The subject of using online birth plans came up last night, so I wanted to distill my advice here on the blog. Turns out, I wrote about it 4.5 years ago. Ha! Ah well, it’s still good advice.
Originally published February 7th, 2012:
First of, let me say this: I know you can’t plan your birth. You can’t decide it’ll last only 20 minutes, or that you’ll only push twice. Do you know this? I hope you know this. Rather, a birth plan is a tool that should be used by a mother to sort out her options and to communicate those preferences to her care provider. While she can not plan what will happen, she can give a good amount of thought to how she will handle what happens. Also? I believe very, very much that it’s something that should be done no matter the place of birth. Even moms planning home births need to think about what they want or don’t want. So, after giving much thought over the last couple of days as to what makes a birth plan good, and what can make it very, very bad, I give you the following advice:
DON’T: Go to a website that “writes” a birth plan for you by having you check off a couple of boxes that sounds good. Why? Well, it comes across that you put very little thought into writing your birth plan. Also, you can end up “choosing” things that are not even an issue at your desired birth place (like saying you don’t want to be told what to wear during labor at a home birth). However, if you feel completely stuck, you can check out one of those websites for some ideas, just make sure you rewrite things in your own words.
DO: start with an introductory couple of sentences. Think along the lines of: This is my second birth. My first birth was very long, and very difficult, with many things that felt like I was not listened to. I am hoping for a much calmer, more supported birth. Or whatever fits your specific situation. Make it short, to the point, and applicable to this birth. It will help the people who are part of your birth team know very quickly what you are looking for, which means that (hopefully) they will be supportive of where you are physically and emotionally, not where they think you should be.
DON’T introduce anyone and everyone in your life in the birth plan. A birth plan is not an autobiography. Please don’t use it to introduce the nursing staff to your cats, or your turtles, or your childhood home that you haven’t been to in 25 years. And for goodness sakes– no pictures of these things!
DO keep the information relevant. If there is something about your medical history that is relevant to this specific labor and birth, include it. Yes, it’s in your chart…somewhere. But save everyone a headache and confusion and include that important information right at the top of your birth plan. Have you already met with an anesthesiologist and found out that you are not, for a specific reason, a candidate for an epidural? Include that! Is the father of the baby not participating in the birth because of religious or cultural reasons? Include that! Trust me, it will save so much time and frustration of everyone is, almost literally, on the same page.
DON’T make your birth plan more than a page long, two at the most. Very important information gets lost in long birth plans, and it can seem like not much actual thought went into writing the plan.
DO make sure only time-specific information is in the plan. Don’t bring a plan to the hospital that talks about laboring at home (or how long you’ll wait before calling your midwife for a home birth). You do need to think about things like that, but it can end up burying the more relevant information.
DO write out a really long plan, if you feel you need to. You can include things like how long you want to labor until calling your doula, or at what point you want to o to the hospital, or fill up your birth tub at home–whatever. But then sit down with someone and go through that list with a very critical eye, and think, “What will people need to know at the time?” Then start to cut things out, leaving a shorter version.
DON’T list things that are not done at your chosen place for giving birth. If they don’t do routine IVs, don’t say, “I do not want a routine IV.” On the flip side, be reasonable. Don’t list things that just CAN NOT happen, like, “If I have an epidural, I do not want an IV.”
DO take good, comprehensive childbirth classes so you can understand all of your options and help you understand how to avoid those things you do not want. So, for instance, if you don’t understand why IVs might be used, you might need a class. If you were never told the many different ways an induction might be done, you need a better class. This might ruffle a feather or two, but knowing about something doesn’t mean it’ll happen. Ignorance IS NOT bliss. Hopefully there are things you’ll never need to go through, but knowing about them, just in case, is always a good idea.
DON’T assume that writing something down means that it will be so. Make sure that your care provider (and, since most people see a group practice, ALL the possible providers) will take the time to listen and respect your voice. There is nothing sadder to me than telling families prenatally to address specific things with a care provider, only to watch those parents find out that Midwife X won’t allow it, or Doctor Y doesn’t believe in it while mom is in labor. Yes, you are the patient, but birth time should not be battle time, and if there are options, find the very best care provider to fit what you want. And yes, it is worth it.
Quickly, in my opinion, what should a birth plan touch on?
- support people
- comfort measures
- labor positions/ tools
- medication preferences
- pushing and birth positions
- newborn procedures (right after birth and the few days after birth)
- post-birth maternal procedures
I’m sure I missed a thing or two (or three). What do you think? What tips would you add? What else do you think is a MUST INCLUDE? Add it in the comments below!