By Kelsey Irvin, MsC, CBD
"High risk" are two words no one wants to hear from their healthcare provider when pregnant. A diagnosis of high risk can change everything, sometimes very rapidly, requiring a considerable amount of bravery and focus to weather through. Three years into my doula practice I made a conscious shift towards specializing in high risk clients. It was these clients that I felt needed me most, pushed into a sphere of worry and stress, I saw how easy it was to lose sight of the sacred nature of birth, tumbling into a series of interventions out of control, resulting in a traumatic birth. After attending several high risk births I put together a plan for these clients to help prevent birth trauma. It was a simple plan; stick to your goals of having as much of the birth you want as possible, while never forgetting to safeguard you and your baby.
If you or your partner have been diagnosed high risk you can use this plan before, during, and after birth as a guide for positive change.
Acknowledge the loss of the birth you wanted. Some parents feel guilty grieving for the birth they wanted for fear of criticism that they aren't prioritizing their baby. A birth vision is a precious thing, but do not be afraid to grieve for this loss, grieving for it beforehand will help you come to terms with the birth you will have, and help you gain intimacy and control.
Write a new birth plan. Research the interventions you are likely to encounter with your high risk diagnosis, and think about how to incorporate them. For example, if you are going to have an IV think about having it placed in your arm and not your hand so you can comfortably hold hands with your partner.
Write a c section plan. Ask if you can have the curtain lowered during delivery so you can see your baby born, request skin to skin during stitching, and strategize with you partner on ways to increase loving touch in the sterile operating room.
Fill your gas tank with positives, do not let the diagnosis lead you into despair. It is easy to go down the garden path of fear when health is questioned, but fear and stress heighten risk factors in labor. Continue to fill your life with positivity. If you find that fear and anxiety over your pregnancy and birth grow into more than you can reasonable handle, seek professional counseling from a therapist or psychologist.
Hire a doula, if you haven't already, that is experienced with high risk labors
Discuss your wishes to maintain sacred space during your labor with your support team beforehand.
You may have to go into the hospital earlier than usual so prepare your laboring space to be cozy and comfortable. Bring lights, blankets, music, scents and images you find comforting.
Make your wishes clear to the staff to have a private space, put a sign on the door reminding all to enter and leave peacefully
Ask the staff to explain each intervention beforehand if at all possible.
If you are stuck in bed try having your partner get in with you to cuddle; loving touch lowers stress levels and shortens labor
Breathe, visualize, relax, and don't be afraid to use the tools at your disposal. Utilize a rebozo to relieve back pressure in a bed, wedge a peanut ball in-between knees to allow the baby to descend and the mother to relax her legs, use scented oils for foot and hand massages to help alleviate pain and anxiety.
Protect your sacred space, allow the chaos to fall away and focus within even when things become hectic.
Touch your baby as it is born, especially if you know a NICU visit is imminent.
Be open to change. A high risk labor can shift rapidly, staying focused on your goals while being flexible to necessary changes helps prevent feeling out of control.
Try and establish skin to skin as soon as possible
Express your desire for colostrum to be given to your infant if they are in the NICU
Find time for a family moment with your new child, it might not happen right away but when the moment comes have a meeting that is just you, honor the transition of your expanding family.
Process your birth, the good, the bad, the ugly. Find an opportunity to tell your birth story in a safe space such as a mothering circle or a caring friend or family member.
Most of all know that giving up a vision of a low intervention birth for a high risk birth makes your birth no less special, all births are sacred, and all laboring mothers are warriors at work, honor that effort no matter what.
With good planning, a strong support system, and an open mind a high risk birth can be as intimate and sacred as the lowest intervention birth. In each birthing environment you and your partner can focus on loving touch, staying calm in the midst of worry, and keeping positive about your ability to birth safely. A high risk birth does not make you any less of a birth warrior, just one that must walk a different path towards welcoming new life into your hands and hearts. Honor the sacred, nurture the soul, and go forth and birth, safe in the knowledge that you are strong.
Kelsey Irvin is a certified birth doula, mother, and research scientist living and working in Richmond VA. She is a professional social anthropologist currently working for the VCU Massey Caner Center, and has run an active birth doula practice since 2007 in the UK and the US. She specializes in high risk births, teen births, LGBTQ families, and surrogacy clients. In her free time she likes to rock climb with her husband and daughter, and read a lot of books.