Perhaps there's just no dib dib dob dob in my blood, but I was a terrible failure as a girl scout. It was the "be prepared" part that brought me down and still causes me problems, memorably illustrated by the dysentery-rich trip to Latin America I enjoyed after refusing to read a single sentence of travel literature.
But when I was pregnant I managed to break the bad habits of a lifetime. My motivation was hearing about the many apparently normal, healthy pregnancies that spiralled out of control in the labour ward, ending in unplanned and invasive medical interventions. I was told that labour is just like that - unpredictable, chaotic, terrifying. A bit like my Latin American adventure. But while friends and family didn't hesitate to censure me for my haphazard approach to overseas travel, the opposite was true of my careful preparations for labour. If I had a dollar for every time I was told that birth plans were futile, since things would never come out the way I expected, I could almost have doubled my baby bonus.
There seems to be a widespread culture of passivity when it comes to labour. Many expecting mothers do dedicate an enormous amount of time and effort to preparation, yet, in my experience, there are just as many who refuse to do adequate homework, preferring to sit back and see how things develop.
It's not that these women are unsure about what sort of labour they'd like to have (almost always an uncomplicated vaginal delivery). They've simply decided that "waiting and seeing" is the only realistic approach. Why bother committing to a detailed birth plan when it will probably go wrong anyway? Perhaps other wait-and-seers are simply in denial, preferring not to think about an experience that is understandably terrifying. The end result is that they approach the business of labour with less preparation than they would bring to buying a new car.
In one sense, this is a perfectly rational approach, if you assume that benevolent, better-informed medical experts will ultimately step in and make the right choices for you. There's a kind of comfort in just closing your eyes and handing the wheel to someone else, particularly if that person seems calm and confident and is wearing a clean white coat. But to simply surrender your agency to the experts misses the vital point that there is no single "right" way to give birth, except perhaps where genuine, life-threatening emergencies are concerned.
Medical experts bring their own subjective values to the decisions they make and the advice they give, and these may not be the same as those of the patient. Similarly, it is naïve to discount the vagaries of the contemporary hospital environment. Most of us are suspicious of large institutions such as banks and government departments because we know they are not set up in a way that always serves the best interests of individual clients. Why would hospitals be any different, particularly when so many of them are over-stretched and under-resourced?
Despite all the rhetoric about the importance of consent and respecting the patient's wishes, my experience of giving birth in a big hospital is that women are encouraged to take a passive role, to defer to both their doctor's opinion and to the institutional imperatives. If you argue, you are often told "that's just the way we do things".
This is not to discount the value of obstetrics. Medical advances have greatly improved outcomes for labouring women, especially those facing complicated births. But in delegating so much responsibility to "the experts", women surrender control over a process that is intensely personal. No matter how much external support a labouring mother receives, she is still the one who has to do the deed (as much as many pregnant women would wish it otherwise), and it's her body that will carry the physical consequences.
Many of the medical procedures that are routinely offered - such as episiotomies, epidurals, and forceps - are significant interventions that can have consequences for the health of the mother or the baby, and for the progress of the labour. Waiting until the maelstrom of labour engulfs you is not the time to investigate whether these procedures are right for you. If you do, the likely result is that you will simply agree to whatever is suggested.
Making adequate preparations will not necessarily ensure that you get your ideal birth, but knowing that you did your best means that you're more likely to accept the results, whatever they may be.
Pregnant women already attract unjustified scrutiny and criticism. No woman should ever be judged for the decisions she makes while in labour, given how indescribable and unexpected that experience really is. But how a woman handles her preparation is another matter entirely, and maybe a lack of preparation deserves scrutiny. To just "wait and see" when the stakes are so high is simply negligent - both for the mother's health and for her baby.