Birth Plans: A Guide, Not a Script

Writing a birth plan is a useful exercise for a couple to do together so that they can review and discuss the choices they have and the options they prefer. While it’s essential to remember the need for flexibility in unpredictable circumstances such as birth, it’s a good idea to go through your wishes and make sure you and your partner are on the same page. That way, when labor comes, mom can rest assured that her partner will know to advocate for her when she may be otherwise occupied by the labor experience, and her partner has a good guideline to follow. Birth plans should be viewed as a statement of preferences and a guideline, not as a script.

You want to make your plan reflect your wishes as closely as you possibly can – which is not easy when you can’t truly know what you might want in labor until you’re in it. I collect birth plans from my students to show to future classes. We just divvy up the pile and pass them around and I encourage people to look not only at content but at appearance. Would you want to read it if you were the care provider? Does it catch your eye and draw you in or does it look like a novel? Is the tone demanding or polite yet firm? We get all kinds of variations: printed on non-white paper, laminated, flow chart style, colored text or boxes, bullet point lists, written from baby’s perspective, humorous, super detailed, super short… It’s a great opportunity for people to get ideas for what they would like to include in their own plan (‘Oh, I never would have thought to mention delayed cord clamping!’) as well as to ask questions about what certain things are (‘What is vitamin K? What is that eye ointment for?’).

We may not like to think of this, but I believe it’s a good idea to have a birth plan in writing and to go over it together with your care provider by 36 weeks because if something should go terribly wrong, you may need to be able to show you have something in writing that stated your desires. A birth plan is not a legal contract, but it may help to serve as some sort of statement of your intent and desires. I’ve had the experience of seeing doula clients’ wishes expressed on their birth plans ignored by hospital staff, once with unfortunate consequences resulting in some legal activity later (but mom and baby were OK!). So I believe it’s in your best interest to put some thought and effort into this exercise.

Here are 5 key tips to bear in mind for writing up your plan:

  1. keep it short: no more than one page
  2. make it legible: type it up and use at least font size 12
  3. include key medical information at the top
  4. express your plans/wishes for pain management
  5. include your desires for the baby’s care: skin-to-skin contact, breastfeeding/use of formula/pacifier, vitamin K options, eye ointment

 

SAMPLE IDEAS FOR YOUR BIRTH PLAN

  • Mom’s Name:
  • DOB:
  • Due Date:
  • Blood Type:
  • GBS +/-
  • Allergies:
  • Medical conditions/concerns:
  • Father:
  • Doula:
  • Care Provider:

We look forward to working with your team to bring our baby into the world! We have taken childbirth classes to be prepared for this special time. We desire a natural, unmedicated vaginal birth with little to no interventions, but we are open to other options should an emergency or complications occur as our number one priority is a healthy mom & baby! I would like to be kept fully informed of my options and be involved in every aspect of decision making.

We would like the following, in order of importance:

Healthy Baby & Mommy!
One Parent with Baby at ALL Times
Vaginal Birth
Natural (Un-medicated) Birth
Immediate Contact & Breastfeeding After Birth
Freedom to Move During Labor
Time to Labor Naturally
No Episiotomy
Limited Monitoring
Natural Expelling of Placenta

If an event should arise where medication or other procedures may be needed, we would like to be informed of our options and have private time for discussion if possible.

  • Freedom of movement with intermittent monitoring and minimal vaginal exams.
  • Clear liquids and light snacks during labor.
  • We will prefer to try natural methods of labor augmentation should the need arise prior to medical intervention. We plan to NOT have the water bag broken unless necessary.
  • I am aware of my pain medication options and will ask if I choose to have any.
  • Normal placenta birth, no pitocin please unless really needed and I’d like the cord to stop pulsing before it is clamped and cut.
  • I’d like to have skin-to-skin bonding right away with initial evaluation of the baby done with the baby in my arms, unless medically needed.
  • Breastfeeding exclusively (no artificial nipples or formula) – if there is a medical need for other sustenance, the parents should be notified first.
  • No circumcision.
  • Vitamin K/eye ointment desires.
  • Yes or no to student/intern participation.

Cesarean Section (if necessary)

As a last resort, if a cesarean section is necessary, we would like to request the following:

  • To be conscious with a spinal/epidural anesthesia and husband’s presence.
  • I prefer to breastfeed immediately or as soon as possible afterward.
  • We prefer the baby and father remain in the recovery room with the mother.
  • We wish the father to accompany the baby if the baby must leave the recovery room after delivery.

Thank you for making the delivery of our child a wonderful and memorable experience!

Did you write up a birth plan? Did it help you feel more prepared for birth?

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