Australian Doula College

Australian Doula College

Renee Adair


Pregnancy and birth offer us a new beginning, new hopes and dreams. As awaiting parents, we carry those hopes and dreams in our hearts and minds. Unfortunately, those hopes and dreams can be shattered by unexpected outcomes before, during or after the birth of a baby.

I myself am a dreamer and a realist. Life is full of daily breathtakingly beautiful moments and unexpected outcomes. The two-­‐walk side by side and we don’t really see either coming.

Unexpected outcomes are not always negative however they take us by surprise and usually leave us questioning the experience, process, support, level of care received and our decisions.

There are many unexpected outcomes associated with pregnancy, labour and the postnatal period. Some women and their partners are met with a plethora of challenges to get pregnant. And that’s just the beginning. Then there are the multitude of women and their partners who we are sending home unhappy, even traumatised, after all of the unexpected experiences they have been exposed to in their labour and birth.

It is not for anyone to judge what looks big or not in terms of a loss or unexpected outcome. What is important is that the rest of us respect the fallout for the mother and her partner. Experiences that may not look so important or large to an outsider may have profoundly affected the woman and her partner.

Some unexpected outcomes:

  • Loss of birth plan expectations overall
  • Your partner didn’t help out in the labour room and you thought they would
  • You were transferred from birth centre to labour ward
  • Instrument assisted birth of the baby
  • You didn’t fall in love with the bub at first sight
  • Your loss of control during the labour
  • The hospital staff were not what you were expecting
  • The baby has some minor or major abnormality
  • The baby needs to spend time in special care nursery
  • Baby is not the sex you wanted/thought
  • Breastfeeding is challenging

I am a firm believer that pregnant couples need to have a vision and a birth plan. Creating a birth plan is an opportunity to understand your options and choices and to lay a foundation for your intentions. A birth plan brings your care providers and support people onto the same page. We must never stop forming an ideal scenario around pregnancy, birth and the post-­‐natal period but here is the thing.

It is important to stay flexible and open to whatever the transition may bring. It may lessen the stress if unexpected outcomes arise. I truly believe labour and birth are designed to be

challenging actually. We need our buttons pushed and we need to investigate and question. Essentially that is the essence of parenting and so I see labour as preparation for the long-­‐ term job ahead.

So, whilst we cannot prepare for unexpected outcomes, we can prepare ourselves about how we might manage them.

In labour and birth, I suggest the following:

  1. Always make the outcome Healthy Baby and Healthy Mum your 1st priority
  2. Be Flexible in your Birth Plan
  3. Always try all the Natural Alternatives First
  4. Always ask the question -­‐ What are our options now? Ask what are the risks and benefits of what’s on offer. What will happen if we do nothing and wait?
  5. Always ask questions about any procedure at all. It is important to feel that you have not lost control completely.
  6. Take a different look! See the labour ‘interventions’ as tools of the labour.
  7. When making final decisions talk them through with your partner and support people.
  8. Give yourself and those with you time to grieve the loss of your plan’ if you need to.

I recommend a professional debrief with a counsellor or your doula, if you have to clear up any doubts, questions or anger that is hanging around after your baby’s birthday. Some women and their partners may also benefit from extra support postnatally. Ultimately, it’s important that new parents feel as positive as possible moving into their new role.


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