The COVID-19 pandemic has been filled with uncertainty, change and adaptation. For pregnant women, there has been even more stress: prenatal visits are canceled or moved to telehealth sessions, hospitals adopt strict visitor policies, and family members can no longer travel to help after the baby is born. A season that should be filled with excitement and loved ones now might involve social distancing and isolation.
But I want you to know that it is still very possible to have a beautiful birth, and birth plans are still relevant.
Before we examine what labor and delivery might look like during a pandemic, let's take a moment to get grounded. Take a deep breath, relax your body and hug your belly. Feel the baby growing inside of you and imagine them in your arms. If anxiety tries to creep back in, come back to picturing that moment—your baby in your arms, safe and sound.
Now, let's chat about the process of getting them here.
I am a doula. When I meet with a client to discuss their birth plan, I always the following questions:
- What's important to you?
- Who should be a part of the birth process? Who has a calming presence?
- What does your ideal birth setting look like? Think about aspects like lighting, scents, and baths or showers.
- Do you feel safer laboring as long as possible at home or in a clinical setting?
I remind women that your answers to these questions may change as labor progresses. For example, you may love the smell of lavender today but hate it in labor. You may be modest now but prefer to be completely naked during labor. You may plan for an unmedicated birth but decide in labor to get an epidural.
A birth plan isn't a set of rules; it's a helpful guide for your support team and provider. It's also an opportunity to research evidence-based practices on fetal monitoring, labor positions, induction, interventions, newborn medications and more.
(Psst: All of this is covered in The Motherly Guide to Becoming Mama! Order your copy today.)
Developing a birth plan can help you have thoughtful conversations with your provider before your birth. Remember that if you find that your provider does not support the type of birth you are envisioning, it may be possible to switch providers or birthing environments.
During this pandemic, women still have the option to create birth plans, research and discuss options. My hope is that women do not view this pandemic as a form of entrapment, but as an opportunity for education.
Here are 9 considerations to keep in mind when writing a birth plan during the COVID-19 pandemic:
1. Find out your birthing place's policies
Check the website or contact your hospital to find their current visitor policy. Ask if your partner is allowed to stay with you through the delivery process and during your postpartum stay. If so, are they allowed to come and go, or will they need to stay put the whole time? If yes, consider packing more items for them in your birth bag.
2. Ask about discharge plans
Ask your provider and pediatrician when they are comfortable discharging you and your baby after delivery. Many women want to leave as soon as it's safe to do so—though talk to your provider about what options will be safest for you.
3. Plan your route
Ask about the hospital entrance when you arrive. Some hospitals are having you enter through the emergency department while others have a separate entrance.
4. Look up sample birth plans online
If you have a doula, review some of their samples. Draft your plan, keeping in mind the factors that are important to you. Review it in detail with your provider and make sure they sign off on the plan or explain any concerns. Your partner will be your greatest advocate at the hospital, so make sure they understand every point in detail.
5. Build your support team
Your support team is critical. One of the hardest changes during COVID-19 is the lack of physical support available to laboring moms. Know that a doula can still be of great value to you virtually, both prenatally and during labor.
If you plan to have a doula or a family member present, think about how they can provide virtual support (FaceTime or Zoom), and put those details in your birth plan. A calming, familiar voice can be a tremendous help.
Just because I'm not allowed to be at the hospital with my clients right now, doesn't mean that my role is eliminated. It's changed, but it's just as important as it's always been. Women need to be supported and advocated for through this incredibly delicate and important process.
6. Remember that the nursing staff at the hospital are also there to support you
Go over your birth plan with your nurse when you arrive and invite them to be a part of your support team. Let them know how much you need and appreciate their help in creating your birth environment and outcomes.
7. Consider all your options
If you're concerned about going to a hospital, or if you aren't happy with some of the answers you receive when researching current hospital policies, you may want to consider an out-of-hospital birth. Many women are switching to birthing centers or home births with midwives. If this is something you're thinking about, research options in your area and interview providers to find a good fit and someone you trust. Remember that home births and birth centers births are only safe for people having low-risk pregnancies; your providers can help you determine if you are a good candidate.
8. Learn about the system and the process
Now, perhaps more than ever, it's critical that you understand the birthing system you are stepping into. Be sure to do your homework so you can advocate for evidence-based care for yourself and your baby.
9. Consider your motivations
Are you making decisions out of fear or in confidence?
For example, are you considering an induction or scheduled C-section so that you can try to control the timing of your labor? Are you choosing an in or out-of-hospital birth simply because you're afraid of the alternative? If these decisions are driven by fear, they may not result in the best possible outcomes.
Instead, make decisions based on evidence and the guidance of your provider.
While we are walking through uncharted territory, one thing has not changed: You are incredibly strong and capable of bringing new life into the world. No matter how many people are in the room with you as you give birth, you are not alone. There are so many people who love and believe in you, and you have everything you need to get through this.