Since you can’t plan how your labor and birth will unfold, I prefer to talk about your birth wishes or birth preferences than your birth plan. Honestly, I feel the biggest value in writing this document, is not in the end product, but in the process.
Prenatally, it’s important for both Mom and Dad/partner (and anyone who will be attending the birth) to be involved in this exploratory journey. As you learn about and research possible interventions and hospital protocols, you can get an understanding of how you feel about things in a non-labor state of mind. You have the luxury of time to evaluate and prioritize your desires.
As the vision your birth comes into focus, you’ll find there are things you want to really insist upon and things you don’t care about either way. You’ll learn about your options in birth (medications, music, med students, artificial rupture of membranes, hep-lock, etc.) and the immediate postpartum period (delayed cord clamping, infant eye ointment, skin-to-skin, etc.)
You may find that you really care about freedom of movement and therefore want to have intermittent fetal monitoring or a portable telemetry unit instead of continuous monitoring; you may decide that you feel neutral about wearing your own clothes verses a johnny. To make these choices, you’ll need to grasp what they mean and you’ll need to know the policies of your chosen place of birth.
It’s all up to you as a consumer. Going through this process empowers you to own your birth. You are taking responsibility in this experience and giving it the due diligence it warrants.
Whatever you include in your birth “plan”, it should be discussed with your provider ahead of time (all of them if you’re in a group). It’s best to discover any problems or sticking points from your caregiver’s point of view before you’re in labor.
If you feel uncomfortable with your midwife/doctor’s answers or sense they won’t be able to accommodate the things you feel strongly about, it’s okay, and encouraged, to seek out a new provider who will honor and respect your wishes for your birth. Many women switch right up to the last minute. Trust and confidence in your provider matters in your birth, so listen to your gut and make a move if you feel ill-at-ease prenatally.
A few tips I always stress include:
- Express birth preferences without being confrontational, don’t make demands.
- One page – keep it short (it’s okay to put the newborn care plan on the back side)
- Be realistic
- Be flexible
- Print it on bright/fluorescent colored paper
- Copies for everyone! Review birth preferences with provider before the birth, bring copies to hospital to review with nurses
- Avoid the phrase “unless medically necessary” – if it’s truly medically necessary, of course all bets are off and you’d want providers to do what they must, this is your wish list so there is no need to qualify statements with this phrase
Formatting your birth “plan” can take different forms, white space and bullets are helpful and you can organize it by parts of birth, (labor, pushing, postpartum, infant care.)You could also simply list preferences under “Things we would like” and “Things we hope to avoid.” You may even want to simply draw a picture of your ideal birth to help you envision this intimate life event.
It is wise to begin your birth wishes document with a phrase that expresses your acknowledgement that birth can be unpredictable and your willingness to be flexible , and include the names of anyone who will be attending your birth with you (doula, friend or mom) and be sure that it meets with hospital rules so you have no surprises when you arrive in labor. It’s also wonderful to start with the reasons you chose your care provider, what is it you like about the practice?
Commit some energy and time to the process of writing your birth wishes. Visualize the birth you want. If you don’t know your options, you don’t have any.
*A birth plan template I like: http://www.pregnancyandbaby.com/calendars/articles/937331/birth-plan-creator but you can edit out “unless medically necessary” and any items that are standards of care at your facility and therefore not needed to list. (For example, episiotomy is less routinely performed now, perhaps you can omit this express request.) NOTE: This template times out and erases all you’ve selected, a solution is to cut and paste elsewhere while you’re researching and prioritizing, then go back in to the template and fill it in more quickly.
© Copyright Leah DeCesare 2012