The Lemon Tree's top tips for birth prep and navigating deviations

What can you do to maximise achieving the birth you truly desire & deserve? If anything changes what can you do to navigate your journey?

This is exactly why it’s important not to make a ‘birth plan’ & why it’s important to put together ‘Birth Preferences’ instead, to communicate what you do want & what you don’t want. What are your negotiables & what are your non-negotiables?

Visualisation is an incredibly powerful tool, sports people & those with an important goal will often consistently visualise their desires & the results they want to achieve. This can be really powerful to help you achieve the birth experience you want.

Occasionally birth can divert & take a different pathway but that doesn’t necessarily mean it’s negative, perhaps your birth will unfold quicker than expected? Some people like to make several sets of preferences for various situations so that however birth unfolds they feel a sense of control & can ensure their wishes are met.

Here are my top tips for birth prep & to navigate any deviations that birth could take:

• Ensure your birth prep programme aligns with you & the birth you want to achieve – who is teaching you? What are their values? Is the course of programme offering all you need to know?
• Practice practice practice – Practice your breathing techniques, listen to your guided relaxations, affirmations & use deep relaxation techniques. Practice for a little or a lot each day & ask your partner/support person to help you as this will build your confidence in the support they can offer, equally they will feel more confident helping you when using the tools & techniques. Before you know it you will be able to do them without thinking. Time + practice = confidence & results
• Make advance decisions – Where possible make as many decisions about anything that’s big or important. A lot of topics are discussed lightly such as induction but they are really important to know more about so you can truly make informed choices. Check out resources from Dr Sara Wickham, Dr Rachel Reed (Midwife Thinking) & Emma Ashworth Birth Rights. Do you want to hire a doula, change care provider or switch to a different hospital trust? Is your baby breech, does your hospital have a designated breech team? Ensure you have the right support for the birth you want, support that feels right in the place that feels right. These changes can sometimes take a little time
• Stay off your back – Being upright, forward, movement & gravity being on your side. Being upright & moving even if it’s just swaying reduces discomfort, lessens the need for pharmaceutical pain relief, reduces interventions, ensures your baby receives sufficient oxygen & creates more space in the pelvis for your baby to descend easily in an optimal position. Movement also boost endorphins – your emotional & physical discomfort reliever
• Make preferences A, B, & C - If you want to. Some people prefer to make 1 set of preferences & truly focus that’s on/visualise the birth they want. Others prefer to make preferences ABC to prepare for any possible scenarios. This is really personal so think about how your mind works & what will serve you best
• Consider various situations & adapting. Think about various scenarios – What if a room at your chosen birth space isn’t available, how could you make a different space comfortable & oxytocin rich? What if there’s not enough time to fill a pool, what could you do/use instead or how could you make birthing on dry land comfortable? If labour was longer or shorter than you had expected what tools could you use? What if birth deviates from your ideal or your original ‘plan’? Which preferences might you be willing to reconsider & which ones or non negotiable? There’s a time & place for everything. Its doesn’t mean you’ve ‘failed’ if you change your mind about something or take a different path. Everything is YOUR choice. YOUR BODY YOUR BABY/BABIES
• Do your research in advance – Ensure you are equipped with enough information, armed with the knowledge & feel confident to make informed choices. For example, what if you reach 42 weeks & you are feeling pressured into induction? What are your options, have you looked at the evidence?
• What if special circumstances arise? – Sometimes, very rarely, special circumstances arise or you might be thrown a curveball. Do you have the knowledge, skills & confidence to navigate the situation? If yes great, if no, what will help you, who will help you, where could you seek information & support? Would some 1-2-1 support help? Someone you could call on? On the rare occasion special circumstances arise, have a think about how you could navigate quick decision making, what’s really important to you & ensure you discuss this with your birth partner in advance
• Always remember your BRAINS! – BRAINS is the most incredible tool to help you navigate different or unexpected events, manage conversations & decision making. So quick & easy to use in ANY situation. Remember this one in parenthood too...

