Hospital Plan v. Your Plan

Why You Need Independent Childbirth Classes

Hospital childbirth classes are usually free.  They cover hospital policy, mention comfort measures like breathing and massage, discuss the standard procedures when you arrive at the hospital, and let you know when you can get pain medication.  You see a labor and delivery room on a general tour.  Basically, they tell you what to expect when you arrive at the hospital.  They merely scratch the surface of labor and birth.

Is that really enough?  Nope, that isn’t enough for any anyone.   Even if you are certain you want an epidural.  In fact, your pain control preferences hardly factor into what a good birth class is about. That is just one of the many decision you make about the care of you and your baby.  Sure, we discuss various pharmaceutical pain management options , and there are important things for you to know.  The real “meat” is knowing the benefits, risks, and alternatives of ANY option and owning the decisions you make. 

The hospital in collaboration with the doctor you have chosen has a plan. They do this several times a day, day in and day out, so in many ways they are on autopilot.  If X happens, then do Y.  If you don’t educate yourself, you are not able to be an active participant.  You are put into the “assembly line” even if you’ve been dreaming of a natural birth for months.  There are a few different “combo meals” for this one—like a normal vaginal birth (maybe with tearing or an episiotomy), an assisted (forceps or ventouse) birth, or a cesarean.  Maybe you get off to a good start breastfeeding.  Maybe your baby doesn’t latch well.  Maybe the “good” lactation nurse is there.  Maybe not. 

You’re completely at their mercy and mostly in the dark. 

Even if you aren’t “into” birth, how your child enters the world is important.  A lot of moms are left feeling like something is missing after one of these “would-you-like-fries-with-that” births.  You know deep inside that it’s more important, that you are an individual, but the system caring for you gives you a number and moves you on down the line. They are just doing their job. 

At better beginnings, we know that the doctors and nurses as individuals are genuinely good people who have your best interest in mind, but frankly, the stats reveal a different big picture view.  The United States rates of cesarean surgery, maternal morbidity, maternal mortality, and postpartum depression are all too high for everyone’s standards.  Our breastfeeding rates are dangerously low.  Our maternity care system in the US is not working as well as it should.  Amongst other nations, we rank in the upper 20s—not the top 5 or even top 10.  It is up to you to take charge of your health and demand the very best care, backed by the latest evidence.

You can have an empowering, healthy birth in this same system, with the same caregivers present, with the same people supporting you.  You just have to do some work ahead of time. 

Here’s the heart of the matter: your care provider, your birth, the things that happen at the hospital are all choices—YOUR CHOICEs.  You have the opportunity to make informed decisions and actively participate in ALL of the choices made about your care unless a true emergency arises.  Even then, you can still have a say, but you have to know how and when to speak up.

If you are a healthy person expecting a healthy baby, you don’t HAVE to do any prenatal testing.  You don’t HAVE to be induced.  You don’t HAVE to push at 10 cm.  You don’t HAVE to have an episiotomy.  You don’t HAVE to have a cesarean.   Your baby doesn’t HAVE to go to the nursery.  You don’t HAVE to do anything.  Honestly.  You decide what is best based on your knowledge and consultation with your trusted care providers.  You’re paying for it, after all.  

You also have to know how to cope with labor, regardless of your pain management preferences.  What if your epidural wears off or doesn’t work?  What if you’re having lots of contractions and they won’t admit you?  What if you get to the hospital too late in labor for any medication?  What if you need or have to have a cesarean? 

Knowing how to relax yourself, slow and deepen your breath, and having people with you who know how to support you calmly benefits you and your baby in any of those situations.  Knowing how to stay cool and express yourself well are good skills for life.  Period.

In our classes, you’ll learn how to make YOUR plan, not a one-size-fits-all method or hospital default.  You’ll learn how to keep yourself healthy so that you can have all of the options available when it’s time to give birth.  You will learn what options are realistic at every step and come to understand that it is important to be flexible and stay open to change.  You and your support will learn to advocate for you and your new baby.  This is part clarifying what is most important to you and part communicating with your caregivers (doctor and nurses).   Again, life skills—what’s your goal, and how do you reach it?

You’ll write a birth plan—not to tell the doctor and hospital staff how to do their job, but aiming to avoid the slippery slope of interventions that go along with the hospital default.  It will politely and succinctly express your preferences and expectations.  It will guide the conversations you have with your doctor prenatally.

Building Blocks for Birth is a real class to prepare real people for real birth.  You are too important for a fast food birth.  We want you to be confident, realistic, and prepared to get what you want in the setting you’ve chosen.  Did I mention that it’s all your choice?  You can leave your care provider at any point, or even leave the hospital in labor and go to a different hospital where you’ll be treated with more respect.  After all, nobody likes poor customer service.  You’d speak up if you ordered a burger and got a burrito instead.

What is a better beginning?

Backyard birth blogging…

I’m sitting in the cool sunshine watching my daughter revel in a rain-filled wheelbarrow. Said wheelbarrow was previously filled with leaves, gravel, and sandy dirt. Add in meticulously plucked pansies, and you have the perfect recipe for an outdoor adventure. “Flowers need water, Mama,” she says. Why now seems the time to sit and write, I haven’t the faintest idea. That’s my life with kids—messy, imaginative, and filled with unlikely inspiration.

Bianca and I often talk about blogging—we need to start, there are so many things to say, etc…. We call our joint childbirth education business “Better Beginnings.” Why? What exactly is a better beginning? Why will independent childbirth classes help you have a better beginning? Why do you need a better beginning?

Hmm, where’s the thought to connect those two ideas—backyard mess and birth classes? Let me be bold—the typical birth class is like sticking a flower into cold, dirty water and assuming all it needs is water and sunshine to grow. The ingredients look right on paper, but they just don’t add up to the desired outcome.

An expecting mother’s confidence must be carefully cultivated and nurtured in order to thrive. Her hopes, support, and fears are important. Her body image, expectations, and ways of handling everyday life are important. There is just not a one-size-fits-all “method,” birth plan, or childbirth class that meets this whole woman’s needs.

A better beginning is an empowered woman in the full birth-bloom of impending motherhood. She strives to gain the support and information necessary to make the best decisions for her family. She is an individual, so she deserves to be treated respectfully. In this way, Bianca and I are unlikely gardeners, carefully tending our flowers to keep them free from easily remedied crises—weeds, bugs, drought, or the careless passerby who stomps on a new bud.

Can we promise you the perfect birth you’ve been dreaming about for months? No, of course not. Predicting what will happen in the moments around birth is like trying to predict the weather. We can give you up-to-date, evidence-based information. Prenatally, this will eliminate fear and misconceptions. In labor, it will give you the power of informed decision making. Being an active participant when it comes to decisions about your care and your baby’s care is deeply satisfying. It is the culmination of all of your preparation, whether you have the birth of your dreams or a true emergency arises.

Though she and I each have two children, the choices we made each time were unique to us. Similar key ingredients influenced our decision making, but the actual choices reflected our situation, support, and knowledge at the time. As parents, we are always growing and learning. We hope that our passion and commitment to continued education and knowledge-seeking is ever reflected in the moments we share with you. It is an honor to serve a woman on her journey to motherhood.

- Kate Fillingim, LCCE