So much planning goes into having a baby. Many expectant parents learn, pretty soon after that positive test, that there are so many choices one needs to make in order to have the birth they want. Books, websites, social media groups and pages, and blogs are often recommended by friends and family, and many of those recommendations are very informative. Twelve years as a Doula and 180+ births in, I’ve narrowed down 6 tips that families can follow that will give them the best chances at a healthy birth outcome.

Before getting into those in detail, it’s important to define what a healthy birth, as well as what a healthy pregnancy or even postpartum is. It’s important to define for yourself what ‘healthy’ means because one person’s definition can vary from another’s. While of course a healthy mother/birthing parent and child can be defined physically, the reason for reflecting on what ‘healthy’ means to an individual has to do with one’s feelings, thoughts and views of birth, both before and after the birth itself.

To one mother or birthing parent, healthy can mean an unmedicated vaginal birth, while to another it could mean a birth with pain medication. For one it can be a home birth, for another a hospital birth, and yet another a birth center birth. Midwifery care might best suit one person, while obstetrical care is better suited for someone else. Regardless of the above, all people should feel heard, supported, valued and respected in their pregnancies, births and postpartum time. When they aren’t, those negative feelings and experiences can affect a person for a lifetime.

Defining ‘healthy’ is personal. ‘Healthy’ is wide ranging when you get down to it and no two mothers or birthing parents should be concerned with another person’s definition. Your best friend or sister or nextdoor neighbor’s choices that differ from yours does not make your choices wrong, or even right. Instead, your choices are right for you, and their choices are right for them.

Now that we’ve gotten all that out of the way, let’s talk about those tips!

Tip #1 - Choosing the right care provider

Are your birth visions in-line with how your care provider practices? Are you best suited to OB care or Midwifery care, and what do you know about the differences of these models of care?

Many times, I’ve come across clients who tell me that they love their Gynecologist, and so they stayed with them for obstetrical care (as the majority of gynecologists are also obstetricians) only to later discover they aren’t seeing eye to eye about the management of their upcoming birth. It’s important to understand that while both professions work with reproductive organs, these are two different fields of medicine. You might really see eye to eye with your GYN, or even your midwife for that matter (as midwives also provide well-woman care just like gynecologists) when it comes to your gynecological care, but do you also see birth in the same ways?

The only way to know this is to know what you think about birth, what you want out of your birth and to ask questions of your care provider in the beginning of your pregnancy or before you even get pregnant if this is something you are planning. OB appointments are typically very quick, and there are many times pregnant people are seeing nurses or nurse practitioners before an OB. Midwifery appointments typically last longer. Ask the questions! Ask them to spend time with you. Find out in the beginning if your visions and thoughts about birth are compatible, because it’s much easier to change care providers earlier on than after 30 or 34 weeks when those conversations and ‘birth planning’ typically come up with many OBs.

Tip #2- Choosing the right venue

Which hospital is in-line with what you are looking for? Is the Birth center best for your needs? How about homebirth options?

Shop around and attend info sessions! Just because you live down the road from a hospital that offers maternity care doesn’t mean it’s the only option for you. For instance, there is only one hospital in Indianapolis that supports water birth (IU Methodist) so if this is something that is important to you, an extra 20 minutes added on to your drive to the birth venue might be very worth it! Other hospitals may allow for water as a labor tool, but don’t support birthing in the water…and that might be perfect for you. Explore which hospitals have tubs!

Maybe you aren’t sure about a homebirth. Parts of it sound like what you want, but you have a nervous partner. If even after an info session with a few of our wonderful homebirth practices around town it isn’t the right choice for you, explore the option of a birth center. If you are wanting a VBAC, and yet are not looking for a hospital birth, talk to homebirth midwives and ask about their VBAC care. Maybe you are not wanting an epidural for pain relief and aren’t a fan of hydrotherapy (water). However, nitrous gas sounds very interesting to you! Explore which hospitals have this as an option. You want an unmedicated, vaginal hospital birth. Which hospitals have a great reputation for a nursing staff that loves natural birth?

The right venue combined with the right care provider can often be a serious key to your healthy birth outcome. But wait… that’s only 2 tips!

Tip #3- Take Birth Classes

Hospital classes, private childbirth classes, Calm Birth, Bradley, Hypnobirthing, Hypnobabies, Birth Bootcamp…

There are many options available! Explore the various classes available in your area and have a chat with the instructor. Read the websites, ask other parents which classes they took, what they liked, but also what they didn’t like and why. You might even take a few classes should they offer different aspects that are important to you. At CCD, we break up our classes into specific areas so that clients can customize a package that suits their needs!

