Making a Birth Plan

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How do I write a birth plan?

Oct 2006

We are a few months away from the birth of our first child and I still don't have a birth plan completed. I'm wondering if a midwife can/will help me with this....Will things make more sense to me after our upcoming labor/delivery classes start? It all seems overwhelming right now and I'm just anxious for words of wisdom/advice from other new/experienced parents. Thanks! Angela

Wait for the class--it might even be an activity or assignment. But this is a good time to think about your birth goals in general (and make sure the class and your own reading are supportive of those). A hospital class will mention natural childbirth, for example, without giving much attention to actual techniques! My opinion is that thinking through your birth goals and preparing appropriately is more realistic than writing a ''plan''! Babies are born all sorts of ways and don't read their parents' birth plans, so you want to remain flexible. And some practitioners might feel that a plan is unrealistic or pushy if it's stated too definitively. But thinking through goals seems helpful-- E.g., I want to labor at home as long as possible. And some requests for your practitioners could also make a difference-- E.g., I do not (or do!) want to be offered pain medication. Even if you don't hand over a full-fledged plan, talk with your caregiver about whether they support your goals, because you don't want to find out about differences at the last minute. no plan, just preparation
Hi, we're expecting our first any day now. I think you should definitely wait until after you've taken your classes -- our class, given through Kaiser, covered preparing a birth plan and yours may as well, or your instructor may be able to help you. You need not have a birth plan on hand until you are a lot closer to your date, since if you went into preterm labor, your plan would not necessarily apply.

Our instructor stressed that the hospital staff sees a LOT of these things, and they basically know what you want if you give them a general idea; so if you are interested in few interventions and as natural a childbirth as possible say that -- you need not say no induction, no epidural, no c-section, etc. Pick out the two or three things that are most important to you, and be sure to list those -- that way, they won't get lost in a long list.

One of the things I read (not covered in our class) is that the term ''birth plan'' is not really very good -- as you know by now from talking to other parents (or you will soon!), there's no such thing as a plan for something like birth. We've called our document ''birth preferences,'' since not everything is according to a plan. We have kept is very short -- less than half a page. These people are busy and who wants to subject them to a disertation?

Our three things are: staying as mobile as possible during labor to be able to get into whatever positions seem best at the time -- after birth postpone any unnecessary proceedures for an hour or two -- breastmilk only, no supplimenting with sugar water or formula.

While our birth preferences haven't been tested, I feel pretty good about them, so I hope you don't mind my lack of field testing. Good luck. Be prepared, but be flexible! anon

Two books that I enjoyed reading, and think would be helpful in deciding on a birth plan: The Baby Catcher by Peggy Butcher (sp) and anything by Inna May Gaskin (she has a few and I can't recall titles). Also there's a section of birth stories on the forums that may give you ideas, and my husband I I found taking a class at Alta Bates to be a good intro. Also helpful was having my husband and other support folks (sister, cousin) read some of the books/ birth stories that I enjoyed so we were all on the same page. Good luck! Jessica
A birth plan isn't an absolute requirement, we didn't have one. Our doctors and nurses were still very responsive to our requests and were good about explaining our options to us. If it is causing you any sort of stress don't worry about it for now. Yes, the childbirth classes will give you some ideas about what kinds of things you might want to include in a birth plan.
congratulations! what wonderful news. while a creating some semblance of a birth plan is probably a good idea, there's no need to become too attached to what you'd like to happen. in fact, being too tied to details that are somewhat out of your control can set yourself up for disappointment.

instead, i would say to make plans about things comfortable are you with your provider? do you feel like he/she is supportive of your wants and needs? a hospital birth, home birth or birthing center? who would you like at the birth? just your partner? a doula too?

please read _birthing from within_ by pam england. reading this book opened our eyes and changed our lives. birth is so much more than a physical process, and our culture unfortunately does not do a whole lot to support this more holistic approach. best to you and your growing family. lydia

Congratulations - a very exciting time! Based on my experience having a birthplan is helpful. I worked closely with my OB on this. Some get a doula too... There are so many resources out there! My only suggestion/comment is try to not get too anxious and keep an OPEN mind - birth is an amazing process and much is out of our control.. I had great trust in my doctor/midwife, which was key. I had some ideas/preferences, but in the end, it all worked out - and not exactly how I imagined. Take care and good luck anon
I remember this feeling exactly! Your OB wants to respect your wishes, so s/he asks about your birth plan, and all the reading you do (especially BPN newsletters!) seems to imply that you have to have decided everything about your labor in advance, and its simply not true. The majority of moms don't have a birthplan (and babies often don't follow them anyway).

