Birth Plan: Why You Need One
Two articles came out recently discussing the need for women to prepare more for childbirth. One article in the L.A. Times discusses a recent study’s finding that fewer than 30% of expecting mothers attended a prenatal birth class with their first pregnancy. Whew! The article and research point out that women receive less information from OBs instead of midwives about their options. Additionally, it demonstrated that younger OBs considered epidurals routine and expressed more concern about vaginal birth than older OBs. A scary trend!
The second article is on Babble.com and it’s an interview with one of my heros, Erica Lyon. She is the author of “The Big Book of Birth” and founder of Realbirth Center in NYC and a veteran of 20 years in childbirth education. She talks about how education opens up choices for women, including the option of a more natural birth. She also emphasizes that women should feel safe, loved, and respected during the vulnerable time of childbirth.
1) Read these articles.
2) Encourage your friends to make a birth plan.
People hear “birth plan” and think it necessitates medicine-free birthing. Not true! It just means sorting through you and your partner’s desires as to how your birth center will handle your labor, delivery, and post-birth. If you know you want an epidural, write that down. If you know you want your mother present, write that down. If you know you want skin-to-skin contact with the baby right away, write that down. The healthcare providers aren’t telepathic and they will do their standard operating procedure (whatever that is) unless you present them with your birth plan ahead of time. If you think you’ll have lots of time to figure this out WHILE in labor, you’re mistaken. Plan ahead.
3) Be open to changes.
I’ve heard mom’s say, “Well, it’s up to the doctor” or “Why make a plan when things might change?” and most frequently, “I’d like a natural birth, but at some point want drugs if it’s too tough.” Clearly you are not in charge of what happens once your body is in labor (either of its own accord or due to induction), so roll with it. If you had planned out a signal term to your partner that it was time for drugs, and then think you can go a little further, that’s okay to change your mind. The midwives, docs, and nurses won’t be mad (or shouldn’t be at all disgruntled) if you don’t want the drugs. Nor should your doula and partner be disappointed in you if you do change your mind. The point is, be flexible with the plan you’ve created. Making a plan does not mean you must follow it.
4) Write it down; sort it out.
By fashioning a birth plan ahead of time, you will discover inevitably that you and your partner have a different approach to an item or two, i.e., does your partner want to cut the cord? Do you want anyone else present in the room? Do you want the baby to room in with you or stay in the nursery with the nurses? Write it down; sort it out. Better to compose the ideal birth scenario before you are at your birth center, than to be scrambling there and adding any stress to an already intense time.
My hospital provided me with a birth plan to fill out. My doula also had a template of her own. It’s not just a “medicine-free” birth thing. It’s in your file, able to read by your healthcare providers, and it’s one less surprise between you and your partner!
Great post and great advice!
Shocking how few women are prepared for childbirth, which can have such long term physical and emotional consequences.
I’d add 2 things:
1) Keep it short. Request other people to act a certain way, rather than stating wishes for your own behavior/situation. Ex: say “Do not offer drugs” rather than “I do not want drugs.”
Avoid the 2 page long philosophical treaty on birth, which the medical staff will either not read or not remember. Highlight what’s REALLY IMPORTANT to you in an easy-to-read format (bullet points, etc.) at the top. If there are less important “preferences,” put those at the bottom.
Example:
– A natural birth is important to me. Please encourage me, especially when I sound the most hopeless.
– Do not offer me drugs. If I ask for drugs, encourage me to wait a little longer.
– Give me the baby immediately after birth. Do not take him away until I’m ready.
– DO NOT give my baby the following treatments (state here: bottle, eye drops, whatever) .
Additional:
Please offer me massages, suggestions on positioning, etc.
2) Have someone OTHER than you or your medical assistant memorize this plan and be its proponent at your birth. Doula, partner, mother, friend, whoever.
When you’re in the throes of labor, you will not be in a position to remember it; and your medical assistant may be too busy with other things.
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Side note: I have heard so many stories of wonderful nurses in delivery rooms who are compassionate but totally clueless about giving practical assistance with positioning, etc. for women in back labor. You really have to verify IN ADVANCE whether your midwife/OBs know how to handle a back labor position (and check with every person who may be on call the day you go into labor, not just your regular provider). If you have any doubt, bring that info to the hospital with you and make sure your labor coach knows it so he can help you!!
Good, great, and fantastic! Thanks for all these thoughts!! The details you provide are very helpful, especially that one should be precise and specific in needs/desires. Essays are neither read nor helpful.
We were fortunate to have a nurse who was very supportive of medicine-free labor. Our doula directed the pushing and the nurse acted in support to her. If we had no doula and had left it up to whomever happened to be the nurse that day, we could have been in very rough shape. Labor coaches & support staff necessary!!
Great points both in the post and the first comment! The only other thing I want to add is that every woman and every baby are completely different, so no one should feel pressured to experience childbirth exactly the way their friends do or even close to a previous birth experience. My three births were each completely different and all full of surprises, but every one ended in a healthy baby and mom, thank the Lord. Unfortunately, sometimes doctors and nurses default to treat every woman the same and neglect to recognize these differences. Birth plans can help remind them you are a unique individual!
Wise reminder! Like everything in parenthood, birthing too is personalized and unique.
When Novice Natural Mama and I sat down with our doula to discuss our birth plan, our doula really pressed us to decide whether or not we wanted to strive for a natural birth without drugs. On a scale of 1 to 10, how important was it to us? Assigning a number value to it helped solidify its importance.
Absolutely! We had to really commit to it mentally and verbally (emotionally, physically, etc).
[…] Those who fail to plan, plan to fail, as my riding coach used to say. See posts here {Birth Plan: Why You Need One}, here {While You’re Birthing, Who’s Got the Kids?} and […]