For almost two months, I have been faithfully blogging once a week. I had the opportunity to leave my doula world here in Bakersfield and visit Scottsdale with my kids -- so I took it! I had this experience, which I knew fit right in to what parents face as they create their personal plans for birth.

A family member works at WestWorld of Scottsdale. This is a huge venue where they host horse shows, rodeos, expos, and auctions. We had been invited to the Barrett Jackson Auto Auction -- we watch this on TV every year. With four boys from 3-17, this show did not disappoint! 

Our family member showed us the following video, in anticipation of our experience -- she was giddy with excitement as the boys watched with dropped jaws:

After we viewed it a few times, I had some questions for my family member. 

"Did you guys know they were going to do that?"
"Did they ask your permission?"
"If they had asked your permission, would you have allowed it?"

Even though she and her whole office couldn't stop watching this video, the answers to all three questions were, "No."

No, they had no idea this was being planned.
No, permission wasn't asked.
No, it would not have been allowed.

There are some scary scenes in this, right? The car drifts past people, past doors, around Mr. Jackson's Bugatti! Things are loud, dangerous-looking, out of the norm for the venue. But the driver has the experience of drifting, and he knows his car. He has learned how the car works, how best to throw a drift, what his car can and can't do. It is obvious he has had a lot of time behind the wheel.  

This fits into how we can craft our birth plans. 

I recently sat with a couple as they worked to put their birth preferences together. The example they were using was mighty -- like four-pages mighty! Four-pages mighty suggests you list every little thing you might even think of doing or accessing or trying. I suggest a less-is-more approach. Include 6ish of the most important choices you want. Now all the others fall under the umbrella of, we will try them if the time arises and the situation fits, generally without getting specific prior approval, but utilizing something until someone says why we can't. Do you see the parallel now? 

So you want to use a peanut ball? Bring it out when it's time -- but you don't need to take up space on your birth plan stating, "Mother will use the peanut ball we brought to optimize baby's position if Mother becomes tired or needs to stay in bed."

Do you get sick or grouchy or faint when you don't eat frequently enough? Instead of writing, "Mother has snacks available and will eat as she feels necessary in order to maintain energy for labor and birth," just pack your food and snack as you need to.

If your goal is to be active in labor, you need not put, "We wish to labor out of the bed, so we will be walking, using the shower, sitting on the ball we brought, and rocking in a chair to achieve this." You can simply show the bed isn't where you want to stay, and get up and get moving. 

Ideally, talking to your doctor ahead of time to discover what specific choices your situation warrants provides leverage. What if your doctor says no to everything you want to try? Then look for evidence. For example, in November 2015 the American Society of Anesthesiologists stated, based on evidence, that "Most healthy women could benefit from a light meal in labor." If your provider isn't keen on that, ask about this ASA recommendation -- why does it not apply to you? You can do this for many of your choices -- find the evidence and ask why you don't fit the recommendation. What is often termed as "hospital policy" can be broken down into "provider preference"; ensure you are getting accurate information.

Learn your choices. Understand how your body and your baby work together towards birth. Decide how you want to shape your experience by the options you face. And go for it.  If you aren't "allowed" to do something, assess the risks and the reasons, and move forward. Try something else. Keep asking questions. Stay busy and active. This is your machine and you know it best.

​Remember that saying: "It's easier to ask for forgiveness than to ask for permission"?

It absolutely applies here. 

I was at a birth as a doula in Bakersfield, CA recently where the couple's nurse was wearing a mask. I didn't think anything of it. Soon I realized the parents were worried, because you know, people in masks cannot be trusted (reference, anyone?).

Many hospitals require their employees to get yearly flu shots. Even as a childbirth educator and health worker formerly employed by a hospital-based midwifery clinic in Chico, CA I was meant to get the vaccine -- it was all ready for me in our on-site medical refrigerator. But like many, I chose to decline it.

What does it mean if you decline the flu shot? The Center for Disease Control has this to say about health workers and vaccinations:

"CDC conducts science-based investigations, research, and public health surveillance both nationally and internationally. CDC adopts recommendations that are made by the Advisory Committee for Immunization Practices. These recommendations may be considered by state and other Federal agencies when making or enforcing laws. CDC also has infection control recommendations for health care settings. However, CDC does not issue any requirements or mandates for state agencies, health systems, or health care workers regarding infection control practices, including influenza vaccination or the use of masks. However, some employers require certain immunizations. Hospitals, for example, may require some staff to get the flu vaccine or hepatitis B vaccine or take other precautions such as the use of masks." 

(This link also had some very non-helpful links for further information.) 

Enter the mask!

When I noticed my clients were looking at their nurse's mask with trepidation, I explained many hospitals require employees who decline the flu vaccination to wear a mask during flu season. The mother looked relieved as she shared, "I just thought she was sick and still working." That's a pretty scary thought when you are about to have a baby!

I then engaged the nurse in our conversation, so she could confirm or clarify what I had said to these parents. She let us know she had a bad reaction to the flu shot once, and ever since, she declines it and opts to wear the mask instead. 

I have a good friend, Jessica, who works in a hospital and also chooses, every year, to wear the mask. As a mother who has a vaccine-injured family member, her reason is different: "I always tell people that I feel safer with a mask on my face than a shot in my arm. I feel better protected. The flu is not the only nasty thing that goes around this time of year, and when the CDC only promises 18-30% effectiveness for this year's flu shot, I'm 100% protected with a mask on my face." 

The next time you see someone in the health field sporting a mask, don't worry -- they likely aren't sick! They may have just decided the flu vaccination is not a health risk they are willing to take, and this is their way of still serving you safely.