Making Decisions During Labour

Guess what? Your birth experience is YOUR BIRTH experience. And while we can’t always plan how your baby is born- or for how your plans may have to change to make that happen- it’s important to realize that the only one with the final say on decisions is YOU.

Sharing your ideas, questions, and worries with your care team helps you to feel more in control and helps your team understand your goals and preferences. Research has shown us that when pregnant people lead the decision-making process, they feel more positively about the outcomes of their labour- even if things didn’t go the way they planned. As birth support experts, we’ve seen it happen more than once: when your voice is heard, your questions are answered, and your decisions are clear, you feel happier, safer, and more confident (shocking, right?). How you’re treated during labour can even effect your physical recovery, the way you parent your baby, and even your self-esteem and confidence during future pregnancies.

Making a decision during labour can be really overwhelming for a few reasons:

1. You’re not thinking straight. Like, at all. When active labour begins, your body is flooded with important hormones like oxytocin, adrenaline, and endorphins. Their job is to help your body keep labour moving, but they can also create an altered state of consciousness. You may feel cloudy, fuzzy, “checked out”, or just unable to focus and/or think rationally. You’re in labour-land!
2. Your stress levels are peaked. Even though you’re trying really hard to stay calm and relaxed, labour is intense. Your body is doing some major hard work, and your mind is busy managing your racing thoughts, your fears, and on staying focused. Your partner may be feeling nervous (which we know you can totally pick up on), and being in an unfamiliar place with unfamiliar people around you can add to your stress.
3. You may feel pressure to make a decision. The doctors, midwives, and nurses on your care team want you to have a healthy, safe delivery. Sometimes, your care team will make a suggestion that you may not understand or that you feel concerned about. When these decisions are time-sensitive, you may feel pressure to make a decision even when you don’t feel like you truly understand what your choices are.

 

Sometimes, communicating with your care team can feel awkward or uncomfortable. Some people feel anxious about potential conflict with their doctor, which may make decision-making even more difficult. Communication is a two-way street, and sometimes you just need some help to get things moving. Our doulas are dedicated to helping you feel great about your birth. When a decision needs to be made, this is how we help our clients do it.

 

Making decisions during labour and birth is easier when you know what questions to ask.

 

Here’s how this might play out during your labour:

Your care provider: “Your labour has been slowing down over the last two hours and your contractions aren’t coming as frequently as they were earlier. We’d like to give you some oxytocin to encourage your labour to continue.”

You: “Is this an emergency? Can you tell me why you’re suggesting this and the benefits?”

Care provider: “No, you and the baby are doing just fine. There’s nothing wrong, we just want to make sure that your labour continues and that you or the baby don’t experience any complications from a prolonged labour. The benefits are that labour moves along and you hold your baby sooner!”

You: “What are the risks to oxytocin?”

Care provider: “Sometimes, oxytocin can cause such strong contractions that your baby becomes stressed by them. If this happens, we may need to turn the oxytocin off.”

You: “If we start oxytocin, what else do we need to do?”

Care provider: “Oxytocin is given through an IV, so we’ll need to start one of those. We’ll also place monitors on your belly to watch your contractions and the baby’s heart rate. Also, you may want to consider an epidural to manage the intensity of stronger contractions.”

You: “Can we need to do this right now? Can we wait a bit?”

Care provider: “Well, no, we don’t need to start oxytocin right now. You can continue labouring without oxytocin, and we can discuss this again in an hour, or sooner if something changes.”

You: “Can we have a few minutes alone to discuss this?”

Care provider: “Yes, absolutely. Let us know if you have any questions!”

Birth is unpredictable. There isn’t always time to ask all of the questions you might have about what’s being suggested to you- but you can always ask, “is this an emergency?”. Remember that it’s okay to insist that the focus and attention of the room be on you and your experience. This is your birth!