Bonus tip - Find out who is teaching these classes, even ones through a hospital. When were they were certified and have they have kept up their certifications? Recently, I heard of a provider in a local hospital that is still teaching the outdated breathing patterns and techniques that Lamaze developed in the 1960s but stopped teaching in the 1980s! In my opinion there is no excuse for this. As birth and education professionals, it’s our responsibility to stay up to date.

Tip #3 - Chiropractic care

Want a potentially faster, easier birth? Visit a chiropractor who specializes in pregnancy to help assist in pelvic alignment and optimal fetal positioning!

Back when I worked as a midwifery assistant in a local homebirth practice, we had a chiropractor who rented one of the rooms in the office. Some of the midwifery clients would choose to see the chiropractor after their prenatal visits. When we started to notice that all the clients who had chiropractic care were having faster, easier births than the ones that didn’t receive such care, the midwife then started to highly recommend that all clients get adjusted regularly! So now, when I sit down with a new client my question isn’t, “Do you see a chiropractor?” but instead “Who is your chiropractor?”

Your body is expanding, of course, to accommodate the growing baby. Things are shifting, your pelvis included. Relaxin, a hormone that allows all of this change in the pelvic ligaments, is our friend, however things can get out of alignment in the body creating breech or posterior positions, never mind sciatic nerve pain and the famous “lightning crotch” pain… Trust me. The chiropractor is your friend. Go make those appointments!

Tip #5- Take an active role in decision-making

Making evidence-based, informed decisions and discussing with your care provider during your pregnancy is key. Of course, your care provider is the medical professional. You’ve hired them because you hopefully feel safe, heard and supported in their care. Yet, you still have the right to be a part of the decisions that are made for you and your baby.

The Postpartum Contraceptive Access Initiative explains it well:

“Decision making is a continuum with the obstetrician–gynecologist or other health care provider leading the discussion on one end, and with patients making the decision on the other end. Although medical knowledge is tipped toward the obstetrician–gynecologist or other health care provider end of the continuum, in shared medical decision making, a middle ground is sought that incorporates sound medical care and a patient’s personal preferences.

Patient-centered goals should also be considered in the decision-making process. However, providers should share their clinical judgment on best choices when they believe a clear benefit exists.”

Here is how ACOG (the America College of Obstetricians and Gynecologists) states it to their members:

Actively involving patients in the planning of health services is recommended as a means of improving the quality of care. This can increase patient engagement and reduce risk resulting in improved outcomes, satisfaction, and treatment adherence.

The foundation for a positive physician–patient interaction is formed by establishing a partnership and creating a meaningful dialogue. Accomplishing this in a brief office visit may be challenging, but with adequate planning these encounters can be structured in a positive way. Improving communication with patients, listening to their concerns, and facilitating active partnerships should be central to any patient safety strategy (1). Involving patients in the planning of health services also is recommended as a means of improving the quality of care (2). Additionally, several studies indicate that physician–patient communication problems may account for an increase in medical professional liability actions (3, 4).

The first time to have these conversations isn’t while you are in labor (and anyway, your OB just might not be in the hospital while you are laboring). You have enough to focus on then! Instead, use good resources, and bring at least three questions to every prenatal visit.

Recommended resources: Evidence-Based Birth, Cochrane Database, “The Thinking Woman’s Guide to a Better Birth”, Improving Birth, Birth Monopoly, Birth Kweens podcast, ICAN

And finally, Tip #6 - Hire a CCD Doula… like a GPS for Birth!

Doulas are not only for natural birth! Doulas can assist and affect all types of births, providing education, information, emotional support for mother/birthing parent and partner.

That said, we aren’t making those choices for you. Instead, we help in making informed choices. In order to make an informed choice, parents need to be exposed to all of the options and information available on the topic at hand. Once that choice or decision is made, your CCD doula will support you in that choice, without bias. This is, after all, your birth!

Other ways your CCD doula can help:

· Doulas provide encouragement and support, even in those stressful moments.

· Doulas don't replace partners but support them too!

· Doulas provide continuous support through pregnancy, birth and postpartum.

· Mothers are 60% less likely to request epidurals and 50% less likely to have a cesarean

· Those who do use medication or have surgical births greatly benefit from needed support

· Doulas help ease parents into life with a newborn!

…plus, if the above tips seem daunting or overwhelming, your CCD doula can make navigating all this so much easier.

While I think we are skilled in assisting those who want a natural birth experience, we really shine when the unexpected arises and there are choices to be made. You’ve got us 24/7 from the moment we are hired. And we’ll be there at 3 o’clock in the morning, for the long haul, no matter what, until we see you meet that baby.

Take a look at our Birth Doulas page as well as our Client Testimonial page and consider attending a Meet the Doulas Night or scheduling a free consultation on our website to learn more.

A healthy birth outcome..with a CCD Doula