Preparing for your birth experience is an important step in your pregnancy. For many moms, this includes creating a birth plan. How do you write a birth plan and what do you include in it?
It might not be exactly what you’re thinking, though. A birth plan isn’t necessarily a sheet of paper you bring to the hospital with you when your water breaks and it isn’t only for moms that want a totally natural birth.
Dr. Mark Werner, an OB-GYN at Beaumont Hospital in Royal Oak, says a birth plan gives the expectant parents a chance to consider and decide “what exactly do they want for the birth of their child.”
That includes the major details – where you’ll deliver and who your doctor will be – and the smaller elements like the music you’ll listen to during labor or pictures you’ll bring. It addresses pain management and interventions, plans for the moments just following baby’s arrival and more – most of which shouldn’t be left for a last-minute discussion in the delivery room.
“It’s better to do it ahead of time to discuss it with your doctor,” Werner says.
You’ll probably find that your obstetrician is happy to try to accommodate your plan – though he or she may warn you to remain flexible in case medical circumstances change.
“Most doctors will accommodate their patients as far as what they want but realizing that they have to step in and change things if they feel a situation with the baby needs to be taken care of,” he says. “There are two lives in our hands. All my patients understand that I’m there for them and the most important thing is that they’re healthy and the baby is healthy.”
Don’t assume your labor and delivery nurse or other hospital staff will frown on your birth plan. Birth plans are increasingly common and many of the requests they include are even becoming standard practice, says nurse Carol Fuller, the director of women and children services at Providence-Providence Park Hospital in Southfield and Novi.
“Ten years ago, birth plans were probably more important than today,” she says, pointing out that things like immediate skin-to-skin contact are common at Providence and other baby-friendly hospitals. “Those are things we do as normal, standard practice in hospitals that promote family bonding and patient-centered birthing.”
What to include in a birth plan
Here are some of the topics you might consider including in your birth plan.
- First and foremost, choose your provider. Do you want to deliver with an OB-GYN or a Certified Nurse Midwife? “If you choose a physician who doesn’t support the kind of birth experience you want, you can get halfway through your pregnancy and find out this is a medically-focused physician or maybe very naturalist-focused and you don’t want that,” Fuller says.
- Decide on a hospital or birthing center. Do your providers deliver at that hospital? Does the hospital have a NICU? If you want to labor in the water, are tubs available at the birth center? “Not every hospital has tubs or not every physician will support that,” Fuller says. “It’s all about making that plan together with your provider.”
- Who do you want present at the birth? If you want your other children there, does the birth center allow it? Will you hire a doula for extra support?
- Plan for pain management. Werner says the use of epidurals has swayed over the years. It’s a popular option today but some patients still prefer to avoid it. “The anesthesia is a big part of the birth plan,” he says.
- Environment. Do you want the lights dimmed? Your own music or photos in the room? You might also choose to bring your own hospital gown.
- Fetal monitoring: Continuous or intermittent? Find out what your hospital allows.
- Other interventions. Some women specify that they don’t want an IV, Pitocin (used to stimulate contractions) or an episiotomy.
- Plans for baby. Who will cut the cord and when? Do you want immediate skin-to-skin contact? Do you want to breastfeed or formula feed? Should the hospital offer baby a pacifier? Who will give baby his first bath and when?
After creating your birth plan and discussing it with your provider, make sure to find out who should have a copy and how you should notify your birth center of your plan.
“As nurses and providers, we really want to support mothers’ rights to have the experience that they want,” Fuller says. “Sometimes when people say ‘birth plan’ the first response they say is, ‘Oh my goodness, a birth plan.’ We really want people to know we just want to partner with them. We want to make it easy for them to have the opportunity to have the experience that they want. We want it to be their birth and their experience.”
Dr. Mark Werner, the Beaumont obstetrician quoted in this story, was Danialle Karmanos’ doctor for two of her pregnancies. To find out more about her natural birth experiences – and how they inspired her to partner with Beaumont for the Karmanos Center for Natural Birth – read this article.