Why i stopped trusting “best practice” - on informed pregnancy and birth planning

Birth is one of the most significant moments a person will ever live through - a transition into the most unknown territory imaginable. It's not just a physical event — it's the moment you become responsible for a new life, their wellbeing, and every choice you make around them. Nothing you've done before will have felt this important. And whether that feels manageable or frightening often comes down to one thing: how informed and prepared you are for pregnancy and birth before you get there.

I think we come to understand where that responsibility actually comes from more as we age and experience more of life — not because anyone hands us the understanding, but because we start noticing things for ourselves. We see the scaffolding our own parents were working within. How much we were cushioned from, protected from the harsher realities of life. But also kept in the dark about some things, misinformed about others, gently steered toward compliance without ever quite being told why.

For me, this showed up around education. Things that were prioritised in my childhood — academia, university, staying in school despite a lot of unhappiness — I don't think were really chosen by my parents, even if it feels that way from here. More likely, they were just repeating what their culture had told them mattered, without necessarily examining it themselves. If your face, or your grades fit, that was the path you were encouraged onto, without much question. There wasn't really an alternative on offer. "Keep going" was the only script anyone gave them to give me.

Birth works the same way. Somewhere, someone — maybe with letters after their name, almost certainly with influence and money behind them — decided what "best practice" looks like. It gets handed down as though it were simply true. "This is what's done now." And it's only later, usually much later, that you get to see it was shaped by what suited the system delivering it, not necessarily by what suited you.

That's the kind of thing you don't usually see until something forces you to look at it.

There's a scene early in the film The Truman Show where a studio light falls out of a clear blue sky and smashes on the ground right behind Truman. It stops him in his tracks. He looks up, confused, trying to make sense of something that doesn't fit the world he thought he was living in.

But that's not the moment he understands everything. It's just the first crack. After it, his car radio picks up a conversation that shouldn't be there — people talking about his exact movements, like they've been tracking him the whole time. Things he'd always half-noticed but explained away start to feel harder to explain away. The people around him being strangely, relentlessly enthusiastic about specific products. The way the same faces turn up in the same places at the same times, like they're not living their own lives so much as orbiting his.

None of it is new. It was all there before the light fell. What's new is that he can't unsee it anymore.

That's the fork in the road. He can shrug, think ‘that’s strange’, and go back to his life. Or he can start pulling at the thread and let himself notice everything else that doesn't add up.

I think most people get some version of this moment somewhere in their life. Mine came in my NHS birth reflection appointment.

That's where I learned that the decision to clamp my daughter's cord immediately after she was born wasn't really about her needs.

She was compromised when she was born — not obviously well — so she needed help, and the decision was made to take her to a resuscitaire for oxygen. That part made sense to me at the time. What became clear in the reflection appointment was that the immediate clamping wasn't about her. It was about what suited the room: the equipment, the layout, the staff. What the evidence actually points to is that she should have stayed attached to her cord — still receiving her own oxygenated blood — skin to skin with me, her own physiology doing the work of bringing her back, rather than being severed from the very thing already doing that job.

That was my stage lighting falling from the sky moment. I could have shrugged it off — she's okay now, thank goodness that was there for her. Or I could sit with the harder thought: she already had everything she needed, through her placenta. She was taken off that and placed on something artificial instead. Why? So that someone could say they'd done something?

What if it had failed — when she was already getting what she needed?

Why do we assume technology is more reliable than the physiological mechanisms our bodies already have to keep a person alive?

Once you start noticing, you can't go back to not noticing. And in pregnancy and birth, that means you're suddenly the one making decisions you may never have expected to have to make — about a life that is completely dependent on you. That's the weight of it. But there's an aloneness in it too, because you realise that nobody cares more about your baby than you do, and yet up to that point, you've probably assumed the expert in front of you simply was the expert. Then there's a moment — maybe more than one — where you see that what is being recommended is serving someone else in some way, even if not consciously, or that it isn't actually what's best for your child. That's frightening - and it's part of why perinatal mental health and physical safety are so tightly bound together. Feeling unsupported in your decisions doesn't just affect the birth itself, it affects how you carry the whole experience afterwards.

This is why conscious, informed decision-making during pregnancy matters - not just gathering facts, but learning to trust your own intuition alongside them. Not informed about which buggy, car seat or sleep aid to buy — those decisions sometimes matter, but they're not the ones that shape the journey. Informed about what actually happens to you and your baby on the way into the world, and in the weeks around it. Because none of the superficial choices matter much if you're not equipped for the ones that do.

This is the work I do - supporting people through pregnancy, birth, and the postnatal period, so they're not left to find these things out the way I did. If you're looking for birth or postnatal doula support, or just someone to help you feel less alone in the decisions ahead, I'd love to talk.