Creating Your Birth Wish List
As the options for maternity care and the number of possible interventions increase, women are facing more decisions than they have in the past. Many women create what is known as a "birth plan" or a "birth vision" to follow while in labor. I personally prefer the term "birth wish list" as using the word "plan" seems too rigid for the unknowns of labor and childbirth. There are some important things to consider while creating a birth wish list.
First and foremost, educate yourself about all options that are open to you. This includes considering whether you want to give birth at a hospital, birth center, or at home. Also consider whom you want to provide care for you during your pregnancy, labor, and delivery. Would you like to have an OB/Gyn, a midwife, or a family practice physician?
Take the time to research the risks and benefits of each option. Ask about their rates of interventions such as episiotomy, induction, and cesarean sections. This is important information that may help you decide on providers and facilities.
It is also preferable to learn about the benefits and risks of the interventions that may be offered to you before or during labor. The list of interventions may include induction, augmentation, epidural, artificial rupture of membranes, and many more. It is important for you to know which interventions you will accept easily and which you would prefer to avoid. It is also important for you to know what you can do to try to avoid the interventions you truly would prefer to avoid.
Another important factor to consider is whether you and your partner or other support people are on the same page. If you wish to avoid an epidural because you are afraid of possible side effects, make sure you share with your support people why this is your wish. It is very hard for the people who love the laboring woman to stay with the plan of an unmedicated labor if they perceive that their loved one is suffering. If you can sense that it is going to be hard for your support people to stay with your plan I suggest hiring a doula as added support for you and your partner. A doula will not make decisions for you but will help you and your other support people feel more comfortable with your wishes.
Be sure to share your birth wish list with your care provider. Usually your care provider can tell which things you are likely to achieve and which points may be more difficult due to hospital policies and such. Some of the things that are quite often unavoidable due to policy are having an IV placed, not being permitted to eat while in labor, and not being able to move around freely. There may be wishes you have that will require a physician's order for you to have or avoid. Sharing your wish list with your provider will give him/her a chance to write those orders that he or she is comfortable with.
When writing your wish list use positive wording for your requests and phrases such as "we hope" or "we would like to". Arrange your wishes in order of most important things first followed by those of less importance. If the highest priority for you is the ability to remain mobile, place that at the top of your wish list. If you would prefer to avoid an episiotomy but will accept one if necessary put it near the bottom. Try to keep your birth wish list to a maximum of one sheet. A long and rambling birth wish list is going to be more difficult for the staff to follow.
Be flexible and remember that no one really knows how labor is going to go until it happens. If you have to detour from your wishes and it isn't a true life-and-death emergency, make sure you ask questions to help you feel comfortable with the change in events. You will be able to tell from the mood in the room if it is something you have time to ask questions about or not.
It can be disappointing if interventions occur and you feel like you've lost control of your plan, but try to remain positive and focus on the joy of meeting your baby. It is alright to feel disappointment if emergencies or deviations happen. After the birth is over and you've had some time to adjust, find a friend or relative that can help you process your birth experience. If you had a doula, this is something that she will do with you. Even during the smoothest labor and deliveries, it is always a good thing to reflect and process your experience.
