Creating a Birth Plan
How to Outline Your Birth Preferences
Many women have specific ideas and desires for their labor and birth. Other women are unsure of what they envision birth to be like. A birth plan can be extremely helpful to both groups of women because it is a tool that allows you to write down your personal preferences and also helps you to explore your options and become more familiar with birth practices.
Popular in the 1970’s, birth plans are starting to make a comeback, but they are still a relatively new tool for pregnant women today. Therefore, it is especially critical to communicate your ideas and wishes clearly with your healthcare providers and to come up with a birth plan that will be positively received. Keep the birth plan as simple and clear as possible. Heading and bullet format is an effective way to achieve clarity. Organize your plan by topic and keep the length to one or two pages, so that your providers will have an easier time reading your birth plan and following your desires when possible.
Focus on your top priorities and the actions that mean the most to you. Everyone has different preferences regarding childbirth, so personalize your birth plan to encompass your philosophies and meet your goals. Ask yourself questions such as:
- How would I like to manage my labor?
- Who do I want with me for labor support: my partner, my mother, a doula?
- Would I like pharmaceutical pain control?
- How do I feel about monitoring devices?
- How do I feel about labor augmentation and induction?
- Do I want to breastfeed directly after giving birth?
The language of a birth plan can make a large difference in how it is interpreted. Use words like “hope, prefer and if possible” as opposed to “demand, should and must be.” When people feel that you respect them and want to work together for the best outcome, they will be more willing to work with you to help you achieve the birth you envision. Health care providers are professionals who take pride in their work and do not want to feel as if you are telling them how to do their job. It can often be helpful to make a statement on the top of your birth plan such as:
“To my Health Care Providers: Thank you for working with us and our birth plan. While these are our wishes and preferences, we understand that birth is unpredictable and we are open and flexible to any medical interventions that may be necessary in the event of an emergency.”
Break your birth plan into sections to help organize your thoughts. For example, you may want to use a time-line approach:
- Labor
- Pain management
- Birth
- Immediate Postpartum Care
- Newborn Care
Once you have decided on the headings for your birth plan, fill in the procedures and policies that are most significant to you during each time period. Think about how you function best and which factors you believe will make the most difference to you. Below are some examples, but just remember that these are general suggestions. Your birth plan will be a more helpful tool for you when you adapt the guidelines to best suit your philosophies and desires.
Labor: I would prefer:
- To be able to walk around and change positions at will if possible
- Vaginal exams to be kept to a minimum
- To have my membranes rupture on their own
- Not to have an epidural but to be able to discuss it with a healthcare provider if I change my mind
Birth: I hope:
- To push in any position in which I am comfortable if medically safe
- Not to have an episiotomy unless medically necessary
- To feel my baby’s head as it crowns
In the event of Cesarean Section: I would like:
- For my partner to be present as much as possible
- For the baby to be given to my partner immediately after birth unless she needs immediate medical care
Immediate Postpartum Care: I would like:
- My baby to be placed directly on my chest (skin to skin) unless she needs immediate medical care
- My partner to cut the cord
- To have the opportunity to breastfeed as soon as possible
Newborn Care: I would like:
- To delay routine exams and baths until I have been able to bond with my baby and try to breastfeed
- My baby to stay in my room at all times. If he needs to leave for a medical necessity, I would like my partner or me to accompany the baby
- My baby not to have any bottles or pacifiers
Discuss your birth plan with your physician or midwife prior to labor in order to have a chance to vocalize your preferences, to be sure that your health provider is comfortable with your plan, and to make sure that hospital policies allow what you would like to do. Also keep a copy in your chart and a few in your labor bag to give to hospital staff and/or the doctor on call.
The most important aspect when writing a birth plan is to remember that birth cannot be planned! Your birth plan gives your health providers a set of preferences and guidelines and shows them that you are making informed choices about childbirth that you would like them to follow when possible. Try not to be upset if something changes and part of your birth plan does not happen; try to stay focused on the birth and the baby. While it can be disappointing if your baby’s birth does not go exactly as planned, remember that the ultimate goal of every birth plan is to have a healthy baby and mother.
A birth plan is meant to be a helpful tool to assist you in having the birth that you desire. There are many online resources to help you write a birth plan and some websites give out templates. Also, contact local nurses or doulas who are typically more than willing to help you come up with a birth plan that best suits your needs.