Your OB and hospital just want you to know that they are willing to work with you IF you happen to have strong opinions about any specific issue. But if you DON'T, that's perfectly fine, too. With my first child, I think I kind of thought that if I didn't have a predetermined opinion about some specific issue by the time I went into labor that they would just not let the baby be born or something until I decided. :) But all hospitals have a default plan for a ''normal'' birth, and contigency plans for every type of complication that might come up. They are very experienced. So if you showed up with no opinions at all about anything, your delivery will almost certainly go just fine.

That said, you are right that your labor classes may well help clarify things. If you are attending a class through your hospital, you can specifically ask the instructor about the hospital's standard procedures. If her response sounds OK to you, then you don't need to do anything.

Don't worry! You'll be fine No birth plan

It was just this time last year when we were working on our birth plan.... My single piece of advice is not to stress over it. My husband and I worked on ours like it was a term paper--we crammed it in when there was hardly any time for it, working carefully on every word and every detail. When labor came, despite directing the staff to it, no one read it. No one asked for it. No one mentioned it.

What mattered, though, was that we had spent the time discussing what we wanted, how we wanted it, and what we would do in a variety of scenarios. Being prepared to be our own advocates was the best thing we got out of the plan. Nurses and staff were too rushed and they changed too often to stop and read. We had to be prepared to repeat our requests to everyone who came in. (Because we delivered late at night, we didn't even have our ob, so the on call doctor didn't know our plan in advance, either.) As for the plan itself, I'm not even sure what happened to it--I know it sat on the counter in the delivery room for a while, but it never made it home with us. It was useful as a process, but useless as a document. anon

Regarding a birth plan - my advice is that the best plan is no plan at all. Having a plan of the way you foresee your labor and delivery process going is only setting yourself up for disappointment.

Of course be knowledgeable about all the possiblities - pain medications, vacuum, c-section. But limit your ''plan'' to what you'd ''rather'' and ''rather not''.

I am so greatful I didn't have a plan. I went in with a ''rather not'' on nearly everything. But when I heard her heart rate drop I trusted my OB to do what was necessary for her to be born healthy - thankfully this meant using the vaccuum but no C-section.

The classes are helpful in going over scenerios, but you just can't possibly plan for *all* the scenarios - will your water break before you go to the hospital, will you have 30 hrs of labor or 6, will you have back labor, will the baby be breach, etc.

Just be ready to roll-with-the-punches! non-planner

All I can say is: Keep It Simple. And, if possible, worry more about getting the baby home and raising him/her than getting him/her out. That's the easiest part, by far. -Best to you in this wild adventure.
I recommend that any birthplan you have allows for ''whatever happens, happens''. My midwife once said having a birthplan is a good way to end up having a C- section. With childbirth you can't plan for a lot of what happens--how long your labor will be, if you'll want pain medication, etc.

I found that a very good way to prepare was to watch ''A Baby Story'' on TLC (The Learning Channel). It's on several times a day, is only half an hour long, and always has a happy ending (they're mini-documentaries, following a couple through the last part of pregnancy, and the delivery).

They cover all types of labor and deliveries--midwives, doctors, C-sections, homebirths, drugs, no drugs, water births, etc. It was a great way for me to prepare for the birth of my first child, and to get ''refresher courses'' for the second and third. It took a lot of fear out of the whole hospital experience, because I was familiar with the equipment, and what the nurses would be doing. Best of luck!!! Heidi

Hi, Angela!

Probably, your birthing classes will be helpful with this. However, as new parents, you are, of course, anxious about these sorts of issues: don't worry, it took me a while to get around to doing mine, too!

