HEDI - Self-Determined Birth

Birth is an exceptional physical and emotional situation. Many people find it to be one of their happiest moments. However, there are also a lot of cases where a traumatic birth leaves deep scars. These can be physical, but also emotional injuries. In order to counteract as many negative experiences as possible, it makes sense to think about how you would like your child to be born while you are still pregnant. The more you know about the process, the more likely you are to have a self-determined birth. You can then better decide what is important to you during the course of your delivery. This includes learning about your rights in this particular situation.

What does ‘self-determined’ mean?

In a self-determined birth, your conscious decisions about the course of the birth are in the foreground. You should be able to actively stand up for your own needs. The prerequisite is that you understand what's happening. This makes it easier for you to say ‘no’ when something goes too far or makes you uncomfortable. It will also give you a better idea of what kind of help and support you want to accept during birth. It's also best to share this knowledge with the people who will be with you during the birth. They can be a great support to you during childbirth and help enforce your wishes. Under no circumstances should any steps be taken against your will. You should be involved in all important decisions before and during the birth.

Self-determined and openminded

Self-determination often starts in the mind. This means that you first have to free yourself from social ideas of how a birth should be. One place to start is by learning about how birth works biologically and what you might encounter during the process. This knowledge will help you to free yourself from the pressure to perform during the birth process. For example, some people feel guilty if the baby doesn't come quickly or the cervix hasn't dilated widely enough yet even though they've been in the hospital for a long time. There's no reason for that at all. Every birth is different and every birth has its own schedule. There is no such thing as a perfect birth either. Things can always turn out differently than you expected without warning. In these moments, and especially in an emergency, it is important to embrace the new situation. When in doubt, you must let go of all notions of an orderly birth process. You can basically rely on the strength of your body and the skills of the medical staff.

Where can I get information and answers?

Even if you're well-informed, that doesn't mean you have to become an expert yourself. Contact the people who will be medically guiding you with your questions about the upcoming birth. You can discuss your questions with your midwife or ask them during childbirth preparation courses. There you can also find out how other pregnant people who already have children prepare for childbirth. You can also ask them what helpful experiences they had during their first birth. Your gynaecologist is also a good person to talk to. They are even required by law to inform you about medical procedures and processes. When you decide on a birthplace, you can also discuss important questions there, for example if you go on a tour of a delivery room or to an informational evening at the birth centre.

Preparing for a self-determined birth

Many pregnant people find it helpful to write down their own wishes and worries before the birth. If you make a list of what you want and what you don't want, you can start sorting through your thoughts. You can also discuss the list with the people close to you. This could be the person who accompanies you to the delivery room or the midwife who is on duty during your delivery. You'll know what to do when things get tough. You can discuss important items on the list when you register to give birth at your birthplace of choice. If you choose a registered midwife, she will be with you before and during the birth. You should also talk to her about these issues.

These questions can serve as a guide for you:

Where do I want to give birth?

To decide this, give some thought to your choice of birthplace.

Would I like to be given pain-relieving medication?

Get advice regarding what forms of pain relief during childbirth are available. This includes learning about how they can fit into your birth experience and if they affect the baby.

If you're thinking about a c-section: What are the pros and cons?

Whether you consciously decide to have a c-section or it's an emergency cesarean section, it's important to know how it will go and the impact it will have on you and the baby.

How can I support the birth process?

At your childbirth preparation courses or with your midwife, learn about birthing positions and how to best use your breathing to help you withstand the pain of childbirth and help your baby along.

Who is allowed in the delivery room and what kind of visits do I want after delivery?

Even if everyone close to you is already waiting excitedly for the new addition to the family, you should decide for yourself when you are ready to receive visitors and who may be with you in the delivery room.

This list is not exhaustive. You should develop it after talking about it with your caregivers, in childbirth preparation courses, or with the people responsible for your medical care.