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Different birth plans please.

Hmm, I’m not sure I like birth plans…

I’m all for planning, and I’m a big fan of thinking through a situation and imagining how you might respond in various scenarios. This is an excellent coping strategy for anticipating an event and gaining confidence in one’s own ability to rise to a challenge.

But I have a problem when every Tom Dick and Sally becomes a child expert and feels compelled to shove their view on how to deliver a child on to another. And the reason I have this problem is simple. The stress of worrying whether or not a mother is doing the right thing is far more detrimental to the health of the child than any of the methods contested.

During pregnancy and after childbirth, women are at more risk of metal health problems than at any other time in their life. Women who have never experienced mental health issues and women with pre-existing conditions alike; pregnancy causes significant mental health problems in 1 in 7 women. This can have a significant impact on the child and the mother.

Reviewing the research on perinatal mental health reveals that there are certain factors that make things like depression, anxiety and PTSD more common during pregnancy and after birth. One of the major factors is too rigid an adherence to a birth plan.

The world and his wife will pipe up with how they think you should bear, feed and care for your child. Yet the expectations put upon you by others causes stress and this stress is much more detrimental to the infant and mother than which method of delivery, pain management or feeding you do or don’t adhere to.

So do plan, but plan differently:

  • Plan how you will encompass your new role of being a mother or your role of being a mother to more children, and how this fits with your existing roles, identity and commitments. Research shows this has a far greater positive impact on a child that how it was delivered or whether it was fed breast milk or formula. Asking yourself what sort of mother you want to be and not want to be and reflecting on where these ideas come from is associated with a more positive pregnancy and better mental health in the early weeks and months.
  • When you talk about your birth plan with your Obstetrician, talk to him or her about how you will tolerate the fact that the process of birth is by its very nature unpredictable. Whilst women can usefully provide a general outline for what they would wish their care to be, there is a need for flexibility about what care may actually be required in terms of analgesic or mode of delivery, and a willingness to adapt to this situation.
  • Don’t expect to be completely calm and in control. Setting high expectations as to how you might behave has potential to generate distress and dissatisfaction and a sense of failure.

Here’s what matters:

  • Ensuring you have social support (from partner, family or friends)
  • Trusting and being supported by the person delivering your baby
  • Positive experience of midwives and those attending to you during and immediately after the birth

Here’s what matters less:

  • How you choose to manage pain
  • How you choose to deliver
  • Whether the baby receives breast milk or formula

So hold your head high. Do what you would like, and prepare to end up doing something completely different. Not stressing about it is far more important to the health of your infant and yourself than the particular method of feeding, delivery or pain management you end up going for.

Dr. Marie Thompson, Clinical Psychologist 

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