” birth choices were the minority. Mean Girls don’t all grow up after high school; they become the Mean Moms who tell you that you’re a “bad mom” if you “prioritize your experience over a healthy baby”. If you ask “can I refuse x test” then you get a bunch of nasty comments about how you’re being “selfish”. If you go past 40 weeks and ask if you can refuse induction, you’re “putting your baby at risk”. Every answer to the “can I say no” line of questioning gets the response “listen to your doctor, (and stop thinking you matter more than your baby)”.
I created my free Facebook Group because I know how awful the Mean Girls can be to any new mom who dares to exercise any bodily autonomy. I have been attacked for telling other moms they have the right to refuse anything and I have been told I don’t deserve my children because I dared to refuse a test or even just because I chose a homebirth.
When you’re pregnant for the first time it’s only natural to want to seek advice and support. We are so isolated from friends and family these days, especially right now in the middle of a pandemic, and parenting forums can be a great source of support for a lot of things. Unfortunately it can also be a major source of anxiety as not everyone on the internet is kind or compassionate. When asking questions of a mainstream parenting forum, be prepared to deal with a lot of mainstream answers.
“I want to refuse x test, am I allowed?” won’t always get you a link to the page on Informed Consent unless the right people are online that day. Most often you could find yourself being questioned as to WHY you want to refuse the test, and others who would tell you that you are being selfish. Perhaps you’ll trigger someone whose baby was sick, and they’ll tell you their horror story and how they would never “put their baby at risk”. Either way, it’s a flip of the coin whether or not someone will respond positively and give you the information you actually need. I’ve done my best to get my comments into certain threads, but often the poor mother has already been beaten down for even daring to ask if she could decline. Unless you are particularly strong-willed and used to bullying so that it no longer affects you, choose your groups you hang out in based on how well the members lift each other up. Part of what I offer in my facebook group is a safe space to ask questions and get real answers, with none of the bullying, toxic behaviour that is so prevalent in certain parenting forums.
You DO Know How to Birth Your Baby, EVEN If You’ve Never Done it Before
Here’s another secret: Your body knows what to do.
If you were unconscious and in labour, your body could still birth your baby and your baby might even crawl up to your breast to nurse on its own. If you go into labor somewhere far from a hospital, your body will still know what to do and you will have a baby. The only thing you need to do is follow your instincts and what your body is telling you to do.
Ina May Gaskin says it best: “let your monkey do it”.
Your thinking brain is not needed in birth, and actually needs to be turned off for you to switch to your primal/animal brain. So even if you don’t have your doctor or your midwife arrive “in time”, you can still birth your baby. That means that if you happen to recognize red flags in a care provider or the hospital, you can say NO and be confident that if they threaten to leave you without care (which is illegal, by the way) you can do it without their help.
There was one woman who fired her doctor in the middle of birthing her baby because he refused to “allow” delayed cord clamping. So the mother birthed her baby and caught it herself, then wouldn’t allow anyone to touch them until she wanted the cord clamped.
Had I known that my body was capable of birthing my son without any cervical checks or fetal monitoring, I might have stayed home and waited until he was crowning to call the midwife. I might have just rented the pool on my own and laboured in it the whole time like I did for my daughter’s birth. I might have said “no, I’m not going to the hospital. I changed my mind. I’m staying home”, and any threats that they wouldn’t attend me would have been dismissed outright because legally someone would have to come out if we called them. You would be surprised how fast doors can open that were firmly shut if you keep pushing at them.
You aren’t powerless, you are powerful. You are the one birthing your baby, and you don’t actually need anyone to tell you how to do that. View your care provider in the role of someone to assist and support you, not someone who “delivers” the baby. As Rebecca Dekker says, “Babies are not pizzas. They are born, not delivered.”
Taking Charge of Your Birth doesn’t happen all at once. It starts with shifting your mindset from thinking you can’t to realizing you CAN. It’s about putting yourself back in the driver’s seat, recognizing what works for you and what doesn’t. In essence, Taking Charge of Birth ensures that you enter parenthood feeling confident that YOU are the expert on your child. People will solicit their advice, criticize you, tear you down, tell you that you’re doing it all wrong, and you won’t feel that sense of shame or fear that they’re right. When you learn how to trust in yourself, fully and completely, that power radiates to all aspects of your life.
YOU are enough ❤
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