BRAINS

Benefits

Risks

Alternatives

Instinct/Intuition

Nothing

Space & time to consider your options

• Think about which elements of your preferences you can always hold onto – Regardless of how labour or birth unfolds, there are many aspects of your labour/birthing experience preferences that you can still apply. Such as delayed cord clamping, skin to skin, keeping your environment calm, having the right support & finding out the sex of your baby yourself
• Keep the right hormones flowing – Remember the importance of oxytocin & how helpful endorphins are. What are your personal key oxytocin boosters? Smells, touch, sounds, audio tracks, sensations, people, objects? Keep that relaxation flowing, your mind calm, your body calm & block adrenaline
• Skin to skin – Ensuring your baby is in your arms or with you as soon as possible after they are born. To bond, to feed, to settle & connect. The benefits are endless. Skin to skin helps feed your baby’s microbiome (healthy bacteria for gut & immune health), it helps regulate your baby’s temperature, metabolic rate, heart rate & breathing. Even if your baby needs support in special care, ensuring you can have contact as soon as possible, touch them, talk to them & discussing kangaroo care. Ensure you express this so your care providers support you to hold your baby & have contact as soon as possible. If you are unable to have skin to skin for any reason your partner/baby’s parent is the next best person to do this
• Consent – Be clear about what you do & don’t wish to consent to, in written form & verbally. Ensure your birth partner is aware of your wishes & can advocate for you if needed. If you have any religious beliefs or strong views/values about anything specific, your wishes must be respected. Know your rights – check out the book ‘Your Rights in Pregnancy & Birth’ by AIMS. Dr Sara Wickham books & Emma Ashworth Birth Rights (check out Instagram) are also fantastic for decision making & looking at the evidence to make informed choices surrounding your rights in childbirth
• Checking out what’s on offer – For example if you were planning on a home birth but for some reason you then went to hospital, what are the rooms like, what are the facilities & options available? What are the guidelines & policies at that particular trust? What specific medications do they use? Different pain relief drugsones have different risks & side effects
• Ask for the evidence & question everything– Especially if things change. Even if it has to be a quick decision it’s rare you wont have a moment to ask questions. Ask ALL the questions you want, no matter how silly they might feel. If the question it important to you then it’s important. Ask for the evidence, question everything, ask for patient information leaflets of medications, ask about risks, benefits, ask for the stats! You might be told ‘a risk doubles’ but is that from 0.5% to 1%? Or is it from 40% to 80%? Ensure your care providers are giving you ALL the info you need

 

What might you like to take into consideration, research into or look at on a deeper level? Which topics might be worth exploring? What can you do in advance?

 

Induction – what is it, what are the risks & benefits of each mrthid?

C section (abdominal birth)– how to have a gentle abdominal birth.

Staying in hospital unexpectedly – childcare, work, pets. Who could help if this situation occurred?

Monitoring – why, when, how, do you want it? What are the benefits & risks of the different types?

Reaching 42 weeks & beyond – options, choices & evidence based information to help you make informed choices. Check out the book “In Your Own Time” by Dr Sara Wickham

Comfort measures - (pain relief options). Risks, benefits, choices, pharmaceutical & complementary options. This is really important as medication such as pethadine crosses the placenta & can make your baby drowsy so if you intend to breastfeed it can make things a little more challenging. Research on this topic/the options is key

Interventions – forceps, ventouse, episiotomy, induction, examinations, tests etc. What do you want to avoid? What would you be happy to negotiate on?

Support – who, when, who do you want to do what? Who & what do you need? Who do you want to avoid? Do you want additional support? Do you have the right support?

Transfer to hospital – how could you adapt, when would you consider transferring & why, under what circumstances?

BBA – birth before arrival. If your baby arrived before a healthcare professional arrived at your home or before you could get to your chosen birth place in time? What would you need to do or not do? Who could you call? Check out @freetobirth on Instagram. You might never consider freebirth but it’s always worth researching simply so you are prepared should this situation occur which is out of your control so if your baby arrived quickly you are somewhat prepared

Students midwives/doctors – are you happy for students to be in your space & care for you? Would you rather avoid it or embrace it?

VE’s – vaginal examinations, why are they suggested, what are the risks & benefits of having them, do you want them or not?

Food & drink - what would give you energy? What are your favourite snacks & drinks?

Sounds – music, guided relaxations, quiet, people talking or not, voices, conversations & language that’s used

Lighting – keeping mood, calm lighting wherever you are, what could you buy or use? How could you adapt your space if things change?

Smells – huge anchors & help release oxytocin & endorphins. Aromatherapy on a hanky anywhere you go, anything you wish to avoid?

Positions & movement – play about with positions in advance, check out biomechanics & how you can support your labour/birth

Tools – birth ball, peanut ball, rebozo scarf, birth stool, hypnobirthing, anchors, heat, cool

Alternative therapies – acupuncture, aromatherapy, homeopathy

Water – birth pool, bath, shower, a jug of water gently poured over your bump or back, to cool you with a wet flannel

Time – time limits, restrictions, birth takes as long as birth takes. Removing time can help you relax & just follow what your body & baby are telling you

Finding out the sex of your baby – if you don’t know already repeatedly tell your care providers how important this moment is. Regardless of how birth unfolds this is still your magical moment

Placenta – physiological or managed 3^rd stage? Risks & benefits of both.What you would like to do with your placenta afterwards, what are your choices & options?

Delayed cord clamping – waiting for white, optimal cord clamping, when & why this is important

Vitamin K – do you want to give it, not give it, why is it given & if you do want to give it what are the options

How you want to feed your baby – if you are formula feeding how can you do so responsively? If you are breastfeeding have you booked a class/workshop to prepare you in advance? Where is there local feeding support in your area?

Vaginal swabbing – if you are planning an abdominal birth have you considered it, researched microbiome?

 

Top tip – Print a few copies of your preferences or a few of each version if you choose to create more than 1. Ensure all care providers have a copy, your birth partner has a copy & you have spares. Laminating them is great to keep them pristine