As expectant parents, you are faced with making many decisions—for your prenatal care, medical testing and procedures, birth experience and newborn care. Your ideals, values and perspectives regarding the birth process are as unique as you are. In preparing for your birth, it is important to evaluate your thoughts with respect to these issues. This may seem like a daunting task, but remember that you are no different as an expectant parent than you always have been. You will be yourself, with the same core ideals and values, but with new, heightened awareness. However, you may find that your partner does not necessarily share all the same inherent ideals as yours. It is imperative that parenting partners set aside special time to discuss each aspect of pregnancy, birth and impending parenthood in order to work together as a team, prioritizing what is most important.
Your first decisions will be where to have your baby and with whom to entrust your care. Are you planning to birth in a hospital or at home? Are you familiar with the hospitals in your area, those that are covered on your insurance plan or those you would consider paying for out-of-pocket? Taking a tour and asking questions are good ways to decide if a birthing facility appeals to you and if it will support your ideals. Even if you are planning to birth at home, you may wish to investigate which hospital is most appealing to you, in the event you may need to utilize their services.
Remember that writing a birth plan, or preference list, or choice sheet, or ideal birth request list—or whatever you decide to call it—is merely a communication tool and not a legal document. Prenatally, it will be a catalyst to in-depth discussion, improved understanding and more personalized care. During your birth it will serve to remind your birth team of your previous discussions, reinforce your personal goals and enlist support in achieving those goals.
A good birth plan is based on the assumption that your pregnancy is healthy and a normal, uncomplicated birth experience is expected, although it should remain flexible in the event that circumstances arise which warrant making different choices. By asking for your rights and authority to be respected, you must also be willing to accept responsibility for the outcome of your decisions.
It should begin with a few personal statements about you, your philosophies, priorities and goals. A personalized birth plan will receive more respect than one that is copied from a book or internet source.
It should always be positive, avoiding the words, “no,” “don’t” and “never.” Focus on what you do want, rather than what you don’t want. (For example: “We would appreciate explanations of the risks and benefits of any procedures offered, and any alternatives available, in order to help us make decisions.”)
It should be short and to the point. Busy caregivers are more apt to respond positively to a concise list of requests, rather than a long list of what is unacceptable. (For example: “We wish to have the baby remain undisturbed with Mom for bonding” lets them know that you want the baby laid directly on your belly after the birth and that you wish to have all newborn procedures delayed.)
It should be realistic and relevant, demonstrating a basic understanding of the policies, procedures and protocols of your chosen place of birth. (For example: stating that you wish to avoid all electronic fetal monitoring during your hospital birth will not be acceptable. However, negotiating for intermittent fetal monitoring is an option.)
It should express your feelings, rather than argue points. (For example: “I would be disappointed to give birth by cesarean and would appreciate assistance in making choices that could help me avoid one” is less offensive than “I do not want a cesarean unless medically necessary because the research says there are too many unnecessary cesareans performed.”)
In the end, the most beneficial aspect of writing a birth plan is in the process of self-discovery that is achieved while you and your partner take the time to explore and investigate your true feelings, desires, fears or concerns while venturing into the awe-inspiring, life-changing process of birthing.