Typically, when people talk about what women and families want during the childbirth process, they usually mean the medical interventions involved in childbirth. Do you want a natural birth or an epidural? Do you want evidence-based practices or standard hospital routine? Do you want delayed cord clamping and skin-to-skin time or routine newborn procedures? While these are all very important decisions to think about that can affect you and your baby's health, I have found that focusing on these objectives alone are only part of the puzzle of helping women achieve a positive and satisfying childbirth experience. The part of the puzzle many have missed has to do with the intrinsic values a woman or a woman and her partner hold that guide most of the decisions in their lives. I believe the five things women want in childbirth are the key to helping us put the ownership of birth back in the hands of mothers and improve childbirth experiences.
Understanding Control in Childbirth
Before we talk about these five values, we have to have an understanding of how personal control functions in birth. Control is an interesting concept in childbirth, and in life really. We want control, yet much of life is out of our control. When women speak about childbirth, they don't want to feel "out of control," and yet they know there is so much of the process they simply cannot control. The most predictable thing about physiological birth is its unpredictability. Just like we cannot fully anticipate the weather, we also cannot (and maybe should not) predict or dictate every single thing that occurs during childbirth.
Also, many women have grown accustomed to the idea that no matter what they say they want in childbirth, their wishes will not be respected, so they attempt to be "open-minded," so as not to set themselves up for disappointment. In fact, in her video series "Do Birth Plans Really Work?" Rebecca Dekker of Evidence Based Birth shares some interesting research revealing that many women who request evidence based practices in childbirth do not receive the care they desire. So, what are we to do, knowing mothers can and should be able to have the kind of care they want, and refuse what they don't, while also remaining flexible toward unknown outcomes and trusting of their healthcare providers?
5 Things Women Want in Childbirth
Since I began developing my childbirth curriculum in 2011, I have been trying to answer these questions and felt that the traditional birth plan just wasn't adequate. I have found that a values-based approach to birth planning helps bridge the gap and allows to families gain ownership (rather than control) in the birthing process, which creates a more satisfying birth experience. In her book A Good Birth: Finding the Positive and Profound in Your Childbirth Experience, author Anne Lyerly describes 5 aspects of control she found present in 101 women interviewed about their expectations and experiences. These are:
- Agency - feeling involved, empowered and capable, that you are the one giving birth, rather than "being delivered"
- Personal Security - feeling physical or emotional safety, whether external or internal circumstances
- Connectedness - feeling connected or attuned to others, including your child, partner and feeling trust for your healthcare provider
- Respect - dignity, self-respect, feeling composed and calm and having the mental ability to birth confidently as well as respect for the sacredness of birth itself
- Knowledge - having information, feeling prepared, and knowing what is happening around you and in your body
Most women tend to gravitate toward one or two of these as being primary in importance to them; however, they are very fluid concepts as well. To some degree, each of us want all of them, but in listening to mothers you will often hear one of these concepts stronger than the others.
Incorporating the 5 aspects of control in birth plans
In Your Birth Experience, we incorporate the 5 aspects of control in our teaching and combine them with other unique components of the curriculum to help parents prepare in an intuitive and highly personalized process. In addition to providing evidence-based information about hospital practices and childbirth interventions, we go far beyond the usual birth preparation and planning to help mothers and their families feel confident about birthing their babies and have the kind of experience they dream about. Contact us today to find out how you can get started on a values-based approach to childbirth education.