Do you really need a birth plan? What’s the purpose of it? “Sometimes I hear that you need to have a birth plan to let them know what you want… sometimes I hear that if you have a birth plan it practically guarantees you a c-section. So, do I write one, or not?”
Birth plans really have two purposes. The first one, I think, is more important. That is, the birth plan is for you as a couple to weigh your options and figure out for yourselves what kind of birth you’d like to have – not are going to have, but would like to have. It gives you the opportunity to explore, in detail each of the interventions, coping techniques, etc. and decide which of those makes sense for you.
It also gives the couple the opportunity to discuss things like, “Remember, I love it when you brush my hair out of my eyes.” or “It makes me feel better when you sing me that little song.” These are the soft skills of labor support. Knowing what kind of music to play (or none); knowing the massage techniques she likes; knowing her favorite pillow or blanket will help make her feel better; knowing that she’s got a knee issue and that hands and knees positions don’t work for her. These things make for a good birth plan.
The second purpose to birth plans is as a communication tool with your care provider (OB or Midwife). Let your care provider know, in advance, that you plan on bringing your birth plan to your 36 week appointment and you’d like to discuss it with them. Bring 2 copies, one to give to them, to go in your file. The other is for you to make notes on.
You want to go in with the knowledge that some of the things you have there may not jive with your care provider’s policies or those of the hospital or birth center. This is where negotiation and compromise come in. For example, if you know you don’t want an IV, you can compromise on a hep-loc and have the port available if an IV should become necessary later on in labor.
If you just bring your birth plan to the hospital without discussing it first with your care provider, you are not likely to have your wishes respected. Then there’s the feeling of being ignored “My nurse and doctor didn’t even read my birth plan!” Well, no, they didn’t. You need to start that discussion.
You’ve already talked to your care provider at your 36 week appointment. Now, when you arrive at the birth center or hospital, discuss it with your nurse. Don’t just hand it to her and expect her to read and follow it. Your nurse isn’t a servant. You need to have her as an ally during labor. Ask her if she has a minute to read it and discuss it with you before hooking you up to the monitor and IV (this assumes a hospital birth). See if there are any compromises to be made. If your nurse is happy, you’ll have better support from her.
So, what you are doing is setting reasonable expectations and laying the ground work for successful communication with your care providers.
Birth plans go awry if you don’t acknowledge the possibilities. If you leave out the “if I need a c-section then…” part then if a c-section becomes necessary, you are left with the devastation of a “failed plan”. Or if you write “I do NOT want an epidural. Period.” Then you decide you do want one later in labor, you now feel like you’ve failed yourself. The artificial limits you’ve imposed upon yourself are, in this case the root cause of your distress – not the epidural itself.
Remember, use your birth plan as a tool for communication – both with your partner and your care provider, rather than as a to do list, or action plan.
Next Post… Artificial Expectations and Attachment to the Idea of Birth
This is really intelligent and caring advice Deena. Thank you for this and I am sure that many families will benefit from the wisdom of the use of a birth plan in the ways that you recommend.
Thanks, Sharon. Birth Plans have been a recent topic of discussion at multiple venues recently. I have more rolling around in my head, so I’m sure there will be additional posts on the subject in the near future.