There's a website that was created to help you make a birth plan: It's not the best organized in terms of topics, but it is very comprehensive. So comprehensive, that most of the things they list are often not necessary to include, because they are now automatically included as part of the procedure in Bay Area hospitals (if you're going to deliver at a hospital). However, it's a terrific resource for helping you develop awareness of what the issues ARE that you'll want to think about for your birth plan. If you have a doula or midwife, that person can help you narrow your final plan down to the necessities.

Finally, I have some books to recommend, if you haven't read them already. I found them incredibly helpful for making decisions about my birth and for addressing general fear/anxiety about the labor/delivery process: ''Ina May's Guide to Childbirth'' by Ina May Gaskin and ''A (or The) Thinking Woman's Guide to a Better Birth'' by Henci Goer. These two books were felt like a godsend. They are extremely well researched and inspiring, and helped me make informed decisions about what I wanted.

Congratulations, and best of luck to you (and welcome to the parent club :)!! Alesia

I spend alot of time preparing my birth plan, and wanted to share my recent experience.

It is great to know what you want and visualize getting it, but birth is a very powerful thing, and you may end up more like a passenger than the driver.

I spent my months of pregnancy reading every book I could get my hands on and practicing relaxation techinques and hypnobirthing exercises. I wanted a fully natural water birth with my nurse-practitioner. I had a detailed birth plan that basically went out the window at the birth.

I had broken water misdiagnosed, and they were going to hospitalize me and put me on pitosin ASAP. I was in the bed with the IV in my arm, and I begged them to check if it was absolutely necessary, and they determined that my water had not broken and sent me home!

5 days later, I went into the hospital, and after 10 hours of very painful labor, I asked for some pain relief and got a shot. A hand held massager was a LIFESAVER. Didn't use any of the essential oils, visualization, etc. Couldn't really hear the music. Most of the stuff I brought for comfort went unused.

Hours later, I begged for the epidural, but it was time for the baby to come out. I did do water birth, which was wonderful, but spent 3 hours pushing very gently, and the baby came out purple and not breathing. She spent the next several days in the NICU which was incredibly painful for all of us. Luckily, she is a thriving, wonderful miracle now.

In retrospect, I wish someone would have guided me into pushing harder and faster. I don't think the water had anything to do with her not breathing. It was relaxing and great.

My message is to trust your gut, but have a doula or a very trusted expert at your birth. I don't think a husband or family member can really do everything for you.

As for after the birth, it is great to have some favorite treats/beverages/cozy clothes/anything from home that makes you comfortable. I wasn't quite prepared for the first week. People that come to help can be a hindrance. Your body is exhausted, bleeding and might leak breastmilk. It can be a difficult messy challenge. Give yourself lots of love and rest.

May your experience be blessed and amazing! Made it through!

It makes more sense to do a birth plan after you do the child birth preperation class so you know what your options are.

I, after two pregnancies, frankly don't believe in written birth plans. I think it's much better to be informed of your options through the classes and have an idea of what you'd like, but remain flexible. I've known many moms that had birth plans in various degrees of detail and just about all of them felt more dissapointment, failure and even guilt when things didn't go according to ''plan'' than those of us who didn't have a concrete plan. If there's one thing about childbirth, you have some control, but a lot of it will just happen and can be unexpected and not what you really want. Who goes into labor saying I want to have 30 hours of labor then an emergency C- section? No one, but you need to be preprared mentally that things may not go according to a set plan but that the main goal is delivering a healthy baby. And that's just the start of parenting, as who knows what type of child you'll have - could be colicky or calm, a good sleeper or bad sleeper. There's so much about parenting we just don't have control over.

I have also heard the following from several friends that work in hospitals and from nurses that have said it on the Parents network -- there is a general consensus that the more detailed a written birth plan, the more chances that things don't go according to plan.

So take the child birth class and you will feel more empowered as you will have more knowledge. Be willing to accept that you may not want intervention or drugs, but in some cases these will help you give birth to a child with fewer complications. I didn't want any intervention and still regret that I didn't allow them to vacumm my first child out - because of unexpected complications he was very close to experiencing some brain damage that could've been avoided by getting him out faster. In the refresher class for my second pregancy, the doula taught us the following acroynm, which was the only plan I took with me to decide on interventions/drugs: BRAN - what are the benefits, what are the risks, what are the alternatives and what is the immediate necessity? anon