Kate Middleton’s birth plan: Three things

Kate Middleton’s birth plan is one of the hot topics around the ‘net this week.

As the veteran of three very different births (first: a cord accident that resulted in the death of my daughter; the second a labour that was under 4 hours from when I first started to care about oddly evenly-spaced “Braxton-Hicks” to the end; the third a lengthy no-painkiller delivery of a “sunny-side-up” baby) here’s what I would like to see on Kate Middleton’s birth plan:

1. Guidelines, not a set of rules
Sometimes I think the emphasis on a joyful birth is a part of the same trend that leads to over-the-top weddings. Yes, I am all in favour of a really good experience for everyone. Your baby’s delivery day is definitely a big deal. Create your playlist, ask for dimmer lights, see about pain management, choose your birth team. If something like delayed cord clamping or cord blood banking is important to you, get that in there. (Here are tips for a natural delivery, if that’s your thing.)

At the same time, there are at least 18 years ahead…and in labour, a lot of things can happen. Of course I realize Kate Middleton’s wedding was an international event (in fact, I watched it from a hospital admission with my youngest) but I worry that the degree to which she is able to orchestrate the rest of her life will lead her to believe that hypnosis is going to control her delivery. Sometimes things will change for a medically necessary reason. And sometimes, something will just plain not happen the way you wanted.

That’s a hard thing sometimes in the context of labour because it’s a physically demanding, emotional, hormone-laden time — but that’s exactly it, it’s a biologically complex process. You can practice hypnosis, but as I learned, you can’t make a baby turn face-down.

2. Failure actually isn’t an option
I have so many friends who have tried for a natural delivery and felt that they failed because they either asked for painkillers or needed other interventions. And they weren’t reading about “Kate Middleton’s birth plan” in all the tabloids the next day!

The trouble with a lot of decisions in labour is that you are weighing risks and benefits during a pretty stressful time. When mums change course to get a c-section, for example, and the baby is fine they may feel that they could or should have kept going. But as someone who experienced the reverse angle on that decision — the extremely rare case where a c-section would have worked and wasn’t performed — I think that kind of hindsight is flawed.

If you end up making changes to your birth plan along the way, that’s okay. The current push towards natural delivery, while it has brought some benefits for women’s health along with it, may lead some women to believe that any intervention is bad. Trust me: If things are truly going wrong, intervention is a really good thing. The trouble is, sometimes your team will want to intervene before the situation is clearly awful, and that’s where I think it’s all too easy to second-guess afterwards. Because it’s true: If the emergency never develops you don’t know if it would have.

Make the best decision you can with the information you have at the time, and then let it go.

As for pain relief, it’s very personal. I’ve done it about all the ways. With my last I regretted that the first ten minutes after he was out were spent recovering…and other than that it was kind of a wash. (Elation kicked in later…which I had with all three babies, even with my daughter in a NICU.)

If you are the kind of person who wants to experience every gritty moment, go for it. If you want to hypnotize yourself so you can deal with the pain, go for it. If you want an epidural, it’s probably a good idea to understand what it involves and what it doesn’t, but it’s generally pretty low-risk, and…go for it. Every labour is different: Different women, different sizes of baby, different positioning…even different sleep in the nights before.

One thing I will say about pain management: When someone breaks their arm and takes painkillers, I’m not sure they have to deal with people commenting about their choices. It would be nice if women in labour could get the same respect.

3. Bring lip balm.
Even Kate Middleton’s birth plan needs this tip.

Which tips would you share with Kate Middleton?

(Here’s more on planning your baby’s birth!)