We recently had a Cafe on how to write your birth plan...if you missed it, here's a recap!
Panelists: Erin Baird (CNM), Leah Miller (CNM), Debbie Perdew (DONA Doula)
Birth plans originated at a time when women had virtually no rights or input regarding their birth. Thankfully, with time and education, there is now a shift started in the other direction. Debbie discourages an “us vs. them” mentality when preparing for birth. She encourages her patients to choose care providers and a birth team that they trust, therefore making a birth plan less necessary. Leah encourages patients to at least think about a birth plan and what their goals are for birth. Knowing all of your options can help take away some of the fear when going into labor. The purpose of a birth plan should not be to set the law, but to get the mother and partner thinking about the options and aware of their choices.
From The Nursing Birth Blog:
1. DO keep your Birth Plan short, simple, and easy to understand (1-2 pages max).
2. DO keep the language of your Birth Plan assertive and clear.
3. DO use your Birth Plan as an impetus for doing your own personal research about your preferences for childbirth.
-Leah agrees with #1 and #3, but cringes at the language of #2. We all want to be respected, but being assertive can cause your hospital team to be defensive instead of helpful. Many years ago assertion may have been necessary to fight for your choices during birth, but hospitals today have come a long way and largely appreciate and honor the wishes of birthing mothers.
4. DO include your fears, concerns, and helpful things for the nurse to know.
5. DO review your Birth Plan with your birth attendant and ask him/her to sign off that he/she read and understands it.
6. DO make your Birth Plan personal (don’t just copy paste) and DO make sure that you understand and can elaborate on everything in the Birth Plan if asked.
-Erin says that #4 is the most important part of your birth plan. The birth plan is an opportunity to introduce yourself and your fears, desires, needs, personality, etc. #5 is also important to ensure that all of your wishes are possible at your place of birth (laws, rules, etc. may be in place that you need to know). #6 is less important, as long as you and your provider know what you're asking.
7. DO look at examples of great Birth Plans online to get some ideas.
8. DO run through scenarios in your mind about how labor could unfold and actually talk these scenarios out with your labor companions and doula (or perhaps even your childbirth educator or birth attendant too!)
9. DO try to treat researching and Birth Plan writing as a fun and exciting experience, not a chore!
10. DO remember to bring your Birth Plan to the hospital!!
-Debbie agrees with #7, and says the #8 is very important because we never know how birth will go. She says that #9 is true...because you're having a baby! That is fun and exciting. #10, of course, is also helpful (you can even email it to yourself in case you forget to bring the hard copy to the hospital).
Overall, our panelists agree that #4, sharing your fears and concerns, is one of the most crucial parts of the birth plan. Keeping it short is also a key factor for Erin. Trying to predict and control a situation that you have almost no control of will likely set you up for failure. Keep your desires short and realistic for a better chance of success.
To avoid offending your caretakers, come with a respectful and collaborative attitude in your birth plan. Erin reminds us that your expert midwives and OBs are there to help you and genuinely want the best for you and your baby. They have chosen this often difficult career path because they love helping women and welcoming babies into the world. Keeping your care-providers on your team, instead of alienating them with demands, will help your birth to be more successful.
An audience member reminds us that having these discussions with your labor partner is at least as important as having them with your care-providers. A birth plan is a great way to start the conversation with your partner and anyone that will be present at the hospital. Knowing your options also allows you to confidently change your mind about anything in your birth plan. Keep in mind that you, your partner and your care-providers are a team working together towards the same goal.
Some things you do not need to include in your birth plan: skin-to-skin (this happens automatically as long as there is no emergency; your partner can also be the one to do skin-to-skin if mom is unavailable); episiotomy (not done anymore unless very necessary); enema (no longer performed).
Ask yourself how your birth plan can help you feel respected and strong. The ultimate goal is to successfully birth a child, and if you remember that then you can feel successful afterwords. One of Erin's patients wrote long and detailed birth plans for her first few births (she had eight children), but for the later children wrote invitations to her birth instead. She realized that she could not successfully “plan” her births and so she learned to let go and invited the unknown, medical personnel, various necessary medical procedures, and more. Ultimately her last birth had various complications and she was able to handle that with joy and keep in mind what the ultimate goal was, without being disappointed or afraid of how her birth was going.
In closing, audience members shared stories of birth plans that were adapted beautifully by her birth team as the labor progressed, and a mom who had the perfect birth that she dreamed of. While we are wise to prepare for the unknown and know that things can go wrong, sometimes they can go exactly right.