What I can promise you about your birth
Updated: Oct 9
I can't promise you the birth you want.
You might be surprised to hear me say that I can't promise you that you will give birth at home, that you won't need to transfer into hospital, that you won't want pain relief, that you won't need an intervention or that everything will unfold exactly as you pictured it when we first sat down together and talked about your hopes for birth.
I'm a midwife. I'm not God.
And actually, I think it's really important that I'm honest about that. Because however much I believe in physiological birth, however much experience I have, however well I know you and however much preparation we do together, there are parts of birth that neither you nor I can control.
But that doesn't mean you are powerless either.
Your choices matter, but they aren't a guarantee
There can sometimes be a strange all-or-nothing conversation around birth. Either we talk as though you can plan the whole thing perfectly, make all the "right" choices and get the birth you wanted at the end of it, or we swing completely the other way and say, "Well, birth is unpredictable. You just have to see what happens."
I don't believe either of those things.
Your choices absolutely matter.
Choosing where you plan to give birth matters. Choosing who you want caring for you matters. Choosing an independent midwife, or choosing to have a doula alongside you, can change the environment you give birth in and the support available to you. Learning about birth, understanding your options, thinking about what makes you feel safe and making decisions about your care all matter.
Those things can influence your birth. They just can't guarantee it.
And I think that distinction is really important, because otherwise we can inadvertently turn birth into some kind of test. If you prepare enough, advocate hard enough, relax enough, hire the right people and make the right choices, then you will get the birth you planned. And if you don't, somewhere along the line you must have done something wrong.
I don't believe that.
Sometimes you can make thoughtful, informed decisions and something happens that you couldn't have predicted. Sometimes your body or your baby does something that wasn't part of the plan. Sometimes new information becomes available and you decide, with that new information in front of you, that you want to do something differently.
That doesn't mean your preparation was pointless. It doesn't mean your decisions didn't matter. And it certainly doesn't mean you failed.
There has to be some surrender
Surrender is something I talk about quite a lot with my clients.
Birth asks a lot of us in that respect. You can prepare for it. You can create the right environment. You can learn how your body works and think carefully about who you want around you. But at some point, you also have to let yourself go on the journey.
Trying to control every contraction, every hour, every sensation and every possible outcome isn't particularly conducive to labour. There comes a point where you need to stop trying to manage birth and allow yourself to actually be in it.
For my Christian clients, there can be another dimension to that surrender too. We can prepare wisely and make decisions carefully, but ultimately we know that we are not in control of everything that happens to us. There are things we have to entrust to God.
But surrender does not mean surrendering your autonomy.
It doesn't mean becoming passive. It doesn't mean that because labour has taken an unexpected turn, you hand over all decision-making to whoever happens to be standing beside you. It doesn't mean your birth preferences suddenly become irrelevant because circumstances have changed.
You can surrender to the fact that you don't know exactly how your birth is going to unfold while still being an active participant in your own care.
You can ask questions. You can say yes or no or ask for more time. You can also change your mind.
You can accept that something isn't happening in quite the way you hoped and still have preferences about what happens next.
And this is where I think having somebody who really knows you becomes incredibly important.
So what can I promise you?
I can't promise you an outcome. But I can take the time to know you.
By the time you give birth, I don't just want to know what you've written on your birth plan. I want to know why those things are there.
I want to know what you're excited about and what you're frightened of. I want to know what happened last time, if you've given birth before, and how that has shaped what you want this time. I want to know which things are really important to you and which things you would be more comfortable changing if circumstances called for it.
And perhaps just as importantly, I want to know what you really don't want.
Because if something changes during your birth, that knowledge doesn't suddenly become irrelevant. In many ways, that's when it becomes even more important.
If plan A is no longer the plan, the question shouldn't simply become, "Right, what do we normally do now?" It should still be, "What matters to you?" What options do we have? What information do you need? Of the things that mattered to you before, which can we still protect? If we do need to change course, how can we do that in a way that still makes you feel heard, involved and safe?
That is something I can offer you, regardless of how your birth unfolds.
Continuity isn't only valuable when everything goes beautifully
Thankfully, it is actually relatively rare in my practice for a birth to take a significant turn away from what someone had hoped for.
But rare isn't the same as never, and I don't want to pretend otherwise.
Sometimes something happens that neither of us wanted.
And I think this is one of the places where continuity of care really comes into its own.
Because you aren't suddenly having to explain yourself from scratch to somebody who has never met you. You aren't trying to communicate the significance of something in the middle of a situation where you're already tired, frightened or disappointed. I'm not reading a few lines in your notes and trying to work out what kind of person you are.
I know you.
I know what we talked about when we were sitting together weeks or months before. I know what you were hoping for. I know why it mattered.
And if the birth doesn't happen in the way you hoped, I'm still there afterwards too.
You don't suddenly become somebody else's problem because the birth didn't go to plan. We can talk about what happened. We can make space for how you feel about it. We can celebrate the parts that were wonderful without pretending the difficult parts weren't difficult. And if you are disappointed or grieving something you had really hoped for, you don't have to tidy those feelings away and tell me that you're just grateful that your baby is here.
Maybe that is one of the biggest things I can promise you.
I can't promise you exactly what will happen when you give birth. I can't control your body, your baby or every circumstance that might arise, and I would never want to sell you the idea that hiring me somehow gives me that power.
What I can promise is that your choices will matter. Your voice will matter. I will know what is important to you, and if circumstances change, I won't forget the person we were making those plans for in the first place.
And whatever journey your birth takes us on, I will still be there.
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