There are many ways to write a birth plan. Here are some basic guidelines about what to do as well as what not to do when communicating the mother’s wishes to her birthing team.
Write a Birth Plan in Early Pregnancy
As soon as a mom begins reading pregnancy books, she begins to see that there are many choices open to her regarding childbirth. Is she interested in getting an epidural? Would she like to plan for natural childbirth? Does she want to use a birth ball during labor? What about a tub or a waterbirth? Could she benefit from using a birth doula? What about natural methods of inducing labor? All of these answers can help guide her to writing her own birth plan.
Why is early pregnancy the best time to begin to write a birth plan? Waiting until late in pregnancy to write a birth plan is problematic for several reasons. It does not give the mother adequate time to research her options or prepare. Not to mention, springing new ideas on her care provider late in pregnancy can create friction and a less than desirable working relationship.
Share Your Birth Plan with Care Provider and Doula
Birth plans should be shared with the care provider, doula and any other available member of moms support team as early as possible in pregnancy. Some moms decide to write their birth plans in conjunction with the advice from their care provider and birth doula as their ideas begin to come together.
Waiting until the mother is in labor and then pulling out a birth plan that a care provider has not seen can cause problems. What if the options the mother is interested in are not available? What if the mother and her care provider do not agree on crucial birth plan issues? For those reasons, the mother ought to be sharing her birth plan with each member of the birth team as she is writing it.
Birth Plans Should be Brief
Busy care providers, whether it be during prenatal appointments or on a labor and delivery floor, do not have time to read a 10 page birth plan. Not to mention, it is highly unlikely that there are so many birth plan issues that absolutely must be included in the mother’s plan that it would require several pages.
A good rule of thumb is for the mother to think about the top five things she cares the most about with regard to her birth. What are the things that would be the most upsetting to her if they happened (or did not happen?) What are the things she is most passionate about? Those few things are the ones to zero in when writing a birth plan. Some of the best written birth plans will be about one full page.
Birth Plans Should Leave Room for Changes
Some medical professionals dislike birth plans since they believe that labor and birth cannot be planned. So much that happens during labor is outside of anyone’s control, so why should the mother get her hopes up? The truth is that while labor is not predictable, there are many choices to research and consider prior to labor starting. The more the mother and her support team are aware of those options and how to apply them during labor, the more gratifying labor will be. In fact research indicates that writing a birth plan provides the mother with a greater sense of control and participation in her labor and birth.
When writing a birth plan, moms should be sure to leave room for the unexpected. What if she needs to be induced? What if she has an unexpected cesarean? How do her options change? What choices can she still make regarding the care of her or her baby? Labor cannot be planned, but it is important for all mothers to have choices no matter what happens.
What to Include in a Birth Plan
Most expectant mothers will want to consider the following items in their birth plans:
- preferences for mobility and position changes
- preferences for hydration including fluids as well as options for eating in labor
- options for pain relief including non-medical comfort measures
- list of support persons desired
- preferences regarding certain interventions such as IV’s, fetal monitoring, episiotomies and pitocin
- infant feeding preferences and when to initiate
- preferences for newborn procedures and timing
What Not to do When Writing a Birth Plan
It is important for mothers and their partners to write their own birth plans, not to copy what someone else has written. If certain birth plan options are not important to that individual woman, they need not be included in her birth plan.
When expectant mothers write their birth plans, they need to make sure they know what the protocols and routines are at their chosen birth facility. If the care providers do not perform enemas or shaving, it makes no sense to include a desire to avoid those things in a birth plan. Nor does it make sense to ask for a walking epidural unless moms know that they are offered.
Birth plans can be a helpful communication tool, however it is important for expectant mothers to know how to write a birth plan as well as how to effectively use one.