Birth Plan Series: Part 1

Have you ever heard this saying:

“If you fail to plan, you plan to fail!”

“If you fail to plan, you plan to fail!”

This rings true for labor and birth. If you have an idea for how you would like your labor and birth to proceed, then a Birth Plan is a must! The American College of Obstetricians and Gynecologists (ACOG) encourages all pregnant women to get prenatal care and to make a birth plan.

What is a Birth Plan?

A birth plan is a written document stating your wishes and preferences for your labor and birth. It is not a contract, it is a plan. This being said, it is important to remember that things may not go exactly as planned. Penny Simkin, author of The Birth Partner, says this about birth plans:

The mother's birth plan tells her caregiver and nurses in writing what options are important to her, what her priorities are, any specific concerns she has, and how she would like to be cared for. The plan should reflect the mother's awareness that medical needs could require a shift from her choices, and it should include her preferences in case labor stalls or there are problems with her or her baby. Although most useful for birth in a hospital, where the nurses (and often the caregivers) do not know the mother, a Birth Plan can help every couple, even if they are planning a home or birth-center birth, to think through their choices and priorities. (Simkin 26)

What Should be Included or Considered in a Birth Plan?

Education about labor and birth practices and procedures is crucial to know what to include in a birth plan. Knowing common birth practices and interventions can fuel your search for evidence-based research on these topics. In her book titled The Thinking Woman's Guide to a Better Birth, Henci Goer shares:

Doctors now use electronic fetal monitoring, a machine that records the baby's heart rate in conjunction with the mother's contractions, on four out of five laboring women. The percentage has risen steadily in the face of a stream of studies showing that its use doesn't improve babies' health. In fact. Its routine use threatens the mother's health by increasing the odds of forceps or vacuum extraction deliveries and cesarean section.

Nearly half of women giving birth vaginally still have an episiotomy, a snip at the bottom of the vaginal opening. The research proves up, down, and sideways, that, with rare exceptions, this procedure does no good and often does harm – sometimes serious and permanent harm.

Few women in this country give birth attended by a midwife. Yet studies consistently find that mothers and babies cared for by midwives experience fewer complications and have fewer tests and procedures compared with similar women managed by obstetricians. Midwives in several large studies have cesarean rates as low as 4 percent. (Goer 2)

So for an example, let's talk about movement in labor. If your preference is to move about freely in labor and utilize different labor positions, then you may consider requesting a saline lock (“hep-lock”) so you're not tethered to an IV pole when not receiving fluids. And you may request intermittent fetal monitoring or a wireless monitor in order to encourage mobility. You may also request to avoid a catheter and instead use the restroom regularly. If freedom to move in labor is a high priority, then epidural anesthesia (which includes IV and catheterization) may be something you choose to avoid AND you may even go so far as to ask in your birth plan that you do not want it to be offered to you.

If You are Not Familiar with Common Birth Practices, Where Can You Find More Information?

I HIGHLY recommend my clients start with a comprehensive childbirth education course such as Birth Boot Camp or the Bradley Method. These topics will be covered in detail in these childbirth courses. For a list of books and websites I recommend, hop on over to my Resources page

I cannot tell you exactly what to write in your birth plan because I do not know your specific wishes and preferences. But I can offer some tips to help you along. Be sure to check back for Part 2 of the Birth Plan Series: Tips for Writing a Birth Plan.

Goer, Henci. The Thinking Woman's Guide to a Better Birth. New York, NY: Berkley Pub. Group, 1999. Print.

Simkin, Penny. The Birth Partner: A Complete Guide to Childbirth for Dads, Doulas, and Other Labor Companions. Boston, MA: Harvard Common, 2008. Print.