Friday, May 16, 2014

Creating a Birth Plan That's Right for You

When it comes to the big event, the birth of your baby, you (the parents) and your baby are the Stars of the Show. Your preferences and wishes for labor, birth, and your early postpartum care for you and your baby are important. While you have placed your confidence in your care providers to ultimately be responsible for you and your baby’s well being, they can do so while also honoring and respecting what is important to you. Writing a “Birth Plan” allows you to 1) think through the process of birth so that you are aware of what needs to be considered, 2) use the birth planning worksheets as a tool to communicate with your partner and your birth team about what is important to you, 3) picture your ideal birth in addition to contingency plans if birth doesn’t go the way you originally planned.

The process of writing your birth plan encourages you to learn about your different options, including: how labor begins, different comfort measures and pain relief, labor support (your partner, family member or a doula), different methods of augmenting a slow labor, positions for birthing/pushing, common medical interventions, common newborn procedures, benefits and tips for successful breastfeeding, postpartum care options, and much more. You can learn about these options by reading books about childbirth, attending a childbirth education class, asking your doctor, midwife, or doula, or searching online. Be careful where you get your information. While the Internet seems easily accessible, it is not always extensive or based on current research.  A childbirth class is the best way to learn about your options, ask questions in an open format, and discuss concerns and thoughts with other parents who are considering the same issues. If a class is not available in our area, perhaps consider private mini-classes with your doula or a midwife. While your care provider is available to answer specific questions, they do not always have the time to provide you with thorough childbirth education.

While you are learning about all of your different options and deciding what is important to you, be sure to consult and discuss with your partner. He will likely have questions that need to be answered and preferences that need to be considered as well, and the birth plan is a great tool to get the ball rolling on these discussions. You can also use the birth plan to red flag any unanswered questions you might need to bring up to your care provider. As you move through your birth plan with your care provider, be open to discuss why something is particularly important to you and share that with your care provider, while also assuring your care provider that you are open to changes as the need arises.

As you think through all of your different options and possibilities, a “perfect birth scenario” begins to take shape in our mind. This is normal and perfectly fine. However, take time to consider “what-if” scenarios as well so that you have contingency plans in place.  For example, what will you do if your labor is unusually long- what pain relief options would you prefer? Or what if you end up needing a cesarean delivery- how might that change your preferences for immediate postpartum time with your baby?

Remember that your birth plan is not a check-list for what will happen during your birth.  It is a plan that includes your wishes and preferences so that your labor support team can tailor their care for you. I like to encourage the students in my childbirth education classes to:

Keep it positive. Long lists of “don’t” and “I don’t want” are not very helpful. Instead keep your phrases positive and open ended. “I would like a natural birth with as few interventions as possible.” Or, “I would like to know what all my pain relief options are throughout my labor.” Or, “We would like to keep our baby with us throughout our hospital stay. We would appreciate your support."

Keep it brief. What are the 3-4 most important things to you? Can you summarize them into brief phrases? Sometimes we need more detail to explain something specific, but your birth support team is much more likely to refer to a birth plan that is brief. “We have prepared for a natural birth. Thank you for helping us reach our goal."

Personalize it. Use pictures, drawings, photos, or colorful writing to help personalize your birth plan. Perhaps you can hang it outside your hospital door or distribute it to the nursing staff when you arrive in addition to leaving a copy with your doctor or midwife.

Be open. We never know exactly how birth will unfold. Your wishes and preferences might change if you were expecting a short labor and ended up with a particularly long one or one that includes back labor. Allow yourself to change your mind. Be open to your birth teams advice.


Above all, appreciate your personal birth experience as perfect for you and your baby. It is a time of growth, a time of learning, and a beautiful rite of passage, whether this is your first or tenth baby. Savor each unique birth experience and remember that our plans and wishes are not necessarily our babies. Allow your birth plan to help your learn, process, communicate, and prepare. And then sit back and allow your birth to unfold.  

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