Everything about creating a birth plan and taking charge of your birth experience.
As you’re considering your labor and delivery options, you may wonder what “low-intervention” means.
“Low-intervention in the labor and birth process promotes the belief that childbirth is a natural, healthy, physiologic process,” said Alexandra Speros White, CNM, FNP, a midwife with Vanderbilt Midwives. “Because every labor and birth is different, taking a low-intervention approach requires that providers and support teams view each woman as an individual and support her specific needs throughout the process.”
Both the American College of Nurse-Midwives and The American College of Obstetrics and Gynecologists support low-intervention labor practices.
Making a birth plan
“The most important thing that a woman can do is find a provider who supports her autonomy and makes decisions with her, not for her,” Speros White said. “Enough emphasis cannot be placed on good communication and trust in the patient-provider relationship.”
Creating a birth plan with your provider’s guidance, or for her to review, helps communication, which is important for creating trust in this working relationship. It also sets the tone that you are at the center of all decision-making.
A birth plan is a document the patient creates that includes goals and visions for your delivery. You discuss it with your midwife in the months leading up to your due date. You should also have it with you when you are in labor. The birth plan helps guide you, your support team and your care providers through the process.
“Writing a birth plan gives women a time to think, ‘OK, so this is what I think I’m going to need,’ ” Speros White said. “It just sets expectations for everyone.” You can use various apps for making a birth plan or talk to your care provider for details.
She suggested that you think of the plan as a philosophy or a general roadmap – not a rigid set of rules. “Low-intervention doesn’t mean no intervention,” Speros White explained. “It means no unnecessary intervention, and all of that looks very different for every woman.”
Options regarding low-intervention birth plans
Remaining at home during early labor while keeping in touch with your care provider is an option if you have a low-risk pregnancy. “If a woman wants low-intervention,” Speros White said, “then trying to labor at home for as long as she can, or feels comfortable, helps a lot with decreasing unnecessary intervention.”
Fetal monitoring – using technology to check on the baby’s well-being – off and on during labor is also safe for low-risk pregnancies. This intermittent monitoring helps keep you more mobile during labor, which can help labor along and may keep you more comfortable.
Moving and positioning yourself in a way that is natural to you is all part of low-intervention labor. “You can be sitting on a birthing ball, walking, changing positions,” Speros White said. Birthing tubs also offer therapeutic options for managing pain and discomfort. During labor and delivery, you can choose your breathing patterns and opt for pushing as it feels natural.
Ultimately, low-intervention labor is about managing the process intuitively and in a way that feels right for you. There aren’t any hard rules about it.
A doula can also support you through low-intervention labor. A doula will be familiar with your birth plan, help communication between you and your support team and support you and your partner during labor and birth.
Those giving birth at the Vanderbilt Birth Center or Vanderbilt University Hospital can hire their own doula, or request a volunteer doula
when they’re admitted during labor. (Patients are not able to meet with the volunteer on-call doula ahead of labor, and the volunteer doula may not be able to stay for the entire labor.)
When to start creating your birth plan
You can start thinking about your birth plan at any point in your pregnancy. Attend childbirth education classes to learn more about options and see what feels right to you.
Vanderbilt midwives provide information and guidance at your first pregnancy clinic visit. They review it in the third trimester.
“The best thing that a woman’s support team can do is truly support her and her baby – as appropriate and healthy, of course – in her decisions,” Speros White said.
Looking ahead to delivery
Vanderbilt Midwives have a combined 250 years of experience in caring for women throughout their lives. We educate and empower women to make the best decisions for their own health and that of their babies. Our midwives can help you have the birth you desire. We also have access to OB-GYNs and Vanderbilt Health’s world-class neonatal care, should you or your baby need it.
