As an experienced paediatrician and neonatologist, I’ve had the privilege of welcoming thousands of babies into the world. I have seen first-hand the excitement, anticipation, and sometimes anxiety that comes with birth, particularly for first-time mums. Every mother (and father) wants the best possible experience, and many have clear preferences about how they would like their labour and delivery to unfold.

I firmly believe that listening to and respecting a mother’s wishes is not just a courtesy – it’s an essential part of providing excellent care. Your birth plan matters, and your choices should be supported wherever possible. However, my experience, as a neonatologist of 30 years experience, has also taught me that birth can sometimes take unexpected turns, and there are moments where balancing those wishes with safety becomes our shared priority.

Understanding Birth Choices in the Cayman Islands

One of the realities of giving birth in the Cayman Islands is that all deliveries take place in hospital. Unlike larger countries, options such as midwife-led birthing centres (you can have a midwife-led delivery at HSA), home births, and water births aren’t currently available or common here. While this may initially feel limiting for some, it also means that expectant mothers have immediate access to expert care should any complications arise.

That said, just because certain birth options aren’t available doesn’t mean you lose control over your experience. Your voice matters, and your birth preferences – whether it’s around pain relief, movement during labour, delayed cord clamping, or skin-to-skin contact – should be heard and respected. I very much see part of my role is to ensure you feel empowered in your decisions while also being prepared to adapt if needed.

Where Birth Plans and Safety Intersect

Many birth plans go exactly as hoped, but there are times when nature takes its own course. As a neonatologist, I’m often called into deliveries when there’s a concern about the baby’s well-being, such as fetal distress, meconium-stained waters, or difficulty breathing at birth. In those moments, a change in plan – such as needing an assisted delivery, a C-section, or immediate intervention for the baby – may become necessary.

I have sat beside many mothers and fathers in those moments, offering reassurance while explaining why a different course of action is needed. One of the most difficult conversations is when a mother has her heart set on one approach but an urgent situation requires a shift. This is where trust in your medical team is essential, and where having a true advocate for your wishes makes a difference, so that you know changes in plan and founded on medical prudence and necessity, not just a busy schedule or a doctor preference (as opposed to a clinical opinion). Good medical teams never make these recommendations lightly; our only aim is to ensure the safest outcome for both you and your baby.

Finding the Right Balance

A truly supportive birth experience isn’t about choosing between a mother’s wishes or medical safety – it’s about working together to find the right balance. Good care means listening carefully to what matters most to you, being transparent about what’s possible in Cayman, and ensuring that any necessary changes are explained with empathy and respect. And if you’re hearing something that conflicts with your birth wishes, it’s OK to ask for clarification.

To help achieve this balance:

• Have open conversations with your healthcare team early on. If you have strong preferences, discussing them during your prenatal visits allows us to explore what’s possible within the Cayman setting.
• Stay informed but flexible. Understanding potential interventions and why they may be necessary can help you feel more in control, even if things don’t go exactly to plan.
• Choose a medical team that makes you feel heard. Birth is deeply personal, and you deserve care providers who take the time to listen, support, and explain.

A Birth Experience that Feels Right for You

Welcoming your baby into the world should be an experience where you feel respected, supported, and safe. My commitment as a paediatrician is to honour the choices you make while always ensuring that the most important outcome – a healthy baby and a healthy mum – is protected.

If you have questions or concerns about your birth preferences in Cayman, I encourage you to have those conversations early. Your wishes matter, and while some aspects may need to adapt for safety, we can always work together to create a birth experience that feels right for you.