Writing your birth preferences is important to do for a number of reasons:
1. It gives you time and space to think about what you want for your birth
2. It opens communication between you and your birth support team
3. It helps you to familiarise yourself with hospital policies
4. You have time to compare policies with national guidelines, international guidelines and evidence based research.
5. It gives you a tool to remain in control and make informed decisions
Key points when writing your birth preferences
Keep your language open and positive. You have a chance to create the atmosphere you wish to birth in. Positivity is key and opens on a good relationship with your team.
Know your chosen hospitals policies. Each hospital has different policies around key factors in labour and birth. You are free to question these and even change hospital if you feel better suited to a different standard of care.
Know the HSE (national) and international guidelines / best practice / evidence. This is key. If you know what the evidence says then you can make an unbiased informed decision, rather than being swept along with a phrase such as “that’s the way we have always done it here”
Keep it to 10 points, or less. Anything more will negate the things that are important to you.
Don’t bother putting things in that are already policy in your chosen hospital (ie drinking water during labour) Again if you are familiar with your hospitals policies then you can avoid this.
Think about the atmosphere you want to birth in. Would you like the lights dimmed, music playing, limit the number of people in the room etc Or are you happy to have lights on, student midwives and doctors in the room etc?
Be firm on the points that are non negotiable for you once all is OK with baby (i.e. if you absolutely do not want an episotomy and would rather have a natural tear if it came to it). Some decisions need to be made in a split second and having discussions around the really important issues before hand are vital.
Create birth preferences for a Caesarean Birth preferences as well. This is a good idea for all the same reasons that are mentioned here. You can have the discussions, make informed decisions and then ‘park it’ to one side. You have your just in case covered, remaining in control. Then you can shift your focus back to the birth you visualise. It can be on the next page so your focus is not necessarily on this outcome if you are not planning to have an elective Caesarean, but it does mean that if things don't turn out as you had hoped you have something written up to help you create a dialogue with staff.
Create your birth preferences with your birth partner. This is important as they will be your advocate for the day. Being aware of what you want and why will help them be a better advocate for you.
Bring multiple copies so you have them for shift changes. Make sure your partner is aware they need to ask the team caring for you to read through them and discuss them with you both.
Finally knowledge is power as they say - but trust in the process is also important. All the above are important and give you the knowledge to discover what you want for your birth. It gets the discussion out of the way before labour begins, as during labour it's important to park the conscious brain as much as you can. You body and your baby know what to do, they are an awesome team, made to work together. Let your advocate voice your preferences and allow yourself to go with your labour journey.
Here at Doulacare Ireland we will always helps our clients draw up their birth preferences after meeting with their birth doula for an antenatal visit. We listen to what is important for our clients and offer information on evidence based care that will enable them to be aware of what they might want to include in a birth preference sheet. We would always encourage clients to have some birth preferences to facilitate improved communication between clients and staff.