So you are having a baby and somewhere along the way it’s been suggested that you put together a birth plan. Your provider may have given you a check the box type birth plan. Your childbirth educator or the book you’ve been reading may have given you a birth plan that looks like many different options to consider—some of which might not even be an option at your birthplace, or may be standard practice at your birthplace and not necessary to include on the plan. In my many years of attending births I’ve seen lots of birth plans (or perhaps we can say “birth preferences”) and a wide range of responses to how they’ve been received by hospital staff. Here are some of my insights.
First, the birth plan is plan “A”- an ideal scenario of how you’d like things to go. Rarely does the entire birth go exactly according to plan. Think of the work of putting together your birth preferences as more of a thought exercise of learning about what is most important to you and your partner. Of course a healthy mother and a healthy baby are first on everyone’s priorities. But what else?
You may have particular concerns that you want to be sure are known and attended to during your labor. Here are a few examples:
“IV starts are often difficult and painful for me, please be sure to have someone very skilled to start the IV or heplock.”
“I feel reassured by being able to hear the baby’s heartbeat on the monitor.”
“<Husband> will not be comfortable watching the birth, do not encourage him to “come see the head”.”
“We’ve had bad experiences of not being listened to by docs in the past. We need to ask lots of questions before making decisions about our care and not feel that procedures are done without full consent.”
Many people have written about Birth Plans already—here area some links to birth plans to help get you started in your thinking:
Kim James, a local birth doula, childbirth educator and doula trainer has some great sample birth plans and thoughts on her website.
Penny Simkin, author of numerous books related to childbirth, a doula trainer and childbirth educator of many years, has a number of good resources on her website, including a nice overview of thoughts around putting together a birth plan for a Cesarean.
Put some thought into what is most important to you and what is most important for the staff to know about you.
When you arrive at your birthplace, be sure to have several copies of the birth plan with you—even if you’ve already gone over it with your care provider in the office at a previous visit. The nurse, midwife or doc on call probably hasn’t seen it, or needs a refresher. Then with each shift change, be sure to let the new staff know your preferences and priorities. This is a good thing for the support people to do, rather than the laboring person who is probably busy coping with contractions. As the time for the birth draws near (“we can see head!”) it’s a good moment to recall your priorities and be sure everyone is aware—perhaps you wanted your partner to announce boy or girl, cut the cord, delay cord clamping, have a hushed arrival, etc. Often an additional staff person or two arrives right around this time and they have almost certainly not read the birth preferences.
Above all, try to be flexible. Birth is generally unpredictable, but do speak up for what’s most important to you.
