Crafting Your Birth Plan
A birth plan (or birth preferences) is a summary of your most important preferences and wishes for your birth. With a birth plan, you say I know my options, I have prepared, I have opinions, and I may not want the default care. With this simple list, you are asserting your desire for individualized care in a system that doesn’t always value (or may just not have time for) this.
Do I have to have preferences?
When I talk to some people about their desires for their upcoming birth, they say something to the effect of “I just want me and my baby to be healthy.” The implication from either the birthing person or the partner is that as long as mom and baby are healthy, nothing else matters. I want to be clear: of course, my main desire for your birth is that you and your baby are healthy; however, I also encourage you to dream bigger.
Side note: I have also seen this sentiment of “healthy mom, healthy baby” be used to dismiss women’s concerns during labor or try to smooth over their disappointments or even traumas from delivery. And perhaps this is why people are scared to hope more from their birth experiences.
Imagine you are going on a trip to Europe. Yes, your main desire if that you get there safely and return safely, unharmed. But what about the journey in between? Surely you want more from the experience. Perhaps to try some delicious and different food, meet people of a culture different from your own, see historical landmarks or beautiful scenery. Childbirth is also a journey. You will have memories of and feelings about the experience and there is much to be discovered and experienced in the process. Your birth deserves the same level of attention and planning that any trip would receive.
This doesn’t mean that after education and consideration, you have to have a long list of yeses and nos, but I encourage you to have something to share with your care team that outlines them how to best care for you and support the birth you desire.
Your main desire
It’s worth first considering what your main desire is for your birth experience. Your main desire may be to feel safe. Supported. Tended to and cared for. To be “awake to” the experience. To get through it with minimal fear, feeling held by those around you. To be instilled with confidence as you enter motherhood. To be filled with anticipation and joy. The number one desire I hear from clients is that they want to feel heard and respected.
Notice how all of these goals can be accomplished with any kind of birth when they are communicated and respected by the care team. If you planned to get an epidural as soon as possible but you got the hospital ready to push, you can still feel safe with the right support. If your plan to birth in the pool doesn’t pan out, feeling respected doesn’t also have to go out the window. One of my desires with my first birth was to birth intuitively with minimal intervention. When I found myself being sent for an unexpected 39 week induction, it felt like my whole plan was falling apart, but after regrouping and eating Chickfila before the Pitocin started, I realized how much was still within my control. I had a really empowering and mother-centered birth despite a big chunk of my “plan” getting derailed.
Identify your most important desire that is within your control and communicate this to your whole birth team. Choose something that cannot be taken away through circumstance. This process of unearthing what you care about can take time and energy, but it is worth it.
The nitty-gritty
From your first contraction to those precious moments after the birth of your baby, you could be confronted with a plethora of decisions. Do yourself the favor of preparing for how you will go about making those decisions. First, you must understand what the default care is from your provider. Ask them to walk you through what to expect once you are under their care. Many birthing locations such as hospitals and birth centers even have their own birth plans available. Listening to birth stories can expose you to the variety of situations you may find yourself in and give you ideas for preferences you didn’t even know you had. A doula can also walk you through how to think through your options and communicate them effectively.
Some things you may consider as you write out these details include:
Environmental preferences (lighting, items from home, music, etc.)
How often are you open to receiving cervical exams?
What comfort measures or medications would you like to use for pain management?
If your labor needs augmented, which methods would you like to pursue first?
Would you like to push intuitively or with guidance or coaching? What position would you like to deliver in?
If the need arises for an induction or Cesarean birth, what preferences can you still include?
There are plenty more things to consider, but these considerations give you a good start.
Putting it all together
Include your name, your partner’s name, and your main birth goal at the top. Include how your care team can support that goal (ex. asking for consent before touching you, not suggesting the use of pain medication, allowing you to labor with as few interruptions as possible, etc.). Then, list out your other preferences succinctly in bullet points. Your entire birth plan should be able to fit on one side of a sheet of paper or on a notecard so that your team can reference it easily.
Show your birth plan to your provider at your 36 week appointment. One doctor encourages asking your provider to sign it as a display of their support. This may work to your advantage if you receive any pushback later on. Go over the plan with your partner so they are prepared to answer any questions about it.
Print out a few copies and give them to each nurse you have. Verbally point out anything that is especially important to you. Then, make sure they read it.
Remember, your birth plan is not a test to pass. It is a sign of your preparation, knowledge, and respect for yourself and your birth experience. It is a way to communicate your needs and desires with those who want to support you. You, and not the sheet of paper, are ultimately the one making the decisions.
Some people roll their eyes at the idea of a birth plan. Certainly, birth is unpredictable and there are areas we may need to adjust or be flexible. Yes, the whole plan may go out the window. We still make a financial plan even though recessions happen. We make college plans even though you may discover a new passion. I find that most parents today don’t need these reminders (if anything, we are more jaded and fearful than ever). They need the support and encouragement to expect more from their care, their providers, and their births.
