Topic Overview

Pregnant women face lots of decisions about childbirth—what tests to have during pregnancy, where to give birth, how to manage pain. But sometimes those decisions are made for women without their opinions and guidance.

You are more likely to have the pregnancy and childbirth experience that you want if you and your doctor or nurse-midwife work as partners. This will help you get the care that you want. And you will be less likely to have tests and procedures that you don’t want.

But for you to reach that goal, your doctor or midwife needs to know your values and preferences.

Decide what matters to you

Decisions about pregnancy and childbirth are very personal. Different women and their partners will make different choices. Your decisions may be based on many things, including your religion, fears, likes, and dislikes.

Some of the choices you make may include:

• Whether to have tests for birth defects.
• Where to give birth.
• Who to have as your support person (or persons) in labor and delivery. This could be your partner, a family member, a friend, or a doula.
• How to manage pain (with medicine, other measures, or both).
• Whether you will breastfeed.

Some of these decisions are ones that you may make right away. Others may take more time to research and think about.

Create a birth plan

A birth plan is one way to start the conversation with your doctor or midwife. It’s usually a written document that states your wishes for labor and delivery. The birth might not go as you hope. But the plan is an ideal picture of what you would like to happen. You can give copies of it to your doctor or midwife, to your support person, and to the hospital or birthing center.

Research your choices

Learn as much as you can about the tests, procedures, and other things you may go through during childbirth. You can look online for health information, or you can ask your doctor or hospital for information about their policies and procedures. You and your partner may be able to take a tour of birthing centers and hospitals.

For each choice you are thinking about, go through it with your doctor or midwife. Ask if he or she thinks that it would be a good idea or not, and why.

Think of the word BRAIN to help you work through each decision. Ask yourself:

• What are the Benefits for me and my baby?
• What are the Risks for me and my baby?
• What are the Alternatives?
• What does my Intuition (or gut feeling) tell me is right?
• What happens if I do Nothing? Can I wait to make this decision?

Talk to your doctor or midwife

It can be hard sometimes for people to talk to their doctor. After all, a doctor is the expert on medicine. But you are the expert on you. You both want the same thing: a healthy baby and mom.

Early in your pregnancy, tell your doctor or midwife how involved you want to be in your care. Do you want to help make most decisions, or just the ones that are most important to you? If you feel strongly about certain types of care, let your doctor or midwife know that.

Try to be flexible

As in any relationship, you and your doctor or midwife may have different views at times. You may be advised against something you want. For example, if you have a high-risk pregnancy, some of your choices may not be a good idea for safety.

Every birth is different. There is no way to know if childbirth will go the way you plan it. Your health or the baby’s could change. So try to be flexible about your wishes.

If an emergency arises during labor or delivery, your doctor has a responsibility to ensure the safety of you and your baby. You may still share in decisions, but your choices may be limited.