Birth Plan Basics

23 08 2009

Once unheard of, it is now routine to hear “this is a copy of my birth plan” as a woman is admitted to L&D. There is a lot of info (and opinions) out there about birth plans. This post is intended as a primer to get you pointed in the right direction.
Often explained as a document outlining how you wish your childbirth experience to go, the birth plan is much more:

The birth plan is way to prepare for your birth: properly prepared, it will require discussion with your care providers and likely personal research and reading. It will allow you to seriously consider how you feel about medications, interventions, procedures, and yes, emergency situations should they arise. It will give you an opportunity to talk with your partner about his/her hopes and fears and to communicate about what is important to you both.

The birth plan is a communication tool: hopefully it will clearly and succinctly spell out your wishes and expectations not just for your childbirth experience, but for the safety of your baby and yourself. It can function as a reminder to your care provider of things you may have talked about weeks before. The birth plan can have the power to speak for you despite staff shift changes, whether or not you have an advocate there for you (partner, family, friend or doula) and whether or not you are in a condition to speak for yourself.

The birth plan is not a frivolous wish list: it is a simple one page statement outlining what you are ok with and what you are not ok with. Birth plan detractors seem to feel that a birth plan reflects a selfish mom’s over-attachment to her own experience. However, we all have the right to informed consent when it comes to medical procedures and your birth plan should focus on this aspect rather than getting caught up in small details like whether or not you want to have your ipod in the room.

The birth plan unfortunately is not a legal document: there will be hospitals and staff members and births where the birth plan does not get followed. Make sure to go over it with your care provider ahead of time. Is your care provider comfortable with the plan? Find out if the points you’ve made are even possible at the place where you are delivering – does hospital protocol even allow everything you’ve outlined? Bring multiple copies with you to give out. Be prepared for shift changes. Remember that circumstances might arise that you didn’t consider ahead of time and some parts of the plan might not get adhered to.

The birth plan is not a road map: no one can really plan out their birth. Birth is almost always surprising in some way. It is hard not to get caught up in your vision of the ideal birth but birth is unpredictable. Remember to account for things you hope will not happen. The birth plan should not become a way to cling to control. Carefully consider the points on your birth plan and thoughtfully write it out. And then, hand it to your partner and let go of the plan so you can embrace the unknowable aspect of birth.




3 responses

10 09 2009

The hospital where I had my first handed out “birth plans” to fill out as part of their intake paperwork. I gave it to my OB and she tossed it aside without even looking at it, saying, “I never look at these b/c they always end up in a C-section.” Nice. With my second, the MW had a form, too, which I was reluctant to fill out b/c of my previous experience, but she actually listened and discussed things and knew *me* and our desires. Totally different experience. A written-out plan hasn’t come up with my HB MW; I’m still debating whether to deal with the formality or not…

10 09 2009

I actually never ended up writing one for either of my children’s births. It really is a personal decision and dictated by the situation. I think the process is really the important part. Taking the time to sit down and ask yourself those questions. But I can’t imagine how awful it would feel to go through the process and have your wishes completely disregarded (as you did with your OB). With my first child I was still so naive and knowing what I know now I would definitely write a birth plan if I had to do it over again. I was just lucky that everything went fairly smoothly and I never needed it. I was also fortunate to have amazing midwives who stayed with me every second of my transfer for retained placenta.

I don’t suppose you still have your first two birth plans? It would be interesting to see how your plans changed over time….

I guess my thoughts are by the 3rd time, you know more and hopefully can assert yourself more, make more informed choices all the way through to the point where your birth plan is written in your head and heart and you may not need it on paper anymore?

10 09 2009

No, I didn’t keep them. They really were more of a checklist of preferences than a thought-out plan, which is why the OB thing surprised me in particular. Mostly with my MW’s they seem to have known me enough to know my wishes, although there were some formalities with #2 (denying Vit. K injection, etc.) that needed to be dealt with through forms. Mostly I just wanted #2 to be as different as possible from my first birth (hospital induction for being “late”).

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