The Birth Plan:
Part 1: Hospital birth
Birth is near. You’ve dreamed of this day, you’ve planned for this day, and you’ve been anxiously awaiting this day. You and your partner have decided that you will be giving birth in a hospital. Maybe you feel as if you have no choice (insurance blocks you from home birth) or maybe you feel safer in a hospital, either way, you’ll be in a somewhat unfamiliar space with medical equipment all around. The person who catches your baby may or may not be the person who has seen you for the last 40(ish) weeks. The nurses on staff will have at least three other mamas who they are caring for. And the whirlwind of beeps, bings, weird looking machines and a whole load of staff may send your head spinning, what can YOU do about it?
While hospital birth has come a long way from ths Monty Python sketch, for some, this is still the reality of birth.
Wouldn’t it be nice to have a say in your birth?
What are the benefits to writing a birth plan?
How can you and your partner plan for your birth without being criticized by hospital staff?
In this post, I would like to cover some of the reasons why writing a birth plan with your partner will benefit you, and how to write a birth plan that doesn’t cause ripples in the pond of the medical world.
Yes, birth is about a healthy mother and a healthy baby; physically AND emotionally healthy. Studies have shown that the way a mother feels about how she gave birth can greatly affect how she mothers and feels about being a mother. Having interventions during labor and birth aren’t inherently bad, but when the laboring woman feels like she’s had NO choice in what is going on, feelings of inadequacy, chaos and depression can follow.
Practicing informed consent AND informed refusal, educating yourself so you know your options, writing a birth plan and having a birth partner are all ways to help the birthing woman to feel more in control of a somewhat uncontrollable event.
What is a birth plan? Good question.
A birth plan is a written out plan of how you would like your birth to go, barring any medical emergencies. It should include what your desires are if a medical complication were to arise. It could address what type of fetal monitoring you are comfortable with, whether that be intermittent, continuous, external or internal. A birth plan might address your desire to eat or drink according to your body’s wishes. What if it is your hospital’s policy to put a time limit on labor but you feel like letting your body follow it’s natural urges? A birth plan can address that.
How do you feel about augmenting (speeding labor up) labor? Maybe you would like to delay certain “routine” newborn procedures. It could include your desire for a natural birth OR your desire for medication to control your pain-your birth plan should address how you would like to cope with pains associated with labor, whether you would like no medication, natural coping techniques, narcotic pain medication, or epidural pain medication and when in your labor you would like to receive them. A birth plan not only lets the medical care providers know what your wishes are, it also lets them know that you’ve been doing your homework and provides a way to open up the line of communication with them. Talking with your care provider(s) and discussing labor and birth is a great way to gain some control in an otherwise uncontrollable event.
Do take this time to research and educate yourself about the decisions you are making. A birth plan is nothing more than words on a paper if you can’t justify and explain your choices to your care provider(s). I recommend writing your birth plan yourself and NOT to use a blank template off the internet. By creating one yourself you are giving yourself an opportunity to really get an idea of what might happen in the birth room and examine your feelings surrounding it.
Do take into consideration that while we can dream and plan for birth, birth is OUT of our control. While most healthy women give birth with no complications, there are times when medical intervention can be life saving. When writing your birth plan it is a good idea to keep in mind that there is a time and a place for interventions. A vaginal birth AT ALL COSTS is not always the best outcome. Knowing your options and why you needed a certain intervention can help you to feel more at peace with a deviation from your plan.
Do use positive communication techniques when writing and discussing your plan with your care providers. Instead of saying “I don’t want an IV’, maybe consider framing it in the positive : “I would like freedom of movement and I feel like an IV would get in the way of that. I would like to avoid an IV and take responsibility of making sure my body is fed and well hydrated by eating and drinking to thirst.” This statement would not only cover the routine IV that most hospitals would place, but also makes clear that you don’t want to be restricted in labor AND your desire to keep yourself energized through food, instead of sugar water (which is what would be in an IV).
Do make sure to bring a copy of your birth plan into a prenatal appointment to discuss it with your care provider BEFORE the birth of your baby. This way you will have a chance to talk about your needs and desires ahead of time. Many times, in a hospital birth, care providers will pay lip service to the wants and needs of a patient, but when labor hits, it all goes out the window and a family ends up with routine procedures that may not have been necessary. Letting your care provider know ahead of time allows you BOTH to understand where each other are coming from, and may give you an opportunity to change your plan of action. For example: does your hospital routinely break a woman’s bag of waters, start an IV and add pitocin to it when they are admitted into labor and deliver? If so, knowing this ahead of time, you may decide to not go into the hospital until you are sure that labor is active and well established, trying to bypass the routine procedure of augmenting labor, which can cause the need for more interventions (something you may or may not want to avoid).
Do keep your birth plan to one page. If you come in with a small novel, it is less likely your nurses or care provider will take you seriously. They do have many other laboring women to take care of and many medical personnel will laugh you off if your birth plan is long and drawn out. Knowing what procedures your hospital does routinely ahead of time can allow you to avoid putting arcane practices on your plan and frees up space for more pertinent things. If you KNOW that your care provider has a 0% episiotomy rate, there is no real need to put in your birth plan “No episiotomy”.
Writing a birth plan gives you (and your birth partner, if you have one) an opportunity to know what options you have in labor, birth and postpartum. If gives you some control in an otherwise uncontrollable world. If gives you a chance to examine your true feelings surrounding labor, birth and postpartum and it can open up a line of communication between you and your care providers BEFORE the big day.
Stay tuned for part 2: Birth Plans: Home birth, coming soon!
I am a mother of two, a breastfeeding advocate and an outspoken natural birth enthusiast. I believe that birth is a normal, biological process that is accompanied with a psychological rite of passage. By educating and preparing most women can enjoy the wonderful benefit of unmedicated birth.