Implementing birth preferences

More information Birth preferences Exploring the many options and possibilities for labour and birth is important. Related books: Preparing for Birth: Mothers Your Birth Rights Gentle Birth Choices Related articles: Birth

It may not be easy to have the birth experience you have planned. Caregivers and hospitals vary in their views and practices, and it is wise to work out your particular requirements early in the pregnancy so you can take steps to find the services you will need in plenty of time for the birth. Details of the options in caregivers and birth place are described in Preparing For Birth: Fathers. You will want to discuss these ideas in detail with your partner and enlist his help in negotiating with hospital staff and caregivers.

Here are some ideas on how you can both go about achieving your goals:

• Find out as much as you can about birth: the process, current practices in hospitals, professional views, etc. Don't just rely on what your friends experienced; ask around widely. Your class teacher will have plenty of information too.

• When you feel ready to make decisions, use this plan to work out what is important to you. There may be some aspects that you will definitely want, or not want, and some areas in which you have no particular strong feelings.

• Discuss your needs with the midwife or doctor as soon as possible. Determine which areas may need further discussion and/or compromise, and those areas in which you agree.

• Visit the hospital and find out their procedures, and how they can meet your needs. Decide if there are areas where compromise will be needed.

• Think about these areas needing compromise. How important are these issues to you? Can you think of any solutions that may be acceptable to all parties?

• Discuss your ideas further with the midwife or doctor and hospital staff. Try to work out mutually acceptable compromises in the areas in which you feel this is needed.

• Look again at your chosen caregiver and birthplace: are there any others who might be willing to accommodate your needs and where compromise will not be needed?

• If you feel you can achieve a happier result with another caregiver or hospital, then consider changing. You can do this even late in pregnancy if you want, and your new caregiver will re- quest your medical notes from your previous one (you could also request these notes yourself).

• If you don't want to change caregivers then you may have to be prepared to accommodate their wishes in certain areas. By deciding early in pregnancy, there will be more time for you to adjust to this, and to explore other ways of redeeming the situation.

• Make sure that both the midwife or doctor and the hospital staff know, well in advance of your labour, what you would like. Visit the hospital again if necessary, to finalise arrangements with the labour ward staff or the post-natal staff. You could also ask your caregiver for a letter out- lining the care you want, for you to take with you to the hospital. This way, even if s(he) doesn't make it, or arrives late in labour, you have a chance of getting the experience you have planned. Make sure that this letter from the doctor is attached to your medical notes.

• Check your hospital's consent form: does it allow for informed consent, after consultation, for all procedures or treatments you will be offered?

It is important to remember when going through these steps:

• It may be unreasonable to expect your caregiver to radically change their method of managing births just for you. You might be better off seeking a more sympathetic person.

• It is unreasonable to expect the hospital staff to accede to your wishes if you haven't spoken to them during pregnancy. They may be unable to provide special care if not warned beforehand that you will want it, and they will be understandably hostile if you come to their ward full of demands.

• The most important point of all: caregivers cannot read your mind. Don't be afraid to talk about anything that is bothering you with those who will be caring for you. Don't assume that all will be well; ask and make sure. Then everyone knows where they stand.

After it is all over it is nice to:

• Write to the hospital and doctor and thank them for their care, especially any extras' they have provided. It not only lets them know that you were happy with their efforts and thus encourages them, but it helps to set a precedent for others who will follow you.

• If you are unhappy about some aspect of your care, tell the appropriate people that too. They need to know how you felt about their assistance.

• Attend your class reunion to let your classmates know how you went and to give your teacher some feedback.

• Fill in your labour questionnaire and return it.