We’ve previously featured posts from the downright lovely Lucy S before, and today she’s talking us through her experiences of birth mapping. For all you mamas-to-be it’s a must-read.
I’ve always liked maps. I like to trace the routes and contour lines, looking for rivers and landmarks. I linger on pages I know, and places I would love to go. A-Level Geography, an MA thesis focused on the placement of ancient tombs in the Tuscan landscape, a job in travel: I suppose it was inevitable that I would turn to a map when a plan failed me, right when I needed it most.
In my first pregnancy, I excitedly filled out the NHS birth plan form. I diligently printed it, I stuffed it full of all my dreams for how my labour was going to go and I stuck it on the front of my notes, so it was unmissable. Our baby would arrive in our local birth centre, preferably in the warm water of the huge birth pool, gathered joyfully into my arms, my husband telling me if we had a daughter or a son. None of that happened. My waters began to trickle at 37+2, but my body resolutely refused to go into labour. The medical staff were firm: my birth plan wasn’t going to happen. The pessary induction failed, and failed in style. After 48 hours of hypercontractions in response to it. I was done. I’d lost out on my water birth already, so I signed up for the epidural I’d said I didn’t want. It went badly wrong, although I’d find that out later. At 9cm dilated, it wore off again, then was whacked up so high I could barely push. The forceps came out. The scalpel flashed.
And finally, finally, some vestige of the plan came together at the last minute. My husband told me our little girl was here. She was placed on my stomach. He cut her cord. She latched on while the stitches went in. We salvaged something precious out of the dregs of our plan, and I’m thankful for that. If you don’t ask, you don’t get. The only good memories from her birth are thanks to the plan- if we’d just gone with the flow, as so many people told me to, then we’d have lost that. Those moments kept me going through the following days, when the damage done became clear.
But oh, the grief. Why had my stupid body done that? Why didn’t it go to plan? Why didn’t it work? I was angry, and sad, and frightened. When I fell pregnant again, I had nightmares about it all happening in exactly the same way, the inevitable unfolding of events. How could I deal with this fear, and how could I plan for my second birth when I knew two painful truths: that plans often don’t work out, but that they are also the safeguard that can protect what you hold most precious.
I turned to the maps.
When you start thinking about a journey, or you start on a long drive, you have an idea of what route you want to take, and how you’d like to get there. I might want to head east and north to my parents’ place, heading onto the A303. But maybe there’s a diversion- an accident. Roadworks. Cows on the road. Should I take the M5 instead? Maybe the bloody M3 is closed again (can you tell that’s happened for real?) Maybe before I even get in the car there’s an issue: I know I can take a train, or call for roadside assistance. All these variations on the journey, all these different plans and routes, mapped out alongside one another, but the destination is the same.
Back to birth. My destination? The same as yours, if you’re pregnant, what we all hope for: a safe delivery into parenthood, for everyone involved.
So how about the route? How can you map out the different ways to get to your destination? For me, there were three key parts making up this “birth map”: Yes, No, and If.
Birth Mapping: The Yes Route
The Yes route was made up of essentials, like my husband as my birth partner, but also contained much of the ideals from my first birth plan. It flagged up that I was using hypnobirthing techniques. It stated that I was happy to have the injection to help me deliver the placenta and that baby should have the Vitamin K jab. It told anyone reading it clearly that I wanted skin to skin, my husband to cut the cord, and first breastfeed as soon as possible.
Birth Mapping: The No Route
The No route was composed of my fears, what I knew I did not want, and why. I did not want anyone visibly watching the clock. I knew I did not want another pessary induction, or another epidural. I did not want a coached second stage, to have people in my face shouting at me. I added in why I did not want these things- why these roads were closed to me. Previous dural puncture. Previous trauma. Using the terms, letting the team know why I was writing these options out.
Birth Mapping: The If Routes
The If roads wove between these two major routes. If the pool was unavailable, I was happy to labour on land but wanted to stay active. If I needed an epidural, changed my mind and asked for one, or needed a section, I wanted the senior anaesthetist available thanks to my history of damage to the spinal cord. If I needed an induction, I would go straight to the drip and skip the pessary. If I haemorrhaged or needed stitching in theatre, my husband was to stay with the baby. If the baby was unwell, he was to go with the baby to neonatal. In many ways, this was the most important section in my preparation for birth. It helped me discover all the different options and envision all the different scenarios, talk them through with my husband and decide what we wanted to do.
On my map, I had the route I wanted to take, the route I wanted to avoid, and the winding lanes between and across them, the diversions across unknown country. I let go of my fear: I felt prepared, and I felt in control no matter what happened. If my labour didn’t start again and I needed another induction, it was ok- like taking the train instead of the car, I knew how I would manage. It all fitted onto one page of A4, laid out like a spider diagram. A green bubble for yes, a red bubble for no, and colour codes for the “IF” routes weaving around them. Geography, we can’t stop colouring in.
Your route might be different. You might know that your YES is a planned section- but what other YESs do you want- can you have music? Can you choose timings? Who do you want with you? What about your Nos? You might know you don’t want to breastfeed, and you certainly don’t want to be discussing your decision in the hazy exhaustion of having just given birth. You don’t want certain words used as they are triggering for you? I suspect a lot of us might say NO to the Bounty reps. What about your Ifs? What do you want to happen if there’s a bump in the road? Do you know what the possible issues might be, and how you’ll work around them?
Of course, as I’ve written about for RMF, a certain young man had his own ideas entirely about the way we were going to reach our destination. I could say that the map was as useless as the plan. But making it, tracing the contours of labour onto my own page, translating past fears into practical decisions, gave me the freedom to “go with the flow.” The map just showed me the different channels and routes that I wanted to flow along.
Have you heard of or used birth mapping? As always, we would love to hear your stories.