When Hilary Swenson became pregnant with her second child, she knew she did not want to have the same interventions she had with her first birth, so she began searching for a doctor in Honolulu who would honor her wishes.

"During my first visit to her, I made a point of discussing my birth wishes," Swenson says. "I explained that I wanted no medications at all unless some complication arose where interventions would be necessary to save Baby and me. I also mentioned that I wanted the lights dimmed when the baby began to crown. I wanted no (continuous) monitoring through the labor and I wanted to be moving about, walking."

As her pregnancy progressed, Swenson continued to talk to her doctor about her birth. By the last month, she had a written birth plan that was placed in her chart at the hospital, so the nurses would know that her doctor agreed with her desire to have no routine interventions, including intravenous fluids, pain medication or an episiotomy.

In the end, everything went as planned, and Swenson was happy with the outcomes of her second and third births, because she took the necessary steps to plan her birth.

The first step in avoiding routine interventions is to find a caregiver who is supportive of your wishes. Swenson asked friends and relatives for recommendations, which is a great place to start. Ask your friends how their births were handled because most doctors and midwives do things in much the same way from one birth to the next. If your friend had continuous electronic fetal monitoring and intravenous fluids, it is likely you also will have them.

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