Birth Plans

What is a Birth Plan?

The term birth plan can actually be misleading — it's less an exact plan than a list of preferences. In fact, the goal of a birth plan isn't for you and your partner to determine exactly how the birth of your child will occur — because labor involves so many variables, you can't predict exactly what will happen. A birth plan does, however, help you to realize what's most important to you in the birth of your baby.
 
While completing a birth plan, you'll be learning about, exploring and understanding your labor and birthing options well before the birth of your child. Not only will this improve your communication with the people who'll be helping during your delivery, it also means you won't have to explain your preferences right at the moment when you're least in the mood for conversation — during labor itself.

 

A birth plan isn't a binding agreement — it's just a guideline. Your doctor or health care provider may know, from having seen you throughout the pregnancy, what you do and don't want. Also, if you go into labor when there's an on-call doctor whom you don't know well, a well thought out birth plan can help you communicate your goals and wishes to the people helping you with the labor and delivery.
Decide early on who will assist at the birth. Most women choose an obstetrician (OB/GYN), a specialist who's trained to handle pregnancies (including those with complications), labor and delivery. Other women choose a certified nurse-midwife a health professional who's medically trained and licensed to handle low-risk births and whose philosophy emphasizes educating expectant parents about the natural aspects of childbirth. Increasing numbers of women are choosing to have a doula, or birth assistant, present in addition to the medical personnel. A doula  is well trained in childbirth and is there to provide support to the mother. The doula can meet with the mother before the birth and can help communicate her wishes to the medical staff, should it be necessary. If your pregnancy is considered high-risk, you may be referred to an perinatologist who specializes in maternal-fetal medicine. 
A birth plan typically covers three major areas:
 
1. What are your wishes during normal labor and delivery?
  • Know how you want to handle pain relief. This is important for most women and is certainly something you have a lot of control over. It's also something you'll want to discuss carefully with your health care provider. Some women change their minds about pain relief during labor only to discover that they're too far along in their labor to use certain methods, such as an epidural. You'll also want to be aware of the alternative forms of pain relief, including massage, relaxation, breathing and hot tubs. Know your options and make your wishes known to your health provider.
  • Think about who you'd like to have with you before, during and immediately after the birth. In a routine birth, this may be your partner, your other children, a friend, or other family member. You can also make it clear if there are any points you want no one to be there.
  • Consider your position during delivery. You can try a variety of positions during labor, including the classic semi-recline or other choices including lying on your side, squatting, standing or simply using whatever stance feels right at the time.
 
2. How are you hoping for your baby to be treated immediately after and for the first few days after birth?
  • Do you want the baby's cord to be cut by your partner?
  • Does your partner want to hold the baby when the baby emerges?
  • Will you breastfeed?
  • Do you want to limit visitors while in the hospital?
 
3. What do you want to happen in the case of unexpected events?
  • No one wants to think about something going wrong, but if it does, it's better to have thought about your options in advance. Since some women need cesarean sections (C-sections), your birth plan should probably cover your wishes in the event that your labor takes an unexpected turn.
  • You might also want to think about other possible complications, such as premature birth.
 
Once you've made your birth plan, schedule a time to go over it with your doctor or nurse-midwife. Find out and discuss where you agree or disagree. During your pregnancy, review the birth plan with your partner periodically to make sure that it's still in line with both of your wishes.