You can find boatloads of information out there on birth plans. But most of them miss what I consider to be the most important part: Putting The Plan Into ACTION!
I consider there to be 4 steps in writing a birth plan:
- Researching your options
- Deciding what is important to you and what you want
- Writing the document
- Carrying out the plan
We will briefly go over the first three before discussing that fourth, often forgotten step.
STEP 1: Researching your options
There are the major choices like
- Where to birth (home, birth center, hospital, WHICH birth center or hospital)
- Who to hire as your care provider (Midwife, Family Physician, Obstetrician)
- Hiring a doula
- Whether to use pain medications or not
and more minor decisions like
- Which music to listen to during labor
- What to wear in labor
- To tweet or not to tweet
Consider all your options and figure out the pros and cons of each.
STEP 2: Deciding what is important to you and what you want
Once all the facts are in, spend some time deciding what is most important to you and what you want. For some, birthing with a midwife might be more important than whether or not they hire a doula. For someone else, the doula might be more important than the place of birth. There is no one RIGHT answer to all of these options, only the right answer for YOU.
If there is something you do not have a strong opinion about, it does not need to be in your birth plan. Save the most important topics for your plan.
STEP 3: Writing the document
Does the thought of doing this make you cringe? That’s OK! You can totally skip this step if you want to! While having a written birth plan can be an excellent communication tool for the nursing staff, the document is not what birth planning is all about. Everyone has different planning styles. Some people like to just think about what they need to do that day when they shower in the morning. Some like to make a list on the back of an envelope (that’s me!) and some like to have color coded calendars. All are perfectly valid ways of planning.
If you want to just think about and discuss what you want, that’s plenty. If you’re a “make a list on a random scrap of paper” type, you may find that filling in my free downloadable birth plan worksheets are all you need to do. And you can skip to step 4!
If you’re interested in a formal written birth plan, keep reading!
Some tips for a written birth plan:
- Make it yours! Don’t do a checkoff plan from the internet. You are not ordering off a menu, and you want the written plan to accurately represent the time and consideration you’ve put into it.
- Keep it to one page maximum! Bullet points are nice. This is where prioritizing is very important!
- Keep it positive in your wording. Your aim is to enlist the staff’s help in achieving your goal, not to put off the staff with “NO this, NO that!” I like to suggest wording like “I plan to birth unmedicated and you can help me by encouraging me to stay active and suggesting techniques you think may help.” or “Since I am planning a HypnoBirth, I would appreciate it if you would chart “Patient declined” instead of asking me about my pain levels during labor.”
- Address any non-birth related issues that you think might be helpful. I have had clients use the written birth plan to remind the nursing staff about Latex or iodine allergies, request a special diet, and inform the nurse how to best communicate with a client who was deaf and needed to lip read in order to understand the nurse.
Step 4: Carrying out the plan
THIS is where most birth plans fall apart, in my experience. Just like browsing Pinterest for 600 hours won’t get you the wedding of your dreams, writing the document without doing anything to make it happen won’t increase your chance of getting the birth that you want.
Some important things you can do to carry out your plan:
- Choose a birth place that does births similar to what you want on a regular basis. I have had many friends and neighbors choose to go to the hospital close by, just because it is close. They plan for and want a natural birth, but they have chosen to birth in a place with very high induction, epidural and cesarean rates. And (not surprisingly) they have a very high chance of being induced, getting an epidural, or having a cesarean.
- Choose a care provider who practices in the way that you hope to birth. A perfect example of this is episiotomy rates. I have yet to meet a pregnant woman who wants an episiotomy, so they often discuss it with their doctor or midwife. Invariably, they get the response “I only do them when necessary” so they feel good about that – but they don’t realize that everyone’s idea of “necessary” is very, very different. I’ve known providers who do 1-2 a year, and I once heard a doctor say that his idea of necessary was “every first time mom needs one, and every mom who had one before needs another one.” Dig deeper. Ask how often they do one, ask if they think you will need one, ask how they can help you not need one. But look closely at the care providers you are considering, and don’t be afraid to change in order to get care that is compatible with your values!
- Take a GOOD childbirth class, actually go, and PRACTICE what you learn! I’ve had moms tell me they only went to 2 of the 5 classes, never practiced a thing, and then be disappointed that hypnosis “didn’t work” at all. Practice will help you to master the techniques before you need them.
- Build a birth support team that will build you up and help you reach your goal. Choose carefully who will attend your birth. I hope you’ll choose to hire a professional doula (maybe even me? :)) and bring others who are supportive of your goal. If your mother thinks the natural birth you’ve planned is a stupid idea, you probably don’t want her fretting in the corner about how hard it is to watch you in pain (been there, seen that!). If your sister thinks epidurals are an anti-woman plot by the paternalistic misogynistic health care system, and you plan to use an epidural, maybe she should wait out in the waiting room. (Also been there, seen that!) You deserve to be surrounded by supportive, helpful people, not Debbie Downers!
So you’ve gone through all four steps, and your Birth Day is finally here! Will it all go exactly as planned? Not too likely. Keep in mind that life rarely goes exactly as planned, and birth is no different. If things do happen and you have to adapt your plan, that’s OK. It does not mean you need to give up EVERY aspect of your plan, it just means you have to improvise a little. Writing a birth plan is not writing a script, but rather a process to help you get the birth you wanted. Staying in the game as an active decision maker is an important part of having a birth experience you can remember as a good experience, and that is possible in just about any type of birth experience.