Seven Steps to an Effective Birth Plan
Have you heard about the concept of a birth plan? Birth plans are usually written documents that parents-to-be create as they get ready for childbirth. The idea behind the birth plan is to communicate your preferences for labor and birth. While this can seem like a daunting task, it can be accomplished by dividing the process into steps: learning about the routines in the setting where you will give birth, figuring out what you are seeking, and then communicating your preferences (I hesitate to call them plans!) with your doctor or midwife and the nursing staff.
Here are seven steps towards getting the birth experience of your dreams:
- Think about who you are and what you want. Do you normally choose everything natural or do you prefer creature comforts? Are you feeling very anxious about birth, or confident? Talk to friends about their birth experiences and read online stories about birth. Not everyone wants the same thing. Know thyself.
- Choose your care provider and birthplace to match your general preferences. It is much easier to get what you seek when you don’t have to work against prevailing values and routines. A birth plan isn’t a contract that can force your birth professionals (and your labor) to follow a certain course.
- Do your homework. Now for the details. Read and research the different choices one can make around childbirth. Who do you want to be with you when you come in to have your baby? Do you want the support of a doula (professional labor assistant), or will your partner (and/or other visitors) be enough support? Do you think you will do best with natural childbirth or an epidural? Do you want the baby in your arms immediately after birth (assuming everything is going well) or would you rather that your little one gets dried off and cleaned up first? These are but a few of the many options. Childbirth classes can help you figure out what you want, but be aware that different classes have very different perspectives. While some classes are oriented towards natural, low intervention birth, other classes assume most moms will get an epidural. Choose a childbirth preparation method that reflects your values.
- Learn about the routines at your planned place for birth. Ask your doctor or midwife about what birth is like for most moms at your chosen hospital. Go on the free tour provided by your labor and delivery unit, and ask lots of questions. Check out the availability of options you desire, such as bathtubs for labor or a newborn intensive care unit. Talk to your friends who have given birth there about their experiences.
- Put it to paper. Many pregnancy websites have sample birth plans you can work off of. One word to the wise here: the less information you put in your birth plan, the more your team will be able to help you. Consider including only the items most important to you, or specifying the general tenor of what you are seeking (like freedom of movement or close observation of how the baby is faring) rather than presenting the staff with a giant list of specifics. From the perspective of your labor team, a huge long list of actions that are not the norm can be overwhelming (and disruptive to their work flow). Be sure the support person or people you are bringing understand what you want and can advocate for you. And try to include in the birth preference document a statement that you trust your team to help you make good decisions quickly in case of an emergency.
- Communicate. Show your birth preferences to your doctor or midwife before the big day. From hospital policies about eating during labor, to your medical risk factors, some preferences may be more or less likely to work out in your specific situation. Ask your doctor or midwife how realistic he or she thinks your goals are. Remember that birth plans have a variable reputation among birth professionals. Your team wants to feel that you trust them to take good care of you, and sometimes the birth plan feels to the team like you are trying to control a situation that isn’t predictable. Not surprisingly, most practitioners are not comfortable signing a birth plan like it was a contract. Birth plans are best thought of as a best-case scenario wish list.
- Be flexible and prepare for the unexpected. Most births don’t go exactly as planned. Keep in mind that the cesarean rate in the US is about 31 percent, and while some of these are scheduled repeat cesareans, first time moms these days still have a 20 percent rate of cesarean birth. Even as you get ready for the experience of your dreams, be sure you are informed about other possible outcomes. Let the team know that you understand that one of the beauties of childbirth is that no two births are exactly the same--and that you hope to be flexible and reasonable if confronted with the unexpected.
There are lots of ways to have a healthy baby. A birth plan can be an asset in two-way communication with your birth team. You are most likely to be satisfied with your experience if you feel you have worked together with your practitioner and the rest of the team to achieve the ultimate goal. Here’s to a beautiful birth and, most of all, a healthy mom and baby!