Planning for the Unpredictable: A Snapshot of Birth Support from a Vermont Doula
- Laura Pascoe
- Nov 14
- 5 min read
I don’t often have photos of myself “in action” as a doula—mostly because when I’m supporting someone through labor, I’m fully in it. My hands, heart, and attention are with the birthing person and their support team, and if a camera is out, it’s me helping them capture moments. (If you’re a client and ever want to snap a photo for me, please know I’d welcome it!)
But this one is special.
It was taken during a birth that didn’t unfold the way my client had hoped. And yet, she left the experience feeling grounded, proud, and emotionally intact. Why? Because she knew, every step of the way, that we had explored every pathway available to her. She remained an active, informed participant—not a passenger being acted upon.
And that is the center of my work as both a doula and a childbirth educator:
Birth planning isn’t really about predicting birth. It’s about preparing for the unpredictable.
Why this matters so much to me
My own first birth did not go “to plan.” After more than 24 hours of intense labor and hours of pushing, I consented to a cesarean. I was grateful for a healthy baby and to live in a place where this wasn’t the end of my story—but I also grieved the vaginal birth I had hoped for. I struggled to immediately connect with my baby (did I mention how exhausted I was by the time she finally arrived??).
I replayed the “what-ifs.” I wondered if there was something I could have done differently.
And yet, I also felt profoundly empowered.
How could those things coexist?
Because I had a birth team—my midwife, my doula, my partner, my dad (yes, my wonderful dad attended both of my births), and even my two cats (one of whom sat on people’s backs while they offered counterpressure)—who ensured I was an informed, respected, central participant in every decision. Nothing was done to me. Everything was discussed with me. Consent wasn’t a form; it was an ongoing conversation.
I felt respected, cared for, and heard. That changes everything. (I later wrote a book chapter on why consent and shared decision making in childbirth matter so profoundly; it appears in Consent: Gender, Power, and Subjectivity—a volume that also includes a chapter by my badass philosopher sister, Dr. Jordan Pascoe.)
Back to this birth, this family, this moment
This client had more than enough strength and resilience to have the birth she desired: an unmedicated birth. She went into labor spontaneously, just as she hoped, and navigated a full weekend of early labor—sometimes called “prodromal labor” (and if you look it up and see “false labor,” please tell the internet to catch up—there is no “false” or “failure” in birth—ever).
When exhaustion set in, she adapted. We had prepared for this possibility; she’d told us ahead of time, “I want an unmedicated birth, but if this goes on a long time, I’m open to an epidural.” So when that moment arrived, I reflected that back to her and her partner. The plan had shifted, but she was ready.
We spent hours moving between rest and movement, quiet and conversation, laughter and problem-solving. We rotated through Spinning Babies techniques, body balancing, positional changes, comfort measures, and a lot of intentional waiting while her body and baby tried to find their way. Meanwhile, her partner was delightful—gentle, funny, steady, so loving toward her. They shared stories, I learned some excellent local family lore, and we found ourselves laughing together in those small, unexpected moments where the room felt lighter.
Her midwives and nurses (we had a few shifts to rotate through!) were so amazing—wise, patient, collaborative. It was the kind of team that makes birth feel sacred, even when it’s messy and unpredictable.
Through it all, my client remained steady. Resilient. Clear-eyed. She even cracked jokes and found silver linings. Like a badass, obvs.
And then, after hours and hours of trying everything available to us… the cesarean reality was staring at us. We talked about it honestly. We joked that we had “thrown a Costco-sized box of spaghetti at the wall.” And it was true—we had tried everything.
She knew it.
They were both was bummed, but they were also ready to meet their baby.
And that clarity made the next steps more grounded, even though they weren’t the ones she’d envisioned.
Even as her birth diverged from her hopes, she knew she still had agency. She knew her voice mattered. She knew she could ask questions, slow things down, or change direction. She knew her preferences were honored, even when they had to adapt. And critically: she knew that what was unfolding was not her fault.
That is the power of shared decision making—not eliminating unpredictability, but ensuring that when the path changes, you aren’t lost. You’re still at the center of your own story. And any feelings that come up are perfectly valid, simply because they are there.
What really stays with us
Babies and bodies sometimes have plans we can’t see. Sometimes we understand why; sometimes we don’t. But the lasting memory of birth isn’t usually the exact sequence of events—it’s how we felt.
Were we respected?
Were we cared for?
Did we understand what was happening?
Did we feel heard, even if the path requires adaptation?
This client did. And witnessing her clarity, resilience, humor, and tenderness with her partner was such a privilege.
If you’re preparing for birth…
My work as a doula and childbirth educator is rooted in evidence, compassion, shared decision-making, and helping you find and honor your own intuition. It’s not about achieving a specific outcome—it’s about helping you feel steady and informed no matter which path your birth takes.
It’s about ensuring your consent is honored, your voice is central, and your emotional wellbeing and sense of dignity matter.
And this is especially important in a country (the U.S.) where women and all who can become pregnant/birth are routinely gaslit, dismissed, and denied autonomy; where misogyny and racism shape too many clinical encounters; where postpartum support is an afterthought; and where we expect parents to perform superhuman feats with almost no structural support. Where parental leave is abysmal (I have a lot more to say on this—later!)
All of that to say: it’s way more than “healthy mom, healthy baby” could ever capture.
We deserve better.
You deserve better.
And while these problems are deeply structural, I want to be clear:
I am continually impressed by how hard our local hospitals in the Upper Valley of Vermont and New Hampshire and the midwives, nurses, and OB/GYNs who work at them center birthing people within the constraints of that system. I see the compassion, the patience, the collaboration, and the genuine effort to create respectful, person-centered care. The individual humans caring for families here are remarkable—it’s the broader system around them that needs changing.
And if you’re a future client…
If you ever want to take a little photo of me during your birth (with everyone’s consent, of course), I’d treasure it. These glimpses into the sacredness of doula work are rare—and meaningful.
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